Acinetobacter baumannii， a prevalent multidrug-resistant pathogen in Intensive Care Units， poses a significant threat to critically ill patients. With limited effective antibiotic options， Acinetobacter baumannii infections lead to high infection and mortality rates. Its resistance mechanisms include efflux pump activity， target mutations， activation of antibiotic-modifying enzymes， biofilm formation， and quorum sensing system regulation. Recognizing Acinetobacter as a priority for antibiotic development， this article emphasized the urgency of developing new antibiotics. It concentrated on novel antibiotic development， exploring non-traditional antimicrobial agents， potential vaccines， and advancing multimodal infection control strategies， serving as both preventive and alternative therapeutic responses to the escalating challenge of antibiotic resistance.

Metabolic associated fatty liver disease（MAFLD） has become a global health problem， so far， few drugs have been approved for marketing， and its complex pathogenesis has led to great challenges in drug development. In this paper， the current status of MAFLD drug research and development at home and abroad， as well as the clinical research and new drug development of compound Chinese medicine in the treatment of MAFLD were summarized. Through the basic research of compound Chinese medicine， it was found that compound Chinese medicine could improve lipid metabolism， reduce inflammation and fibrosis， and regulate intestinal microflora through comprehensive intervention of multi-target and multi-pathway regulation. It is suggested that compound Chinese medicine may be one of the potential new drug development fields for MAFLD treatment in the future. This article reviewed the intervention of metabolic-related fatty liver disease with compound traditional Chinese medicine, aiming to provide a reference for clinical practice.

Objective To study the secondary metabolites and their antibacterial activities from a marine-derived fungus Aspergillus sp. SWMU-WZ04-3. Methods The secondary metabolites from the fermented extracts of the fungus Aspergillus sp. SWMU-WZ04-3 were separated and purified by silica gel， gel column chromatography， semi-preparative high performance liquid chromatography and other modern chromatographic analysis methods. The structures of the compounds were identified by Nuclear Magnetic Resonance （NMR） analyses and Mass Spectrometry （MS） spectroscopic data， and by comparing with the data in previous literatures. Their antibacterial bioactivities were tested by disk diffusion method. Results Nine compounds were isolated from the fermentation broth of Aspergillus sp. SWMU-WZ04-3 and identified as 3，4-dimethoxyacetophenone （compound 1）， ethyl （2E）-3-（4-hydroxy-3-methoxyphenyl） prop-2-enoate （compound 2）， 4‐methyl‐5，6‐dihydropyren‐2‐one （compound 3）， 3，15-dihydroxyl-（22E，24R）-ergosta-5，8（14）， 22-trien-7-one （compound 4）， 9，12-octadecadienoic acid （Z， Z）-2，3-dihydroxypropyl ester （compound 5）， 1'-Hexadecanoic acid-2'，3'-dihydroxy-propylester （compound 6）， 2-（4-Hydroxyphenyl）ethyl 2，2-dimethylpropanoate （compound 7）， （22E， 24R）-stigmasta-5， 7， 22-trien-3-β-ol （compound 8）， β-sitosterol （compound 9）， respectively. In vitro biological activity results showed that compound 4 exhibited inhibitory effect against Escherichia coli at a concentration of 1 mg/mL， while other compounds had no obvious antibacterial activity. Conclusion Compounds 2， 5， 6 were isolated from Aspergillus sp. species for the first time， compound 4 has anti-Escherichia coli activity. The fungus Aspergillus sp. SWMU WZ04-3 has value in the further studys.

Objective To explore the predictive value of lung ultrasound B-line score combined with diaphragm function-related parameters for weaning from severe mechanical ventilation patients. Methods A total of one hundred and fifteen critically ill mechanically ventilated patients admitted to our hospital from April 2021 to August 2023 were selected. Patients’ readiness for weaning was assessed through lung ultrasonography with a calculated B-line score， and spontaneous breathing trials （SBT） with a T-tube pressure support. The indicators of right diaphragmatic excursion and thickness were determined by bedside ultrasound at 30 min of SBT. The diaphragm rapid shallow breathing index， diaphragmatic excursion， and thickness were recorded. Patients were divided into the success group （n = 78） and the failure group （n = 37） based on their respiratory status 48 hours after weaning. The clinical data were collected， multivariate Logistic regression was used to identify factors affecting the successful weaning in critically ill mechanically ventilated patients， and receiver operating characteristic curve （ROC） was plotted to evaluate the predictive value of lung ultrasound B-line score combined with diaphragm function-related parameters for weaning in critically ill mechanically ventilated patients. Results The failure group reported a larger B-line score and diaphragm rapid shallow breathing index， and a smaller changes in diaphragmatic excursion and thickness compared to the success group （P < 0.05）. The Acute Physiology and Chronic Health Evaluation Ⅱ（APACHE-Ⅱ）， Sequential Organ Failure Assessment （SOFA） score， respiratory rate， and shallow breathing index were notably higher in the failure group than in the success group， the duration of mechanical ventilation was less than that of the weaning success group （P < 0.05）. Logistic regression analysis denoted that lung ultrasound B-line score， diaphragmatic rapid shallow breathing index， right diaphragmatic excursion， diaphragmatic thickness， APACHE-Ⅱscore， SOFA score， respiratory rate， and rapid shallow breathing index were important factors for successful weaning in critically ill mechanically ventilated patients （P < 0.05）. ROC curve indicated that the area under the curve （AUC） of combined test of lung ultrasound B-line score， diaphragmatic rapid shallow breathing index， right diaphragmatic excursion， and diaphragmatic thickness for weaning in critically ill mechanically ventilated patients was 0.931， which was larger than separate test （P < 0.05）. Conclusion Lung ultrasound B-line score combined with diaphragm function-related parameters has a high predictive value for weaning in critically ill mechanically ventilated patients.

