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关键词： 维持性血液透析   单核细胞趋化蛋白-1   血管抑制蛋白-1   烟酰胺腺嘌呤二核苷酸磷酸氧化酶4  

摘要： 目的维持性血液透析(maintenance hemodialysis,MHD)患者血清单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)、血管生成抑制蛋白-1(vasohibin-1,VASH-1)及烟酰胺腺嘌呤二核苷酸磷酸氧化酶4(nicotinamide adenine dinucleotide phosphatase oxidase 4,NOX4)水平变化及意义。方法选取2022年3月—2024年2月安徽医科大学附属合肥医院收治的MHD治疗患者,首次透析前、透析3个月后测定血清MCP-1、VASH-1及NOX4,根据预后情况分为预后不良组与预后良好组,比较2组一般资料及首次透析前、透析3个月后血清MCP-1、VASH-1及NOX4水平,Logistic回归分析MHD患者预后的影响因素,受试者工作特征(receiver operating characteristic,ROC)曲线评价MCP-1、VASH-1及NOX4差值对MHD患者预后的预测价值。结果共选取240例患者。随访1年,失访6例,共234例患者获得随访,其中预后不良组50例(占21.37%),预后良好组184例。透析3个月后,2组患者血清MCP-1、VASH-1及NOX4水平均较首次透析前升高(t=23.361、37.308、13.511、19.689、12.967、18.486,均P<0.001),预后不良组血清MCP-1、VASH-1、NOX4水平及差值均高于预后良好组(t=7.384、12.974、6.409、12.638、5.415、12.296,均P<0.001);多因素Logistic回归分析显示:校正糖尿病、白蛋白后,△MCP-1(OR=1.332,95%CI:1.106~1.605,P<0.001)、△VASH-1(OR=1.383,95%CI:1.132~1.689,P<0.001)、△NOX4(OR=1.313,95%CI:1.061~1.626,P<0.001)仍与MHD患者预后独立相关;ROC曲线显示△MCP-1、△VASH-1、△NOX4联合预测患者预后的曲线下面积(area under the curve,AUC)为0.869,大于各指标单独预测(Z_(联合-△MCP-1)=2.497、P_(联合-△MCP-1)<0.001;Z_(联合-△VASH)=2.566、P_(联合-△MCP-1)<0.001;Z_(联合-△NOX4)=2.842、P_(联合-△MCP-1)<0.001)。结论MHD患者血清MCP-1、VASH-1、NOX4水平升高,差值与预后生存密切相关,△MCP-1、△VASH-1、△NOX4联合预测预后效能较高,有助于临床早期识别高风险患者,及时优化、调整透析策略。

关键词： 氟泽雷塞片   靶向治疗   非小细胞肺癌   胆汁淤积型   药物性肝损伤   肝毒性   药品不良反应  

摘要： 目的探讨氟泽雷塞片所致药物性肝损伤(Drug-Induced Liver Injury,DILI)的风险因素、可能机制和治疗策略,为临床安全用药提供参考。方法分析1例氟泽雷塞片治疗晚期非小细胞肺癌的病例,对靶向药物引发的DILI进行鉴别,深入探讨其发生机制及针对性治疗策略。结果患者经氟泽雷塞片治疗后发生重度胆汁淤积型DILI,关联性评价为“很可能”,经停药、保肝利胆等治疗后,患者肝功能指标显著改善。结论临床使用抗肿瘤药物应重视肝毒性相关风险,发生DILI需及时停药和对症处理。

关键词： 甜玉米   鲁甜玉1号   栽培管理   病害防治  

摘要： 甜玉米是禾本科玉米属的栽培变种,营养丰富、口感清甜,兼具水果鲜食与蔬菜烹饪的双重食用属性。近年来鲜食甜玉米消费需求持续攀升,种植该品类玉米既能为种植户带来可观的经济效益,也能满足消费者对特色农产品的多样化需求。本文从地块整理、适期播种、田间管理强化及病虫害防治等关键环节入手,系统总结并阐述了鲜食玉米鲁甜玉1号高产栽培管理技术。

