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目的探讨延髓头端腹内侧部（RVM）内致炎细胞因子肿瘤坏死因子α（TNFα）和白介素-1β（IL-1β）释放增多导致5-羟色胺（5-HT）向脊髓释放增多在慢性术后疼痛（CPSP）模型中的作用。方法按照随机方式将SD 大鼠进行如下分组：对照组、皮肤/肌肉切开和牵拉（SMIR） （1d，7d）组、SMIR＋RVM内注射TNFα或IL-1β中和性抗体组、SMIR＋RVM内注射TNFα或IL-1β组、SMIR＋RVM内注射溶剂组，用up-down 方法测量大鼠50%机械刺激撤足阈值，免疫组化检测RVM内TNFα或IL-1β表达情况，酶联免疫吸附测定法 （ELISA）方法观察RVM及脊髓背角内5-HT含量的变化。结果SMIR可引起大鼠机械痛敏，表现为50%机械刺激撤足阈值下降，持续至少3周。SMIR后，RVM内神经元和星形胶质细胞中的TNFα和IL-1 ß表达上调。TNFα 或IL-1β 中和抗体（每天一次行SMIR术前30 min给予，共4次））微量注射入RVM可阻断SMIR引起的50%机械刺激撤足阈值下降，并可降低RVM及脊髓背角5-HT的含量。正常动物RVM内注射TNFα和IL-1 ß也可导致50%机械刺激撤足阈值下降，且引起RVM及脊髓内5-HT含量增加。结论RVM中致炎细胞因子增多可能通过引起5-HT释放增多参与调控SMIR后慢性术后疼痛的发生发展。

目的：研究CD4 T淋巴细胞内的基础ATP浓度代替CD4/CD8比值用于评估结核病感染者免疫状态的可行性。方法：本研究通过磁珠法分离相同体积全血中的CD4、CD8细胞，并计算CD4和CD8细胞的基础ATP浓度来评估结核病感染者的免疫状态，以QFM（Quantiferon Monitor）检测法作为对照。结果：研究发现传统的CD4/CD8比值或CD4 T细胞计数方法不适用于结核病患者。采用CD4细胞的基础ATP浓度来监测活动性结核患者和健康人群，在以290.7×10-6 g/L为cut-off值，AUROC为0.8719，其灵敏度为86.21%，特异性为76.19%，差异有统计学意义（P+T淋巴细胞胞内基础ATP浓度来评估结核病感染者的免疫状态。提示CD4+ T淋巴细胞的基础ATP浓度比CD4/CD8比值可以更好用于评估结核病患者的免疫状态。

目的探讨肺癌脊柱转移瘤患者的手术疗效及影响患者生存期的预后因素。方法随访2013年3月至2020年5月于中山大学孙逸仙纪念医院接受诊治的156例肺癌脊柱转移瘤患者，根据纳入与排除标准，36例患者的病例资料入选本研究进行后续分析。根据治疗方式将患者分为手术治疗组（n=26）和保守治疗组（n=10），分别采用视觉疼痛评分（VAS评分）、卡氏日常功能状态评分（KPS评分）及Frankel分级对患者治疗前后的疼痛程度、功能状态和脊髓神经功能进行评估，采用 Kaplan-Meier 法绘制生存曲线，对影响疾病预后的多种因素采用Cox比例风险模型进行分析。结果两组患者治疗前基线特征齐，具有可比性。手术组患者治疗后VAS评分从术前的8.00 （3.00~9.00）分下降至术后的2.00 （0.75~2.00）分，KPS评分从术前的50.00 （40.00~60.00）分上升至术后的60.00 （50.00~70.00）分，Frankel分级较术前改善，差异均有统计学意义（P＜0.05）。而保守组患者治疗前后的VAS评分、KPS评分及Frankel等级的差异均无统计学意义。36例患者中位生存时间为22.0个月， 95%CI为（6.3， 37.7）个月，1年生存率68.7%，2年生存率48.0%，3年生存率33.6%。单变量生存分析结果显示性别、吸烟史、病理类型、放化疗和靶向治疗对患者生存期有显著影响。多因素COX比例风险模型生存分析结果显示靶向治疗和放化疗是影响肺癌脊柱转移瘤患者预后的独立因素。结论外科手段治疗肺癌脊柱转移瘤能有效缓解患者的疼痛程度、提高生活质量和改善神经功能，靶向治疗和放化疗是影响肺癌脊柱转移瘤患者生存期的重要因素。