Objective To investigate the protective effect and underlying mechanism of liraglutide on brain injury in lipopolysaccharide （LPS）-induced septic mice. Methods Ninety C57BL/6 mice were randomly divided into three groups （n = 30）： the Control group， the Sepsis group （LPS）， and the LPS + Liraglutide group （LPS + Lira）. The LPS and LPS + Lira groups received intraperitoneal injections of LPS （15 mg/kg）， while the Control group received an equal volume of normal saline. The LPS + Lira group was subcutaneously injected with liraglutide （200 µg/kg） twice daily for 3 consecutive days， starting 2 days before the LPS injection. Results Significant differences were observed among the three groups in terms of survival rate， brain water content， the number of normal pyramidal cells in the hippocampal CA1 region， apoptosis rate， oxidative stress markers， inflammatory cytokine levels， and related protein expression （P < 0.05）. Further pairwise comparisons showed that， compared to the Control group， the LPS group had a significantly reduced survival rate （P < 0.05）， increased brain water content （P < 0.05）， decreased number of normal pyramidal cells in the hippocampal CA1 region （P < 0.05）， and an elevated apoptosis rate （P < 0.05）. Additionally， oxidative stress and inflammatory cytokine levels were significantly higher （P < 0.05）， with increased expression of NLRP3， Casp1 p10， Caspase-3， and Bax proteins （P < 0.05）， and decreased expression of Bcl-2 （P < 0.05）. The LPS + Lira group showed significant improvement in all these indicators compared to the LPS group （P < 0.05）. Conclusion Liraglutide exerts a protective effect against LPS-induced septic brain injury by inhibiting the activation of the NLRP3/Caspase-1 signaling pathway， thereby reducing inflammation， oxidative stress， and apoptosis.

Primary biliary cholangitis （PBC） is a chronic autoimmune cholestatic liver disease， and its pathogenesis is not clear. Ursodeoxycholic acid （UDCA） is the first-line drug for the treatment of this disease， but there are still some patients with poor response to UDCA， and the overall prognosis of patients with incomplete response is poor， so it is urgent to use safe and effective second-line drugs. In recent years， more and more clinicaltrials have proved that traditional Chinese medicine is effective in the treatment of PBC. It has outstanding advantages in improving patients' biochemical indicators， improving UDCA response rate， improving clinical symptoms， anti-fibrosis， regulating immunity and improving the quality of life. However， there is a lack of high-quality evidence-based medicine and long-term endpoint events research. This article primarily reviewed the progress in clinical research related to the understanding of the etiology and pathogenesis of primary biliary cholangitis （PBC） from the perspective of traditional Chinese medicine， as well as how traditional Chinese medicine can improve the therapeutic effects of PBC， providing a reference for clinical research and practice.

Objective The purpose is to explore the impact of timing based nursing interventions on self-management ability of patients undergoing autologous arteriovenous fistula anastomosis， and to evaluate their effectiveness. Methods From October 2022 to January 2024， 130 patients who received hemodialysis treatment after autologous arteriovenous fistula anastomosis in our hospital were divided into study group and control group by digital random table method， with 65 cases in each group. The control group received routine nursing intervention during hospitalization， while the study group implemented nursing intervention based on timing theory. SPSS 26.0 software was used for statistical analysis. The self-management behavior and quality of life of patients in the two groups were tested by independent sample t test， and the incidence of complications was tested by χ² test. Results There was no significant difference in the scores of self-management behavior and quality of life between the two groups before intervention （P > 0.05）. After intervention， the scores of self-management behavior and quality of life in the study group were higher than those in the control group （P < 0.05）， and the incidence of complications was lower than that in the control group （P < 0.05）. Conclusion Nursing intervention based on timing theory has some effect on enhancing self-management ability of patients with autologous arteriovenous fistula anastomosis， and provides reference for clinical application.

Liver regeneration is a key biological process for the liver to maintain normal physiological function and respond to injury. Accurately evaluating and predicting the state of liver regeneration is of great significance for liver surgery planning， liver disease treatment strategy formulation， and patient prognosis judgment. This article provided a systematic review of the current application status of artificial intelligence （AI） in the field of liver regeneration， covering evaluation methods based on imaging， clinical data， and molecular genomics. It analyzed the challenges currently faced in terms of data quality and algorithm interpretability， and looked forward to the future development prospects of AI under the guidance of multimodal fusion， real-time dynamic monitoring， and personalized medicine， providing reference for promoting innovation in liver regeneration research and clinical practice.

中枢性脑卒中后疼痛（central post-storke pain,CPSP）是一种慢性顽固性中枢神经性疼痛综合征，是由中枢神经系统血管病变引起的疼痛，与躯体感觉系统损伤有关，表现为与脑损伤区域相对应的躯体部位的持续或间歇性疼痛，伴有感觉异常。目前，CPSP的发病机制尚不明确，现有研究表明疼痛信号传导通路功能障碍、中枢脱抑制、中枢敏化、神经胶质细胞机制、神经递质失衡、离子通道改变等均与CPSP有关。随着CPSP患病人群的增多，当前治疗和管理面临巨大挑战。常见的管理策略包括药物治疗和非药物治疗，但治疗效果有限。未来研究重点应在多学科综合治疗、功能神经影像学建立预测模型、生物标志物开发、新药物靶点探索以及关注CPSP与焦虑、抑郁和睡眠障碍共患病的基础研究上。本文就CPSP的神经机制与临床管理策略作一综述，以期找到更有效的治疗方法，提升患者的生活质量。

Liver fibrosis constitutes a critical intermediary phase in the advancement of numerous chronic liver diseases towards cirrhosis and hepatocellular carcinoma （HCC）. However， significant challenges remain in the prevention and treatment of liver fibrosis， especially in preventing its progression to cirrhosis and HCC. Unfortunately， there is currently no efficacious pharmacological intervention available for the prevention and management of liver fibrosis. Extensive longitudinal studies have substantiated the efficacy of Traditional Chinese Medicine （TCM） in the prevention and treatment of liver fibrosis. Enhancing the therapeutic efficacy of TCM in the treatment of liver fibrosis， as well as optimizing its potential to inhibit the onset and progression of liver fibrosis， cirrhosis， and HCC， continues to be a critical area of research. The therapeutic concept of "Combination Therapy with Diverse Methods and Prescriptions" was proposed as early as in "Huangdi Neijing". Building on this concept， integrating various TCM therapies to create a multi-method， multi-target treatment plan is crucial for enhancing liver fibrosis treatment efficacy. Guided by the therapeutic concept of "Combination Therapy with Diverse Methods and Prescriptions"， the multi-dimensional and systematic therapeutic approach has been consistently employed to inhibit and reverse liver fibrosis， yielding significant outcomes.

Chronic hepatitis B is a progressive disease that leads to a significant number of deaths each year due to cirrhosis and hepatocellular carcinoma. In recent years， with the deepening understanding of the mechanisms of Hepatitis B virus infection， advancements in different transformation strategies for nucleos（t）ide analogs and long-acting interferons， and the development of new drugs， a cure for hepatitis B has become an achievable goal. This paper reviewed the concept of clinical cure for hepatitis B， its historical development， potential mechanisms， the current treatment landscape， and the latest progress in new drug development. The challenges encountered in the process of curing hepatitis B and directions for future efforts were also discussed， providing a reference for clinical research and practice.