关键词： 食管癌   转移   细胞角质蛋白19片段抗原21-1   γ-谷氨酰转肽酶   预测  

摘要： 目的:分析细胞角质蛋白19片段抗原21-1(CYFRA21-1)、γ-谷氨酰转肽酶(GGT)水平联合检测对食管癌转移的预测价值。方法:回顾性分析2024年2月至2025年10月该院收治的117例食管癌患者的临床资料,设为观察组,另选取同期该院114名健康体检者作为对照组。比较两组及转移、非转移患者CYFRA21-1、GGT水平,绘制受试者工作特征(ROC)曲线,分析CYFRA21-1、GGT水平单项及联合检测预测食管癌转移的价值。结果:观察组CYFRA21-1、GGT水平均高于对照组,差异有统计学意义(P<0.05);转移患者CYFRA21-1、GGT水平均高于非转移患者,差异有统计学意义(P<0.05);ROC曲线分析结果显示,CYFRA21-1、GGT水平单项及联合检测预测食管癌转移的曲线下面积(AUC)分别为0.826、0.803、0.897,联合检测预测价值高于单项检测。结论:CYFRA21‑1、GGT水平联合检测对食管癌转移的预测价值均高于二者单项检测。

关键词： CD8(+) T cells   NSCLC   OX40(+) Tregs   PD-1 blockade   Th17   Treg/Th17 balance   mIHC  

摘要： OX40⁺ regulatory T cells mediate tumor immune escape and correlate with clinical response to neoadjuvant therapy in NSCLC, but the underlying mechanisms remain incompletely understood.

关键词： Alpha-1 antitrypsin deficiency   hepatocellular carcinoma   non-cirrhotic liver   genetic predisposition to cancer   AATD allele variants  

摘要： Patients with alpha-1 antitrypsin deficiency (AATD) have a 20- to 50-fold higher risk of developing primary liver cancer (PLC), such as hepatocellular carcinoma (HCC), in both cirrhotic and noncirrhotic livers, highlighting AATD as a potential oncogenic factor. In this exploratory study, we aimed to describe the frequency and characteristics of AATD alleles in patients with HCC arising in noncirrhotic livers.

关键词： GLP-1 analogues   Type 1 diabetes mellitus   Hypoglycaemia risk   Gastrointestinal adverse events   Drug safety  

摘要： Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly explored as adjuncts in Type 1 Diabetes Mellitus (T1DM), though concerns regarding hypoglycaemia and diabetic ketoacidosis (DKA) limit their adoption. To comprehensively evaluate their safety, we conducted a systematic review and meta-analysis following PRISMA guidelines. Major databases were searched through June 2025. Outcomes included hypoglycaemia, DKA, gastrointestinal adverse events, and study withdrawals. Twenty-five studies (23 RCTs, 2 observational) were included. Updated pooled data established a neutral risk for overall hypoglycaemia (RR 1.01; Moderate certainty) and serious adverse events (RR 0.89; Moderate certainty). Furthermore, no significant increase was observed for severe hypoglycaemia (RR 0.74; Low certainty) or DKA (RR 0.60; Very Low certainty), though statistical imprecision warrants cautious interpretation. However, GLP-1 RAs significantly increased nausea (RR 2.89) and vomiting (RR 3.10), driving a twofold increase in early treatment withdrawal (RR 2.02; Moderate certainty). Subgroup analysis revealed that overall tolerability significantly improves after six months of therapy. In conclusion, in pooled analyses, GLP-1 RAs were not associated with increased severe hypoglycaemia or DKA, although evidence remains limited. However, a substantial early gastrointestinal burden necessitates cautious patient selection and stepwise dose-titration to maximize patient tolerability and long-term adherence.

关键词： Depressive symptoms   Loneliness   Loneliness scale   Older adults  

摘要：

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  Overall, 595 (19.3%) participants developed depressive symptoms during follow-up.
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  Loneliness was a predictor of the onset of depressive symptoms in older adults.
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  The 20-item UCLA-LS had the highest predictive accuracy for loneliness assessment.
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  Loneliness assessment is essential for predicting future mental health outcomes.s.