文章对布里渊光时域分析（BOTDA）分布式光纤传感系统中的偏振效应机理及受激布里渊散射的矢量模型分析进行了阐述。对目前国内外的研究现状,从受激布里渊散射效应中偏振相关布里渊增益谱分析、控制偏振态以及抑制偏振衰落技术等方面进行了详细介绍。布里渊光纤传感系统矢量建模分析和偏振态控制技术具有很好的研究前景,对未来研究中利用偏振态的敏感特性进行分布式传感光纤的温度、应变和振动信息测量及抑制偏振衰落来提高光纤传感系统空间分辨率都具有参考价值。

广义预编码辅助空间调制在每一个时隙内通过选择激活接收天线组合来传递空间维度信息比特。在相同频谱效率和信噪比的情况下,相比于传统的广义空间调制系统,广义预编码辅助空间调制系统的误比特性能有显著提升。同时,针对广义预编码辅助空间调制系统现有的检测算法具有较高的计算复杂度的问题,提出了一种基于广义预编码辅助空间调制的分组检测算法。仿真结果表明,该算法的检测性能接近最大似然检测算法,且复杂度显著降低。

目的 分析下肢康复机器人联合头针治疗对老年缺血性卒中患者步行效率和协调功能的影响。 方法 本研究为前瞻性研究，连续纳入2022年12月—2023年6月在商丘市中医院治疗的老年缺血性卒中患者为研究对象，按照随机数表将其分为对照组和观察组。对照组患者在常规治疗的基础上增加平地行走式下肢康复机器人康复训练（30 min/次，每周3次）；观察组患者在常规治疗的基础上增加平地行走式下肢康复机器人康复训练联合头针治疗（留针30 min，1次/d，每周5 d），两组均治疗4周。 在治疗前及治疗4周后采用日常生活活动量表（activity of daily living scale，ADL）评估患者日常生活能力；采用Fugl-Meyer评估（Fugl-Meyer assessment，FMA）量表评估下肢运动功能；采用Berg平衡量表评估平衡功能；采用功能性步行（functional ambulation category，FAC）量表、6 min步行距离和起立行走计时（timed up and go，TUG）评估步行功能；采用徒手肌力检测（manual muscle testing，MMT）评估患者股四头肌、腘绳肌肌力；采用Prokin系统记录平均轨迹误差（absolute trajectory error，ATE）及完成时间，评估患者的本体感觉功能。另外，采用表面肌电分析系统分析患者股直肌、腘绳肌、胫骨前肌、腓肠肌内侧头的肌电均方根（root mean square，RMS）值。 结果 治疗后两组患者的ADL评分均高于本组治疗前，且治疗后观察组的ADL评分高于对照组[（85.21±7.55）分 vs.（73.51±6.90）分，P＜0.001]。治疗后两组的FMA量表评分和Berg平衡量表评分均高于本组治疗前，且治疗后观察组的FMA量表评分[（28.74±3.14）分 vs.（22.31±2.77）分， P＜0.001]和Berg平衡量表评分[（41.82±3.21）分 vs.（30.49±2.78）分，P＜0.001]均高于对照组。治疗后两组患者的FAC量表评分、6 min步行距离均优于治疗前，TUG短于治疗前；治疗后观察组的上述指标均优于对照组[FAC量表评分：（3.89±0.41）分 vs.（2.87±0.34）分，P＜0.001；6 min步行距离：（314.38±18.93）m vs.（269.05±20.31）m，P