目的 观察G蛋白偶联胆汁酸受体1（G protein-coupled bile acid receptor 1,TGR5）被激活后对内皮素-1(endothelin-1,ET-1介导的心肌细胞凋亡的作用，并探讨其机制。方法 首先分对照组和ET-1组，ET-1浓度分别为10^-6、10^-7、10^-8 mmol/L，分别培养12、24、36、48 h，流式细胞术检测各组各时段凋亡率。选择凋亡率较高的ET-1浓度及时间，进行后续实验。后续实验分为对照组、ET-1组、TGR5激动组、TGR5表达抑制组、TGR5空病毒组，流式细胞术检测各组心肌细胞凋亡率，CCK-8测心肌细胞存活率，RT-PCR检测TGR5mRNA,Western blot检测TGR5、C/EBP同源蛋白（C/EBP homologous protein,CHOP）、c-Jun氨基末端激酶（c-Jun-N-terminal protein kinase,JNK）、磷酸化JNK（phosphorylated JNK,p-JNK）及门冬氨酸特异性半胱氨酸蛋白酶（casepase-12）表达。结果 ET-1在10^-8～10^-6 mmol/L的浓度范围呈浓度依赖性，48 h内呈时间依赖性介导心肌细胞凋亡（P <0.05）。后续实验发现激活TGR5后，相较于ET-1组，心肌细胞凋亡率下降，心肌细胞存活率提高，且CHOP、p-JNK、Caspase12蛋白表达受到抑制（P <0.05）。而抑制TGR5表达后可阻断TGR5对心肌细胞凋亡的抑制作用，降低心肌细胞存活率，CHOP、p-JNK、Caspase12蛋白表达增加（P <0.05）。结论 ET-1可介导心肌细胞凋亡，其机制可能与内质网应激（endoplasmic reticulum stress,ERS）过度激活有关，而TGR5可能通过抑制ERS，拮抗ET-1对心肌细胞介导的凋亡作用。

Objective To observe the efficacy of entecavir （ETV） alone and in combination with peginterferon （Peg-IFN） in the treatment of patients with high viral load chronic hepatitis B （CHB）. Methods This prospective cohort study included 152 patients with high viral load CHB who were treated at four hospitals， including the First Affiliated Hospital of Nanchang University， between December 2019 and December 2023. Based on the patients' conditions and their own wishes， the patients were divided into the ETV group （n = 102） and the Peg-IFN and ETV combined treatment group （n = 50）. The primary endpoint was defined as HBV surface antigen （HBsAg） seroclearance at week 48. Secondary endpoints were the 48-week HBsAg decline level， HBV e antigen （HBeAg） seroclearance， HBV-DNA negative conversion rate and decline level， and ALT decline level. Measurement data conformed to normal distribution and were compared between two groups using two independent samples t-test， and within-group comparisons before and after treatment were analyzed using repeated measures ANOVA. Count data were compared between two groups using the chi-square test， and within-group comparisons before and after treatment were statistically analyzed using Cochran's Q test for multiple comparisons. Results ALT， HBV-DNA， and HBsAg levels decreased significantly in both groups throughout the 48-week treatment period compared with pre-treatment （P < 0.001）. At 48 weeks of treatment， alanine aminotransferase （30.82 ± 9.86） U/L was significantly lower in the ETV group than in the combination therapy group （37.57 ± 19.84） U/L （P = 0.027）； The HBV-DNA and HBsAg levels in the ETV group were significantly higher at（1.22 ± 1.17）lg IU/mL and（3.65 ± 0.85）lg IU/mL， respectively， than those in the combination therapy group at（0.82 ± 0.96）lg IU/mL and（2.62 ± 1.45）lg IU/mL （P = 0.034， P < 0.001）. Both HBeAg and HBV-DNA clearance were significantly higher in the ETV group at 48 weeks of treatment compared with pre-treatment （P < 0.001）， whereas the difference between HBsAg clearance and pre-treatment was not statistically significant （P = 0.171）. HBsAg， HBeAg， and HBV-DNA clearance rates were significantly higher in the combination therapy group at 48 weeks of treatment compared to pre-treatment （P < 0.05）. At 48 weeks of treatment， HBsAg and HBeAg seroclearance rates of 2.0% and 13.7%， respectively， were significantly lower in the ETV group than in the combination therapy group at 12.0% and 38.0% （P = 0.027， P = 0.001）； The HBV-DNA clearance rate of 89.2% in the ETV group was lower than that of 94.0% in the combination therapy group， but the difference was not statistically significant （P = 0.509）. Conclusion The Peg-IFN combined with ETV regimen can be the first recommended treatment option for patients with high viral load CHB.

Chronic viral hepatitis B has become one of the major public health problems facing the world， bringing great pressure and economic burden to the society. The cause of this disease in Chinese medicine is mainly exogenous dampness-heat and epidemiological toxins， and the pathogenesis is that dampness， phlegm， stasis， and toxins fight with each other and congest the organism， which depletes qi and blood， and yin and yang can not be connected with each other， and ultimately leads to the failure of the functions of organs and bowels. According to the clinical symptoms of chronic hepatitis B， based on the theory of "disease caused by epidemics and toxins"， the team adopted the three-phase detoxification method to treat chronic hepatitis B based on the symptomatic characteristics of different stages of the disease， which achieved good clinical efficacy and provided theoretical guidance for the treatment of chronic hepatitis B by Traditional Chinese Medicine.

China is a high prevalence area for chronic Hepatitis B virus （CHB） infection， which has caused significant harm to public health and imposed a substantial economic burden. Due to differences in main transmission routes， genetic backgrounds， and virus genotypes between China and regions like Europe and the United States， more than 80% of hepatocellular carcinoma （HCC） occurrences in China are associated with chronic Hepatitis B （CHB）. Additionally， the number of new HCC cases and the number of patients who die from HCC each year in China account for nearly half of the global figures. Antiviral therapy is an important measure to block or delay the progression of HBV-related liver diseases and reduce the occurrence of HCC， and the only indicator that can bring long-term good outcomes for patients is the disappearance of HBsAg. HBsAg loss has become the ideal therapeutic point for chronic HBV antiviral therapy. As the efficacies of antiviral therapy is affected by multiple factors， in order to improve the incidence of HBsAg disappearance with existing antiviral drugs， it is necessary to optimize treatment according to the situation of patients， including advantageous patient selection， combination therapy of PEG-IFN and NA， extended therapy， intermittent therapy， and consolidation therapy after HBsAg disappearance. This article discussed the optimal treatment strategy of antiviral therapy for chronic HBV infection in pursuit of HBsAg disappearance， and provided reference for clinical practice.

