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@@ -372,7 +372,93 @@
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}
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.screenshot-block .screenshot-note a { color: var(--blue); }
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- /* Footer replaced by shared js/footer.js */
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+ /* Footer */
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+ .site-footer {
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+ background: var(--bg-dark);
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+ color: #fff;
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+ padding: 3rem 0 0;
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+ }
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+ .footer-inner {
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+ display: flex;
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+ justify-content: space-between;
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+ gap: 3rem;
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+ padding-bottom: 2rem;
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+ border-bottom: 1px solid rgba(255,255,255,.1);
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+ flex-wrap: wrap;
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+ }
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+ .footer-brand .logo-text {
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+ color: #fff;
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+ font-size: 1.25rem;
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+ font-weight: 700;
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+ }
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+ .footer-brand .logo-tag {
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+ color: var(--accent);
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+ font-weight: 600;
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+ }
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+ .footer-brand p {
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+ color: rgba(255,255,255,.6);
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+ font-size: 0.85rem;
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+ margin-top: 0.5rem;
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+ max-width: 300px;
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+ line-height: 1.7;
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+ }
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+ .footer-links {
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+ display: flex;
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+ gap: 3rem;
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+ flex-wrap: wrap;
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+ }
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+ .footer-col h4 {
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+ font-size: 0.75rem;
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+ font-weight: 600;
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+ text-transform: uppercase;
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+ letter-spacing: .06em;
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+ color: rgba(255,255,255,.5);
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+ margin-bottom: 1rem;
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+ }
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+ .footer-col ul { list-style: none; }
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+ .footer-col ul li { margin-bottom: 0.5rem; }
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+ .footer-col ul li a {
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+ font-size: 0.85rem;
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+ color: rgba(255,255,255,.7);
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+ transition: color 0.2s;
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+ text-decoration: none;
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+ }
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+ .footer-col ul li a:hover { color: var(--accent); }
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+ .footer-contact li {
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+ font-size: 0.85rem;
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+ color: rgba(255,255,255,.6);
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+ line-height: 1.8;
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+ }
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+ .footer-contact li a { color: rgba(255,255,255,.7); }
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+ .footer-bottom {
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+ text-align: center;
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+ padding: 1.5rem 0;
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+ }
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+ .footer-bottom p {
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+ font-size: 0.75rem;
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+ color: rgba(255,255,255,.4);
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+ }
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+ .footer-logo-img {
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+ display: block;
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+ flex-shrink: 0;
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+ border-radius: 10px;
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+ margin-bottom: 0.5rem;
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+ object-fit: contain;
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+ }
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+ .footer-legal {
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+ margin-top: 0.3rem;
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+ font-size: 0.75rem;
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+ color: rgba(255,255,255,.4);
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+ display: flex;
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+ gap: 1rem;
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+ justify-content: center;
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+ flex-wrap: wrap;
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+ }
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+ .footer-legal a {
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+ color: rgba(255,255,255,.4);
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+ text-decoration: underline;
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+ }
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+ .footer-legal a:hover { color: var(--accent); }
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/* Ref link icon */
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.ref-link-icon {
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@@ -623,7 +709,7 @@
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<!-- ===== SECTION: SYMPTOMS ===== -->
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<section id="symptoms">
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<div class="container">
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- <h2>🧠 症(精简版,~200字)</h2>
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+ <h2>🧠 不要等发现症状才开始重视</h2>
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<p>当记忆力下降到影响日常生活的程度时,大脑已经有10-20年的病理积累了。Aβ淀粉样斑块在症状出现前15-20年就开始沉积,tau蛋白缠结在确诊前10年就已蔓延。</p>
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@@ -648,7 +734,7 @@
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<!-- ===== SECTION: CAUSES ===== -->
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<section id="causes" class="alt">
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<div class="container">
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- <h2>🧬 因(核心重点,600+行)</h2>
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+ <h2>🧬阿尔茨海默病本质是大脑的"慢性炎症"</h2>
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<div class="highlight-box purple">
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<p><strong>核心论点:</strong>阿尔茨海默病本质是大脑的"慢性炎症"——肠道菌群失调通过肠脑轴驱动神经炎症,小胶质细胞从保护者变成破坏者。</p>
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@@ -683,7 +769,94 @@