： 【目的】探讨二氧化碳激光打孔预处理联合5-氨基酮戊酸（ALA）光动力治疗难治性巨大跖疣的疗效和安全性。【方法】入组难治性巨大跖疣患者，采用二氧化碳激光打孔预处理疣体组织，再进行ALA光动力治疗，评估治愈率和不良反应。【结果】20例患者接受1-3次光动力治疗后，治愈率达85%（17/20）。其中2例（10%）接受1次治疗，5例（25%）接受2次治疗，10例（50%）接受3次治疗。均未见感染或瘢痕。人乳头瘤病毒（HPV）单一型别感染5 例，双重或多重HPV型别感染15例，两组之间跖疣治愈率无统计差异。【结论】采用超脉冲二氧化碳激光打孔联合光动力治疗，可提高巨大难治性跖疣的治疗效果。HPV型别与难治性跖疣病情和治疗预后的相关性有待进一步深入研究。

文章仿真研究了两种改进型光双二进制调制格式。首先对比分析了产生两种改进型光双二进制调制格式的发射机结构及两种调制格式的码型和频谱特性,随后进行了系统的传输性能仿真。仿真结果表明:当残留色散较大时,改进Ⅱ型光双二进制调制格式性能较为优异;而在-13.22.8dBm入纤光功率范围内,与改进Ⅱ型光双二进制和NRZ（非归零）码调制格式相比,改进Ⅰ型光双二进制的Q值最高,抗非线性效应能力最强。

目的】探讨系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）CD154表达水平、及CD40/CD154对SLE患者分泌自身抗体的影响和地塞米松（Dex）对此的作用。【方法】选择SLE活动期患者（10例）和正常对照者（11例）,分离PBMC,检测其CD154的表达水平;培养PBMC,应用CD40 mAb和Dex进行干预,使用ELISA法检测培养液上清抗dsDNA水平。【结果】①活动期组PBMC CD154表达水平明显高于对照组6.4%±2.1%vs 1.5%±1.2%,（P〈0.05）;②活动期组培养液上清抗dsDNA抗体水平明显高于对照组[（11.8±6.8）U/mL vs（5.6±2.3）U/mL（RPMI 1640）,（11.4±7.0）U/mL vs（6.3±2.1）U/mL（IgG）,P均〈0.05];③CD40 mAb使两组培养液上清抗dsDNA抗体水平明显增高[活动期组：（18.6±7.7）U/mL vs（11.8±6.9）U/mL,对照组：（8.3±4.4）U/mL sv（5.6±2.3）U/mL,P均〈0.05]。④在活动期组,Dex明显抑制CD40 mAb引起的PBMC培养液上清抗dsDNA抗体水平的增高[（8.8±5.2）U/mL vs（18.6±7.7）U/mL,P〈0.05],使其低于非特异性处理时水平[（8.8±5.2）U/mL vs（11.8±6.8）U/mL,P〈0.05];Dex不影响对照组。【结论】活动期SLE患者PBMC表达的CD154水平升高,此能够促进抗dsDNA抗体的分泌,而Dex能够抑制其作用。

【目的】观察急性超容性血液稀释(AHHD) 与控制性降压(CH)联合应用对脊柱手术病人血流动力学、 氧供、氧耗及动脉血乳酸浓度的影响。【方法】20 例拟行脊柱手术病人, 麻醉诱导后25 min 内输入60 g/L 的羟乙 基淀粉( 贺斯200/0.5, HES) 15 mL/kg。手术开始时用硝酸甘油+艾司洛尔进行控制性降压, 维持平均动脉压 (MAP) ( 60±5)mmHg。主要手术操作完成后停止降压。术中连续监测心率(HR) 、血压(BP) 、中心静脉压(CVP) 、心 输出量(CO) 。分别于诱导后动静脉置管完成时( 基础值, T0) 、手术开始即刻(AHHD 后, T1)、手术开始后60 min ( T2) 和停止降压后30 min( T3) 同时取动、静脉血进行血气分析及检测动脉血乳酸(LA)。据氧动力学值计算氧供 (DO2) , 氧耗(VO2) , 氧摄取率( ERO2) 。取同期20 例仅行术中CH, 未行AHHD 的脊柱手术患者作对照组, 对比两 组术中输血量及手术前后Hct、Hb 变化。【结果】试验组CVP、CO 在T1 、T2、T3 各时点均明显高于T0 值( P< 0.05 或P < 0.01) ,但仍在正常值范围内。在T1- 3 时点试验组Hct、Hb 明显降低( P < 0.01) 。DO2 在T1 时点明显升高( P < 0.05) , 在T2 时点明显降低( P < 0.05) 。ERO2 在T2 时点明显高于T0 值( P < 0.05) 。试验组VO2 和LA 在各时点 差异无统计学意义( P >0.05) 。与对照组比较, 试验组输异体血比率明显减少(P =0.001) , 而手术前后Hct、Hb 无 明显差异。术后随访两组病人均无并发症发生。【结论】AHHD 与CH 联合可安全用于骨科脊柱手术, 并明显减少 术中异体血用量。