Objective To explore the value of serum citrullinated histone H3 （CitH3）， procalcitonin （PCT）， interleukin⁃10 （IL⁃10） in predicting （Acute Lung Injury）ALI after extracorporeal cardiopulmonary resuscitation （ECPR）. Methods A total of 126 patients who underwent ECPR from January 2021 to April 2024 were chosen， and fasting blood samples were collected the next day after admission to determine the levels of serum CitH3， PCT and IL⁃10. They were separated into the ALI group and the non⁃ALI group， according to whether ALI occurred after ECPR. Clinical data， serum CitH3， PCT， and IL-10 levels were compared. The risk factors of ALI after ECPR were analyzed by Logistic multivariate regression. The predictive value of serum CitH3， PCT， and IL-10 for ALI was analyzed using receiver operating characteristic （ROC） curve. Results Out of 6 patients， those who did not cooperate to complete the relevant examinations were excluded， resulting in 120 patients. During their hospital stay， 28 cases of ALI occurred（the ALI group）， while 92 cases did not have ALI（the non⁃ALI group）. The ALI group showed higher scores of Acute Physiology and Chronic Health Scoring System（APACH Ⅱ）， Sequential Organ Failure Assessment（SOFA）， and recovery time from cardiopulmonary resuscitation to spontaneous circulation （P < 0.05）. Serum CitH3， PCT， and IL-10 levels in the ALI group were significantly higher （P < 0.05）. Logistic multivariate regression analysis showed that the recovery time from cardiopulmonary resuscitation to spontaneous circulation， serum CitH3， PCT， and IL-10 were independent risk factors for ALI （P < 0.05）. The ROC curve analysis revealed that the area under the curve （AUC） for serum CitH3， PCT， and IL-10 individually were 0.886， 0.837， and 0.852， respectively. The AUC for the combined detection of the three markers was 0.951， which was significantly higher than that of the individual detections of PCT and IL-10 （P < 0.05）. Conclusions Serum levels of CitH3， PCT， and IL-10 in ALI patients increased after ECPR， indicating a certain predictive value for the occurrence of ALI， with especially notable results when these markers were detected in combination.

在新型冠状病毒感染危重患者中，出现急性肾损伤的情况并不罕见。清肺排毒汤作为通用方被列为新型冠状病毒肺炎（COVID-19）中医临床治疗首选，现有证据表明，其可防治与COVID-19相关的急性肾损伤。本文从“既病防变”的角度出发，探讨清肺排毒汤防治COVID-19相关性急性肾损伤的证治规律。本文还基于中医学中的五行学说、三焦辨证和六经传变等相关理论，提出“泻母补子”“三焦分治”和“太少两解”的“既病防变”新思路，以期为中医临床应对疫病防治提供借鉴。

肾纤维化（renal fibrosis,RF）是慢性肾脏病（chronic kidney disease,CKD）最主要的病理表现和共同的进展途径，与CKD的严重程度密切相关。目前诊断肾纤维化的金标准是肾穿刺活检，但其临床应用存在一定的局限性。除血、尿等特异分子标记物外，随着影像学技术尤其是特异放射性示踪剂标记的正电子发射断层显像技术等的发展，[68Ga] Ga-FAPI-04 PET/CT等无创手段诊断肾纤维化已成为目前研究热点。本文旨在将无创诊断肾纤维化手段的最新研究进展做一述评，以期为临床早期诊断肾纤维化提供参考。

目的 配制Lieber-DeCarli液体饲料，通过酒精热量过渡、酒精不过渡、酒精体积过渡三种方法诱导酒精性肝病（alcoholic liver disease,ALD）小鼠模型，比较其肝功能损伤程度、血脂水平和肝脏脂肪变性程度。方法 健康雄性C57BL/6J小鼠36只，随机分为6组（n=6），即酒精热量过渡对照组（A1）、酒精热量过渡组（A2）、酒精不过渡对照组（B1）、酒精不过渡组（B2）、酒精体积过渡对照组（C1）、酒精体积过渡组（C2），在饲喂相应液体饲料的第16、22、28 d分别处死对应组小鼠，测定并比较血清天门冬氨酸氨基转移酶（aspartate aminotransferase,AST）、谷氨酸氨基转移酶（glutamic acid aminotransferase,ALT）、总胆固醇（total cholesterol,TC）、甘油三酯（triglycerides,TG）、高密度脂蛋白胆固醇（high density lipoprotein cholesterol,HDL-C）、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）含量；肝脏苏木精-伊红染色（H&E染色）观察肝脏病理改变；肝脏油红O染色观察肝脏脂肪变性。结果 血清生化结果显示，各模型组小鼠血清ALT、AST、TG含量均高于其对照组（P <0.05）;A2、B2、C2组小鼠血清AST、ALT含量无明显差异（P> 0.05）;A2组小鼠血清TC、HDL-C含量高于B2、C2组（P <0.05）;A2、C2组小鼠血清LDL-C含量均高于B2组（P <0.05）。病理结果显示，各模型组小鼠肝脏H&E染色均可见肝细胞脂肪变性；肝脏油红O染色均可见橘红色或红色脂滴聚集。结论 Lieber-DeCarli液体饲料中三种方法诱导的ALD小鼠模型肝功能损伤无差异，表现为不同程度的肝脏脂肪变性及血脂异常。

With the progression of nanotechnology， magnetic nanomaterials， especially magnetite （Fe₃O₄） nanoparticles， have increasingly showcased their pivotal role in the field of medicine. The Fe₃O₄ magnetic nanomaterials garner considerable interest from researchers due to their unique magnetic properties， superior biocompatibility， and facile surface functionalization capabilities. Under the influence of external magnetic fields， these materials demonstrate rapid and directed mobility. Furthermore， their nanoscale dimensions give rise to high specific surface areas and enhanced surface energies， which facilitate the efficient adsorption and conjugation of drug molecules and biomolecules. Moreover， the stable chemical properties and low biotoxicity of Fe₃O₄ magnetic nanomaterials render them highly promising for various medical applications. In biomedical research， Fe₃O₄ magnetic nanomaterials have been widely adopted across multiple domains and achieved notable advancements. This article presented a comprehensive overview of the research advances of Fe₃O₄ magnetic nanomaterials in diverse areas such as drug delivery systems， tumor hyperthermia therapy， blood purification， enzyme-catalyzed therapy， magnetic resonance imaging （MRI）， protein and nucleic acid separation and purification， and cell separation and immune analysis. It also looked forward to potential development paths and innovation points in the technology..

Objective To study and analyze the correlation between serum long non coding RNA human leukocyte antigen complex group 11 （LncRNA HCG11） and microRNA（miR）-26b-5p levels with cerebral infarction area and functional prognosis in patients with acute ischemic stroke. Methods From January 2021 to December 2022， 106 patients with acute ischemic stroke admitted to our hospital were collected. They were separated into the small area group， the medium area group， and the large area group based on the infarct size. After one year of follow-up， patients were categorized into a good prognosis group and a poor prognosis group based on the modified Rankin Scale （mRS）. QRT-PCR was applied to detect the relative expression levels of LncRNA HCG11 and miR-26b-5p. Logistic regression was applied to analyze the factors that affected the infarct size and prognosis of patients. Receiver operating characteristic （ROC） curve was plotted to analyze the diagnostic value of LncRNA HCG11， miR-26b-5p for infarct size and prognosis. Spearman correlation was used to analyze the correlation of LncRNA HCG11 and miR-26b-5p with infarct size and National Institutes of Health Stroke Scale （NHISS）. Results The level of LncRNA HCG11 increased and the level of miR-26b-5p decreased in patients with large area acute ischemic stroke infarction （P < 0.05）. Compared with patients with good prognosis， patients with poor prognosis had higher level of LncRNA HCG11 and lower level of miR-26b-5p （P < 0.05）. There were statistically significant differences （P < 0.05） in the history of hypertension， hyperlipidemia， NHISS scores， and C-reactive protein （CRP） levels among patients with different infarct sizes. LncRNA HCG11 was positively correlated with both infarct size and NHISS （r_梗死面积 = 0.553， r_NHISS =0.462， P < 0.001）， and miR-26b-5p was negatively correlated with both infarct size and NHISS （r'_梗死面积 = -0.534， P'_梗死面积< 0.001；r'_NHISS = -0.447， P'_NHISS< 0.001）. MiR-26b-5p was a protective factor that poor prognosis in patients. Hypertension history， NHISS score， CRP， and LncRNA HCG11 were risk factors for poor prognosis in patients （P < 0.05）. LncRNA HCG11 and miR-26b-5p and the combined diagnosis of infarct size in patients was superior to the diagnosis of separate indicators （Z_{LncRNA HCG11} = 3.049，P_{LncRNA HCG11} = 0.002；Z_miR-26b-5p = 2.657，P_miR-26b-5p = 0.008，AUC=0.937）. LncRNA HCG11+miR-26b-5p predicted patient prognosis significantly better than LncRNA HCG11， miR-26b-5p， CRP， NHISS alone （Z_{LncRNA HCG11} = 2.207， P_{LncRNA HCG11}= 0.027； Z_miR-26b-5p= 2.080， P_miR-26b-5p= 0.038； Z_CRP = 2.341， P_CRP = 0.019； Z_NHISS = 2.093， P_NHISS= 0.036， AUC=0.892）. LncRNA HCG11 was negatively correlated with miR-26b-5p （r= -0.425， P<0.05）. Conclusion Serum LncRNA HCG11 level increased and miR-26b-5p level decreased in patients with acute ischemic stroke， both of which were influencing factors on cerebral infarct size and functional prognosis， and showed certain diagnostic and predictive value for cerebral infarct size and functional prognosis.

目的 探讨丁酸钠对单侧输尿管梗阻（unilateral ureteral obstruction,UUO）诱导的肾间质纤维化的影响及其作用机制。方法 将大鼠随机分为假手术组、UUO组及UUO+丁酸钠低剂量组（1 g·kg-1·d-1）、UUO+丁酸钠高剂量组（2 g·kg-1·d-1），每组10只。在术后第7、14 d，每组分别随机选取5只大鼠处死，HE染色观察大鼠肾脏组织形态，Masson染色观察大鼠肾间质纤维化情况，免疫组化和RT-PCR方法检测Ⅰ型胶原（collagen I,Col-I）、α-平滑肌肌动蛋白（alpha-smooth muscle actin,α-SMA）、肿瘤坏死因子-α(tumour necrosis factor alpha,TNF-α)、白介素6(interleukin 6,IL-6)、转化生长因子β1(transforming growth factor-β1,TGF-β1)、血清/糖皮质激素调节的激酶1(serum/glucocorticoid regulated kinase 1,SGK1)、结缔组织生长因子（connective tissue growth factor,CTGF）和p65的表达水平。结果 与假手术组相比，UUO组的HE染色可见肾小管扩张、炎症细胞浸润等病理改变，Masson染色可见蓝色胶原沉积明显增多，且随着时间延长，其肾脏病变加重；经丁酸钠干预后可减轻肾脏的损伤、病理改变以及肾间质纤维化程度，且UUO+丁酸钠高剂量组较UUO+丁酸钠低剂量组改善更明显。此外，与假手术组相比，UUO组大鼠肾组织中α-SMA、Col-I、TNF-α及IL-6的蛋白及mRNA表达水平显著增加（P <0.05）；丁酸钠干预后UUO模型中α-SMA、Col-I、IL-6及TNF-α的蛋白及mRNA表达水平降低，且UUO+丁酸钠高剂量组较UUO+丁酸钠低剂量组下降明显。同时，与假手术组相比，UUO组大鼠TGF-β1、SGK1及其下游靶点p65和CTGF的蛋白及mRNA表达水平均显著上调（P <0.05）；经过丁酸钠干预后，可以改善UUO模型中TGF-β1/SGK1信号通路的变化，且UUO+丁酸钠高剂量组改善更明显。结论 丁酸钠可能通过改善炎症及调节TGF-β1/SGK1信号通路明显改善UUO大鼠的肾间质纤维化。

血管免疫母细胞性T细胞淋巴瘤（angioimmunoblastic T-cell lymphoma,AITL）是一种高度侵袭性的T细胞淋巴瘤亚型，目前尚无标准治疗方案，患者的生存状况不容乐观。AITL显著的疾病异质性和复杂的发病机制，以及诊断和治疗上仍未被满足的医疗需求都使得该疾病备受关注，对AITL进行早期精准诊断和及时有效治疗对改善患者预后至关重要。在病理组织学的基础上，新兴的分子技术和流式细胞术正逐步提高AITL早期识别的准确性。基于传统化疗效果有限，当前研究正聚焦于靶向治疗和免疫疗法的开发。本文就AITL的发病机制、诊断方法以及治疗策略等方面进行述评，展望未来在该领域的研究方向。