【目的】探讨降钙素基因相关肽(CGRP)在原发性高血压(EH)病情监测中的作用。【方法】对65 例EH 病人在降 压治疗前后测定血浆CGRP 和内皮素(ET)水平, 并与对照组相比较。【结果】EH 组患者血浆CGRP 水平明显低于对照组(P

摘 要 采用氢廓清技术定量测定30 只新西兰兔股骨头血流量,同时监测血压、心率及肛温。结果股骨头 血流量为( 7. 55± 2. 75) mL· g- 1· s- 1 ,血压为( 13± 1. 45) k Pa,心率为( 243± 49)次· min- 1 ,肛温为( 37. 57± 0. 47)℃。表明氢廓清技术是一种简单、可靠、经济的局部骨血流定量测定法,且可用于人体, 具有重要临床应用 价值。

This paper summarized the nursing experience of a child with electrolyte disturbance after craniopharyngioma resection. Postoperative children with craniopharyngioma are prone to electrolyte disorders, and children in serious condition may have demyelination and other symptoms, directly affecting the prognosis. Medical staff should take close observation of the vital signs and consciousness, accurately record the fluid intake and output, monitor changes of body temperature, and reduce secondary damage caused by electrolyte disorders. The diet nursing should be carried out in combination with Traditional Chinese Medicine emotional nursing. (本文总结1例儿童颅咽管瘤切除术后患儿出现电解质紊乱的护理经验。颅咽管瘤切除术后患儿容易出现电解质紊乱, 严重者可出现脱髓鞘等症状, 直接影响预后效果。医护人员应严密观察患者生命体征和意识, 准确记录出入量, 监测体温变化, 减少电解质紊乱带来的继发损害; 同时给予饮食护理, 实施中医情志护理。)

This paper observed the effect of Traditional Chinese Medicine (TCM) acupoint application in the treatment of abdominal distension after surgical treatment for intracranial medulloblastoma in an infant. Nursing measures such as routine care, diet nursing and emotional care were summarized. On the basis of routine nursing, the TCM acupoint application was carried out to relieve the abdominal distension. The acupoint application is a safe and easy-to-operate technique of TCM nursing, which could help ease the suffering of children and increase their comfort. (本文总结穴位贴敷治疗1例婴幼儿颅内髓母细胞瘤术后腹胀的护理经验, 主要包括常规护理、饮食护理、情志护理。在常规护理的基础上, 护理人员结合中医特色护理技术穴位贴敷给予干预, 其操作简单, 能有效改善患儿腹胀症状, 在减轻患儿痛苦的同时又能够增加治疗期间的舒适度。)

This paper summarized the literature of application of moxibustion therapy for patients with chronic renal failure. Moxibustion therapy is able to slowing the progression of renal function, improve the regulation of immune function, reduce the urinary protein. As a Traditional Chinese Medicine characteristic nursing technology, the moxibustion therapy shows advantages in slowing the progress of the renal failure. (本研究总结艾灸治疗慢性肾功能衰竭(CRF)的相关研究进展。艾灸可以改善CRF患者肾功能、调节患者免疫反应、减少尿蛋白和延缓肾功能进程, 艾灸的应用体现了中医护理的特色优势, 其在延缓肾功能衰竭进展方面具有积极的临床意义。)