目的 了解男童家长对包皮环切术知晓率、接受意愿以及对男童外生殖器健康重视度现况，评价包皮环切术科普宣传的干预效果。方法 本研究主要采用横断面调查和自身前后对照干预试验。偶遇抽样抽取895名泸州市小学及初中门口接送孩子的男童家长进行横断面问卷调查。选择横断面调查人群中愿意配合并且两次问卷所用手机微信账号一致的男童家长作为对象进行自身前后对照干预试验，干预后再次派发问卷进行效果评价，使用SPSS 17.0统计学软件，应用χ²检验、方差分析等统计方法分析数据。结果 横断面调查收集有效问卷895份，科普干预效果评价收集有效问卷402份。横断面调查结果显示家长对包皮环切术的总体知晓率为52.18%，接受意愿为65.14%；对男童外生殖器卫生、健康的关注度为60.67%。经过一个月的科普干预，参与干预试验的402名家长的知晓率由46.76%升至82.09%（χ²=109.43,P <0.001），接受意愿由55.72%升至96.02%（χ²=178.30,P <0.001），对男童外生殖器健康的关注度由23.38%升至98.75%（χ²=480.30,P <0.001），干预前后差异显著。结论 泸州市男童家长对包皮环切术相关知识的知晓率、接受意愿以及对外生殖器关注度仍有待提高，通过公众号推文、视频讲解、直播讲座和专家答疑等方式进行科普宣传后，家长的知晓率、接受意愿以及对外生殖器关注度明显提高，科普宣传效果显著。

<正>《西南医科大学学报》是经国家新闻出版广电总局批准向国内外公开发行的综合性医学学术期刊，中国高校优秀科技期刊，已被众多国内外数据库收录。本刊为双月刊，刊发论文以创新性、学术性、实用性、热点难点研究、规范化、标准化为主要特点。刊载栏目主要有专家述评、专家论坛、技术创新、基础医学研究、临床医学研究、影像医学研究、药学研究、护理学、综述等。

乳腺外佩吉特病（extramammary Paget's disease,EMPD）是一种发现历史较长的罕见皮肤恶性肿瘤，好发于老年人，不同国家、地区发病情况存在明显差异，整体上随着人口老龄化的加剧，发病率呈上升趋势。本病生物学行为常表现为惰性，临床上易与多种皮肤疾病混淆，加之发病机制，尤其是细胞起源仍存有争议，常导致病程迁延，诊断被延误。EMPD可分为原发和继发两类，其诊断及评估强调活检，并应注意伴发身体内肿瘤的检查。EMPD的治疗复发率较高，可分为手术和非手术两类，前者关键点在于病灶切除范围的确定，术中/切缘病理检查较为重要；后者目前尚缺少统一规范的方案。本文就EMPD的诊疗及研究现状进行评述，以期为本病相关临床医生及研究人员提供参考。

神经源性膀胱（neurogenic bladder,NB）是一种由神经损害或病变所致的下尿路功能障碍，可引发多种下尿路症状，同时合并多系统并发症，严重者可导致肾衰竭。神经源性膀胱的病因复杂，主要包括神经系统因素、感染性疾病和医源性因素。由于病因复杂，临床表现缺乏特异性，神经源性膀胱的诊断、分型和治疗是临床亟需解决的重点及难点问题。本文系统性地归纳了神经源性膀胱的诊断标准，包括病史采集、排尿日记、实验室检查、泌尿系超声、尿动力学检查和神经电生理；汇总了神经源性膀胱的疾病分型法，如国际尿控协会（INTERNATIONAL CONTINENCE SOCIETY,ICS）分型法、廖氏分型法、Madersbacher分型法、Krane-Siroky分型法和SALE分型法等；整理了临床现有的神经源性膀胱的治疗方法，如药物治疗、手术治疗和骶神经电刺激术；结合了国内外组织工程和干细胞研究的最新进展，展望神经源性膀胱治疗的新方向。

Objective To summarize the serious complications of CT-guided microwave ablation of Ⅸ tumors in the liver and related prevention and treatment strategies. Methods A retrospective statistical analysis was conducted on 104 severe complications in patients with hepatic Segment Ⅸ tumors who underwent CT-guided percutaneous microwave ablation in the Department of Hepatobiliary and Pancreatic Surgery of our hospital from October 2013 to July 2023. Results The surgical success rate of the whole group was 100%. Postoperative complications were massive pleural effusion and liquid pneumothorax in 1 case， abdominal hemorrhage in 1 case， liver abscess in 1 case， ablation needle rupture in 1 case， delayed biliary tract injury in 1 case， and tumor-duodenal fistula in 1 case. The incidence of serious complications was 6.7%， and no deathoccurred during periablation. Conclusion CT-guided percutaneous microwave ablation for tumors in hepatic segment Ⅸ was associated with a low incidence of serious complications， indicating that the procedure was both safe and feasible.

Objective To explore the predictive effect of heart rate variability （HRV） on noise annoyance and develop a model for identifying and assessing noise annoyance. Methods A group of employed subway drivers participated in a simulated train driving experiment under different noise conditions. The Weinstein Noise Sensitivity Scale， subjective noise annoyance questionnaire， and electrocardiogram data were collected. HRV features were extracted and transformed into a standard normal distribution using Z-Score normalization. Random Forest （RF） was used for feature selection and important features were inputted to establish various driver noise annoyance identification models based on HRV features. The impact of individual noise sensitivity on accuracy was also discussed. Results Multiple HRV features were found to be related to noise annoyance. Feature selection revealed that individual noise sensitivity significantly influenced the identification and detection of noise annoyance. Among various classification models， the Convolutional Neural Network （CNN） model achieved the best performance in identifying annoyance levels， with an accuracy of 90.03%. Conclusion The deep learning model based on HRV demonstrated excellent performance in identifying noise annoyance， providing a method and theoretical support for real-time recognition of occupational noise annoyance.

Objective Investigating the value of combined serum annexin A1 （AnxA1）， a disintegrin-like and metalloproteinase with thrombospondin type-1 domain 13 （ADAMTS13）， and electrocardiogram parameters in assessing the degree of coronary stenosis and plaque stability in patients with acute myocardial infarction （AMI）. Methods A total of 280 suspected AMI patients admitted to our hospital from August 2020 to August 2022 due to chest pain were collected as the study subjects， according to the results of coronary angiography and cTnl level， they were grouped into a non AMI group （135 cases） and an AMI group （145 cases）， the serum levels of AnxA1 and ADAMTS13 were compared between the two groups. According to the coronary Gensini score of AMI patients， they were grouped into the mild group （55 cases）， the moderate group （53 cases）， and the severe group （37 cases）. The serum levels of AnxA1 and ADAMTS13 were compared among patients with different numbers of coronary artery lesions and different degrees of coronary artery lesions. The receiver operating characteristic curve （ROC） was used to analyze the predictive value of serum AnxA1 and ADAMTS13 combined with electrocardiogram for severe coronary artery disease and plaque stability in patients with acute myocardial infarction （AMI）. Results Compared with the non AMI group， the serum AnxA1， QTc， and TP Tec levels in the AMI group were increased［（0.97 ± 0.26 ）vs （1.31 ± 0.38） μg/mL］ ［（417.56 ± 29.11 ） vs （456.88 ± 28.62） ms］ ［（106.53 ± 15.28） vs （120.48 ± 14.91） ms］， ADAMTS13 levels decreased ［（1.22 ± 0.39） vs（0.86 ± 0.29 ）ng/L］ （P < 0.05）. Compared with the single vessel group， the serum AnxA1， QTc， and TP Tec levels in the double vessel and multi vessel groups increased［（1.08 ± 0.15）vs（1.36 ± 0.21）vs（1.60 ± 0.25 μg/mL］ ［（439.84 ± 19.73）vs（459.73 ± 19.80）vs（479.74 ± 20.11）ms］ ［（114.82 ± 11.40）vs（121.89 ± 10.96）vs（127.41 ± 10.57） ms］， ADAMTS13 levels decreased［（1.05 ± 0.27）vs（0.82 ± 0.19）vs（0.61 ± 0.13）ng/L］ （P < 0.05）.Compared with the mild group， the serum AnxA1， QTc， and TP Tec levels in the moderate and severe groups increased ［（1.11 ± 0.14）vs（1.35 ± 0.20）vs（1.55 ± 0.27）μg/mL］ ［（438.96 ± 20.37）vs（459.44 ± 21.19）vs（479.84 ± 22.42）ms］ ［（113.43 ± 11.58）vs（121.88 ±11.39）vs（128.96 ± 11.16）ms］， ADAMTS13 levels decreased ［（1.03 ± 0.23）vs（0.88 ± 0.17）vs（0.58 ± 0.12）ng/L］ （P < 0.05）. Compared with the stable plaque group， the serum AnxA1， QTc， and TP Tec levels in the unstable plaque group were significantly increased［（1.15 ± 0.24）vs（1.46 ± 0.31）μg/mL）］ ［（440.37 ± 29.11）vs（472.29 ± 28.62） ms］ ［（112.44 ± 15.63）vs（127.98 ± 15.17）ms］， ADAMTS13 levels significantly decreased［（0.97 ± 0.18）vs（0.76 ± 0.09）ng/L］， with statistically significant difference （P < 0.05）. The ROC curve results showed that the AUC of combining electrocardiogram parameters to predict the degree of coronary artery disease in AMI was 0.948， which was better than individual detection （P < 0.05）. The ROC curve results showed that the combined prediction of electrocardiogram parameters for severe coronary artery disease in AMI had an AUC of 0.925， which was superior to their individual detection （P < 0.05）. Conclusion The combination of electrocardiogram and serum AnxA1， ADAMTS13 showed better predictive value for severe coronary artery disease and plaque stability in AMI， providing a reference for clinical diagnosis of AMI.

小阴茎是指阴茎外观结构正常，其拉伸长度小于同年龄组人群阴茎平均值减2.5倍标准差的异常短小阴茎。导致小阴茎的常见病因包括：下丘脑-垂体-性腺轴（HPG轴）功能障碍、雄激素合成和作用障碍、常染色体或性染色体非整倍体引起的综合征、阴茎发育不良或缺如、母亲抗真菌药物或抗雄激素药物使用、环境内分泌干扰物影响、特发性小阴茎等。小阴茎患者常合并小睾丸、男性第二性征不足、成年后不育症、身材矮小等表现。对阴茎长度的精准规范评估应测量其拉伸长度。小阴茎患者应由多学科团队进行临床、遗传学和内分泌综合评估，在明确病因基础上，积极临床干预，个性化选择治疗方案，以期有效改善阴茎长度，提高生活质量。根据性激素作用于HPG轴环节的不同，可将药物治疗分为应用GnRH脉冲泵治疗的青春期全模拟方案、应用促性腺激素治疗的部分模拟方案及应用睾酮或双氢睾酮的终端模拟方案。但目前尚无针对小阴茎的诊治规范和专家共识，其最佳治疗时机、药物方案选择和最佳适应证等均值得深入研究。

前列腺增生是老年男性患者的常见病，发病率极高，病因机制复杂且受多种因素影响。内分泌干扰物是一类广泛存在的化合物，结构类似于激素，可对人体内分泌产生干扰。前列腺生长受到性激素调控，内分泌干扰物可以影响前列腺的生长进而导致前列腺增生的发生和进展。本文综合性分析了内分泌干扰物对前列腺增生影响的研究现状，重点分析了内分泌干扰物促进前列腺增生的作用机制，同时提出了减少内分泌干扰物暴露的预防措施，以期为临床医生和人民群众提高对内分泌干扰物和前列腺增生疾病之间联系的认识，减少内分泌干扰物的危害提供参考和借鉴。

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目的 手性黄烷酮类天然产物存在于多种中药材或食品中，有多样化的生物活性，是具有重要研究价值的药物先导化合物。本研究探讨如何高效、经济地鉴定黄烷酮类天然产物的手性。方法 以联二萘酚（binaphthol,BINOL）类化合物作为手性溶剂化试剂（chirul solvating agents,CSA），选择9种含ABX自旋耦合系统的黄烷酮类天然产物作为待测底物，通过核磁共振测试氢谱的变化进行手性识别，并计算其对映体过量值（enantiomeric excess,ee），再选择其中4种样品进行高效液相色谱（high performance liquid chromatography,HPLC）手性拆分，激发态圆二色谱（exciton circular dichroism,ECD）绝对构型测试。结果 9种样品加入S型BINOL均能够通过核磁共振氢谱进行识别，并计算出ee值。4种样品通过HPLC能够拆分为8个对映异构单体，均能通过ECD判定出绝对构型，证明4种样品是鲜屑混合物。结论 在核磁共振氢谱中，运用BINOL溶剂化试剂能够经济、高效地识别含ABX自旋耦合系统黄烷酮类天然产物的手性，判断其是否为天然来源的鲜屑混合物，并计算出ee值。

Objective This study aimed to utilize biotin-based proximity labeling mediated by the TurboID enzyme to map the activity regulation network of the transcription factor Smad3. Methods This study constructed an inducible expression plasmid containing Smad3 and TurboID gene sequences， and integrated it into Smad3 knockout renal tubular epithelial cells （TCMK1） via lentivirus-mediated transfection， forming an overexpressed stable transgenic cell line. Upon stabilizing the transduction， the research team optimized the biotin labeling concentration and duration before conducting the biotin-labeling experiments. Biotinylated protein complexes were enriched and purified using streptavidin magnetic beads， followed by proteomic analysis to identify candidate proteins interacting with Smad3. Results A Smad3-TurboID inducible overexpressed stable cell line was successfully constructed in Smad3 knockout TCMK1 cells. The optimal biotin concentration and labeling duration were established at 25 μm and 20 minutes， respectively. Proteomic analysis filtered out a series of potential Smad3 interacting candidate proteins， examples include Yap1 and Stat3. Conclusion Employing TurboID-mediated proximity labeling， this study successfully identified numerous candidate proteins that potentially interact with Smad3. These discoveries provided a solid foundation for future in-depth research into the functions of Smad3 protein and its regulatory network within the cell. Identification and functional analysis of these interacting proteins will lead to a more comprehensive understanding of the biological roles ofSmad3.