This paper summarized the nursing experience of a cerebral palsy patient with postoperative urinary retention treated with intradermal acupuncture combined with digital acupoint pressure therapy. Key issues of nursing included daily nursing care, dietary guidance, psychological therapy, health education n operation method and precautions. Based on the scientific evaluation and acupoint selection by syndrome differentiation, individualized nursing interventions were carried out to relieve the postoperative dysuresia and pain, and improve the recovery of the patient. (本文总结皮内针配合手指点穴治疗1例脑瘫患者术后尿潴留的护理经验, 包括生活护理、饮食指导、心理干预以及皮内针、手指点穴的操作方法和注意事项。通过科学的评估, 辨证取穴, 针对患者的个体进行护理干预, 能有效缓解患者排尿困难的症状, 减轻痛苦, 促进疾病的康复。)

This paper summarized the nursing experience of a patient with pain caused by periarthritis of the shoulder treated with the combined application of Traditional Chinese Medicine (TCM) characteristic nursing techniques. Followed by the auricular acupoint massage, the auricular acupoint blood-letting therapy was performed to relieve the shoulder pain and discomfort. The auricular acupoint sticking and pressing therapy showed a long-term stimulation effect, while the balanced cupping therapy was able to enhance the local stimulation effect. The combined application of TCM characteristic nursing techniques are effective in relief of pain in patients with acute periarthritis of the shoulder, which is worthy of promoting. (本文总结了中医特色护理技术联合应用治疗1例肩周炎疼痛患者的护理体会。在耳部按摩的基础上进行耳穴放血, 以减轻肩关节疼痛和缓解肩关节不适, 耳穴贴压则可以起到持续刺激的作用, 平衡火罐作用于局部, 以达到加强刺激的效果。联合疗法能够更好地缓解肩周炎发作期患者的疼痛症状, 值得临床借鉴。)

To implement standardized protective measures and to evaluate the safety and effectiveness of peripherally inserted central venous catheter (PICC) for severely and critically ill patients with COVID-19 in the isolation ward. PICC catheterization was performed to 9 patients who were diagnosed with COVID-19 and treated in the isolation ward. These patients were all given standardized protective measures during the PICC operation. The one-time success rate of catheterization was 100. 00%. There was no postoperative complications such as infection, bleeding, phlebitis, thrombosis, and no nosocomial infection occurred. The implementation of PICC catheterization in severely and critically ill patients in the isolation ward is safe and effective, and standardized protection in catheterization can effectively reduce the risk of cross-infection in hospital. (通过实施规范化防护措施, 评估经外周静脉置入中心静脉导管(PICC)在隔离病房收治的重型和危重型新型冠状病毒肺炎患者中应用的安全性和有效性。回顾隔离病房接受诊治的9例确诊/疑似患者的临床资料, 患者接受PICC置管术, 且术中实施规范化防护措施。9例患者均一次置管成功, 术后未发生感染、出血、静脉炎、血栓等并发症; 无一例置管患者和医务人员发生院内感染。隔离病房收治的重型和危重型新型冠状病毒肺炎患者中实施PICC置管安全、有效, 置管中规范化防护可以有效避免院内交叉感染的发生。)

This paper summarized the multidisciplinary collaboration-based nursing measuers for a patient undergoing percutaneous transluminal coronary angioplasty (PTCA) combined with cerebrovascular interventional surgery. Key issues and consideration of nursing included: Close observation of vital signs, prevention of cardiac tamponade and intracranial hypertension after interventional surgery, monitoring of kidney function and coagulation function, prevention of arterial puncture bleeding and prevention of venous thrombosis of lower limbs, adopting the treatment of integrated Traditional Chinese and Western medicine to improve the symptoms of constipation and insomnia, improving the postoperative quality of life of patients, comprehensive analysis of patient psychological state after major surgery and implementation of corresponding psychological nursing and specific discharge guidance. (本文总结1例心脏血管经皮冠状动脉腔内成形术(PTCA)合并脑血管介入手术患者的护理措施。护理要点包括: 严密观察生命体征, 介入手术后预防心包填塞与颅内高压, 加强肾脏功能和凝血功能的监测, 预防动脉穿刺处出血和预防下肢静脉血栓形成, 通过给予中西医结合护理改善便秘及失眠的症状, 提高患者术后生活质量, 全面分析患者大手术后心理状态并给予相应的心理护理和有针对性的出院指导。)