目的 探讨短肽P10581对前列腺癌骨转移的镇痛效果及对吗啡镇痛耐受的影响。方法 首先，将前列腺癌PC3细胞注入大鼠胫骨建立前列腺癌骨转移模型，分组（n=4）检测大鼠机械性缩足阈值（paw withdral threshold,PWT），筛选短肽P10581的最佳镇痛浓度，并取大鼠背根神经节DRG神经元，Western blot法检测压电蛋白Piezo2蛋白。其次，大鼠模型随机分为吗啡组(5 mg·kg^-1)、P10581 A组(6.4μg·kg^-1)、P10581 B组(12.8μg·kg^-1)和生理盐水组（n=10），皮下注射相应药物后，每小时测量大鼠PWT。另外，大鼠模型随机分为吗啡组(5 mg·kg^-1)、复合用药Ⅰ组(0.2μg·kg^-1 P10581+5 mg·kg^-1吗啡)、复合用药Ⅱ组(0.4μg·kg^-1 P10581+5 mg·kg^-1吗啡)、生理盐水组（n=10），记录皮下注射后7 d内大鼠PWT。结果 短肽P10581对前列腺癌骨转移模型的最佳镇痛浓度为51.2μg·kg^-1，在此浓度下，大鼠DRG神经元中Piezo2表达降低，差异有统计学意义（t=3.569,P <0.05）。在镇痛效果研究中，给药后3 h内三组均有明显镇痛效果，且吗啡组镇痛效果强于P10581 A组和P10581 B组；第4 h时，三组的镇痛效果无差异（P> 0.05）;7 h后，与吗啡组相比，P10581 A组（t=11.60,P <0.001）和P10581 B组（t=28.84,P <0.001）镇痛效果显著。在短肽P10581对吗啡耐受性影响的研究中，单独使用吗啡时，自第2 d起镇痛效果随时间减弱，出现吗啡耐受；微量短肽P10581与吗啡联合使用时，相比吗啡组，第7 d复合用药Ⅰ组（t=38.41,P <0.001）和复合用药Ⅱ组（t=34.92,P <0.001）的镇痛率分别提高了61.31%和69.78%，仍保持明显的镇痛效果。结论 相较于吗啡，短肽P10581对前列腺癌骨转移的镇痛作用更具有时间优势，并且微量短肽P10581可明显降低吗啡耐受性。

慢性前列腺炎/慢性盆腔疼痛综合征（chronic prostatitis/chronic pelvic pain syndrome,CP/CPPS）是泌尿男科的常见病、多发病，临床症状多样，包括下尿路症状（lower urinary tract symptoms,LUTS）、盆腔疼痛、性功能障碍、神经精神症状等，严重危害男性泌尿生殖系统健康，影响患者生活质量。由于CP/CPPS缺乏特异性的实验室诊断指标，导致很多患者诊断不明，治疗效果不满意。建立以临床症状为核心的诊断和治疗评价体系，更能体现疾病复杂多样的本质，符合改善患者临床症状和提高生活质量的治疗目标，有助于该疾病的准确诊断和针对性治疗。本文从CP/CPPS临床症状的角度出发，根据CP/CPPS患者常见临床症状（LUTS、盆腔疼痛、性功能障碍）进行分类阐述，重点论述针对该症状的最新治疗进展及相关作用机理，以加深对该疾病的理解，为该病的治疗和科学研究提供新的思路。

前列腺癌骨转移是前列腺癌晚期阶段的突出表现，也是前列腺癌患者死亡的重要原因。本文综述了前列腺癌的恶性生理学行为及其骨转移机制，探讨了原发性前列腺癌产生具有骨转移表型的肿瘤亚群的机制，以及促进转移级联反应各个环节的因素。克隆进化理论揭示了前列腺癌细胞通过基因突变形成不同转移潜力的亚克隆；上皮-间质转化理论和基质金属蛋白酶在一定程度上揭示了肿瘤是如何进行局部侵袭和血管内渗；种子与土壤理论、循环肿瘤细胞理论解释了前列腺癌细胞在骨髓中的定植和微转移灶的形成；肿瘤微环境理论揭示了再激活的前列腺癌细胞如何与其他细胞协同形成转移灶。本文旨在为前列腺癌骨转移机制的进一步研究提供理论支持，并为临床治疗策略的优化提供参考。

目的 探讨脑梗死急性期神经功能缺损与血压昼夜节律的相关研究。方法 收集2021年3月-2022年8月咸阳市中心医院收治的符合纳入标准的急性脑梗死患者110例，入院第2 d进行24 h动态血压监测，期间填写《神经功能缺损症状调查表》，记录患者血压昼夜节律类型及神经功能缺损加重的发生时段。根据患者神经功能缺损变化分为加重组和无变化组。血压昼夜节律分为超勺型、勺型、非勺型、反勺型。神经功能缺损加重的发生时段分为：[0:00,4:00)、[4:00,8:00)、[8:00,12:00)、[12:00,16:00)、[16:00,20:00)、[20:00,24:00)。对加重组和无变化组血压昼夜节律的变化规律、脑梗死急性期神经功能缺损与血压昼夜节律的相关性及加重组神经功能缺损在各时段的分布情况进行统计分析。结果 （1）加重组和无变化组血压昼夜节律变化比较有统计学意义（χ²=37.389,P <0.01），加重组以反勺型为主，超勺型次之；无变化组以勺型为主，非勺型次之。（2）脑梗死急性期神经功能缺损与血压昼夜节律的Logistic回归分析，OR值为1.821（P <0.05）。（3）加重组神经功能缺损在各时段的发生例数及比较有统计学意义（χ²=38.217,P <0.05），发生时段主要集中在[4:00,8:00)时段。结论 血压昼夜节律的异常改变可能导致脑梗死急性期神经功能缺损的加重，[4:00,8:00)时段可能是脑梗死加重的高峰时段。