BACKGROUND: Kidney deficiency and blood stasis syndrome are common traditional Chinese medicine syndromes observed in knee osteoarthritis, which serve as fundamental pathogenesis factors. There exists a significant connection between the two. Previous studies have demonstrated that kidney deficiency and blood stasis syndrome effectively contribute to knee joint cartilage degeneration and the progression of knee osteoarthritis. However, the mechanisms underlying the promotion of knee joint cartilage damage remain unclear and require further investigation. OBJECTIVE: To investigate the influence of kidney deficiency and blood stasis syndrome on the progression of knee osteoarthritis in Sprague-Dawley rats. METHODS: Sixteen Sprague-Dawley rats were randomly divided into two groups: a model observation group and a control group, with eight rats in each group. Animal models of kidney deficiency were induced by ovary removal in the model observation group, while the control group was given a sham procedure for ovarian removal. Two months after modeling, both groups underwent modified HULTH surgery to induce knee osteoarthritis. One week after modified HULTH surgery, the model observation group was subcutaneously given adrenaline hydrochloride to make blood stasis models, while the control group was subcutaneously given normal saline. At the 5th week after modified HULTH surgery, blood rheology, coagulation parameters, triiodothyronine, tetraiodothyronine, and estradiol levels were measured. Knee joint X-ray images were taken, and knee joint sections were stained with safranin O-fast green, hematoxylin-eosin, and immunohistochemistry. RESULTS AND CONCLUSION: Compared with the control group, the model observation group exhibited significant increases in whole blood viscosity at low, medium, and high shear rates, as well as increased plasma viscosity. Fibronectin levels in the coagulation parameters were significantly increased, while prothrombin time and activated partial thromboplastin time were significantly decreased. Triiodothyronine, tetraiodothyronine, and estradiol levels were all significantly decreased. Radiographic results showed that the model observation group exhibited more severe degree of knee joint space narrowing and surface roughness, with the appearance of high-density shadows. Hematoxylin-eosin and safranin O-fast green staining demonstrated more severe cartilage damage in the model observation group, with significantly higher OARSI and Mankin scores compared with the control group. Compared with the control group, immunohistochemistry results showed a significant reduction in the expression of extracellular matrix type II collagen and aggrecan protein in the cartilage of the model observation group rats. Moreover, there was a significant increase in the expression of matrix metalloproteinase 13 and aggrecanase 5, which are inflammatory factors. These results indicate that the Sprague-Dawley rat model of knee osteoarthritis with kidney deficiency and blood stasis was successfully established. Kidney deficiency and blood stasis syndrome further aggravate cartilage extracellular matrix degradation and cartilage degeneration by promoting the expression of inflammatory factors, thereby promoting the progression of knee osteoarthritis in rats. [ABSTRACT FROM AUTHOR]

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Objective To identify the relationship between physical activity, insulin resistance and cardiovascular risk in individuals with different glucose tolerance status and to provide evidence for exercise intervention in people with different glucose tolerance status. Methods A total of 691 patients with different glucose metabolism status were recruited as subjects of the research. Spearman correlation analysis was used to study the relationship between. exercise frequency and insulin resistance, insulin sensitivity, neck circumference (NC) and neck circumference height ratio (NHtR) in the subjects with different glucose metabolism status, the relationship between NC and insulin resistance and insulin sensitivity in different glucose metabolism groups. Results 171(62.9%) Subjects with diabetes were intervened by exercised every day. Spearman correlation analysis showed the correlation between exer- cise frequency and tri-glyceride triglyceride-glucose index (TyG index) (r=-0.120, P<0.05) and NC (r= -0. 168, P<0.05) were negatively correlated. In subjects with diabetes, NC was positively correlated with triglye- erides (TG) (r=-0.100, P<0.05), homeostasis model assessment of insulin resistance(HOMA-R) (r=-0.163, P<0.05), total cholesterol/high-density lipoprotein (TC/HDL-C) (r=-0.214, P<0.05) and TyG index (r= -0. 156, P<0.05). Conclusions Increased frequency of exercise is associated with reduced NC, improved insulin resistance, and cardiovascular risk factors in subjects of our team with newly diagnosed diabetes. Exercise has no significant effect on insulin resistance of subjects with normal glucose tolerance and pre-diabetes. [ABSTRACT FROM AUTHOR]

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