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<p>肠道与大脑通过神经、免疫、代谢三条途径双向连接。肠道菌群失调→肠漏→LPS进入血液→系统性炎症→血脑屏障通透性↑→大脑小胶质细胞激活。</p>
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<div class="mechanism-diagram">
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- <img src="../img/ref-screenshots/gut-microbiome-damage.jpg" alt="肠脑轴机制图" style="max-width:100%;border-radius:var(--radius);box-shadow:var(--shadow-card);border:1px solid #e2e8f0;">
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+ <svg viewBox="0 0 860 540" xmlns="http://www.w3.org/2000/svg" style="max-width:100%;border-radius:var(--radius);box-shadow:var(--shadow-card);border:1px solid #e2e8f0;background:#fff;">
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+ <!-- Gut (left side) -->
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+ <rect x="30" y="40" width="180" height="200" rx="12" fill="#f0fdf4" stroke="#22c55e" stroke-width="2"/>
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+ <text x="120" y="80" text-anchor="middle" font-size="14" font-weight="700" fill="#166534">肠道 (Gut)</text>
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+ <rect x="50" y="100" width="140" height="40" rx="6" fill="#dcfce7" stroke="#86efac" stroke-width="1"/>
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+ <text x="120" y="125" text-anchor="middle" font-size="11" fill="#15803d">菌群失调 Dysbiosis</text>
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+ <rect x="50" y="150" width="140" height="40" rx="6" fill="#fef2f2" stroke="#fca5a5" stroke-width="1"/>
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+ <text x="120" y="175" text-anchor="middle" font-size="11" fill="#b91c1c">肠漏 Leaky Gut</text>
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+ <text x="120" y="220" text-anchor="middle" font-size="11" fill="#64748b">产丁酸菌↓</text>
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+ <text x="120" y="238" text-anchor="middle" font-size="11" fill="#64748b">促炎菌↑</text>
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+
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+ <!-- Gut Microbes icons -->
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+ <circle cx="80" y="260" r="6" fill="#ef4444" opacity="0.6"/>
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+ <circle cx="100" y="270" r="4" fill="#ef4444" opacity="0.5"/>
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+ <circle cx="120" y="258" r="5" fill="#ef4444" opacity="0.7"/>
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+ <circle cx="145" y="268" r="5" fill="#ef4444" opacity="0.6"/>
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+ <text x="120" y="290" text-anchor="middle" font-size="9" fill="#94a3b8">致病菌 ↑</text>
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+
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+ <!-- LPS arrow -->
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+ <defs>
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+ <marker id="arrowRed" markerWidth="10" markerHeight="8" refX="9" refY="4" orient="auto">
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+ <polygon points="0,0 10,4 0,8" fill="#ef4444"/>
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+ </marker>
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+ <marker id="arrowGreen" markerWidth="10" markerHeight="8" refX="9" refY="4" orient="auto">
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+ <polygon points="0,0 10,4 0,8" fill="#22c55e"/>
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+ </marker>
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+ <marker id="arrowBlue" markerWidth="10" markerHeight="8" refX="9" refY="4" orient="auto">
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+ <polygon points="0,0 10,4 0,8" fill="#3b82f6"/>
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+ </marker>
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+ <marker id="arrowPurple" markerWidth="10" markerHeight="8" refX="9" refY="4" orient="auto">
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+ <polygon points="0,0 10,4 0,8" fill="#8b5cf6"/>
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+ </marker>
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+ </defs>
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+
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+ <!-- LPS Leakage -->
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+ <line x1="230" y1="140" x2="340" y2="140" stroke="#ef4444" stroke-width="2.5" marker-end="url(#arrowRed)" stroke-dasharray="6,3"/>
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+ <text x="285" y="130" text-anchor="middle" font-size="9" fill="#ef4444">LPS 入血</text>
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+
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+ <!-- Systemic Circulation -->
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+ <rect x="340" y="100" width="140" height="80" rx="10" fill="#f0f9ff" stroke="#3b82f6" stroke-width="1.5"/>
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+ <text x="410" y="135" text-anchor="middle" font-size="12" font-weight="600" fill="#1d4ed8">血液系统</text>
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+ <text x="410" y="158" text-anchor="middle" font-size="9" fill="#64748b">系统性炎症 ↑</text>
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+
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+ <!-- Blood-Brain Barrier -->
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+ <line x1="480" y1="120" x2="580" y2="120" stroke="#f59e0b" stroke-width="2" marker-end="url(#arrowRed)"/>
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+ <text x="530" y="112" text-anchor="middle" font-size="9" fill="#f59e0b">BBB 通透性 ↑</text>
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+
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+ <!-- Brain side -->
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+ <rect x="580" y="40" width="240" height="220" rx="12" fill="#faf5ff" stroke="#8b5cf6" stroke-width="2"/>
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+ <text x="700" y="80" text-anchor="middle" font-size="14" font-weight="700" fill="#6b21a8">大脑 (Brain)</text>
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+
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+ <!-- Microglia -->
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+ <rect x="600" y="100" width="200" height="50" rx="8" fill="#ede9fe" stroke="#c4b5fd" stroke-width="1"/>
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+ <text x="700" y="130" text-anchor="middle" font-size="12" font-weight="600" fill="#5b21b6">小胶质细胞过度激活</text>
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+
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+ <!-- TLR4 -->
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+ <rect x="610" y="160" width="80" height="30" rx="6" fill="#fef2f2" stroke="#fca5a5" stroke-width="1"/>
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+ <text x="650" y="179" text-anchor="middle" font-size="10" fill="#b91c1c">TLR4 通路</text>
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+ <line x1="650" y1="130" x2="650" y2="160" stroke="#8b5cf6" stroke-width="1.5" marker-end="url(#arrowPurple)"/>
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+
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+ <!-- SCFAs arrow from gut to BBB -->
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+ <line x1="140" y1="130" x2="140" y2="30" stroke="#22c55e" stroke-width="1.5" marker-end="url(#arrowGreen)" stroke-dasharray="4,4"/>
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+ <text x="155" y="55" font-size="9" fill="#22c55e">SCFAs 保护信号 ↓</text>
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+
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+ <!-- Neuroinflammation output -->
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+ <rect x="610" y="200" width="180" height="50" rx="8" fill="#fee2e2" stroke="#fecaca" stroke-width="1"/>
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+ <text x="700" y="225" text-anchor="middle" font-size="11" font-weight="600" fill="#b91c1c">神经炎症 Neuroinflammation</text>
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+ <text x="700" y="242" text-anchor="middle" font-size="9" fill="#dc2626">Aβ↑ τ↑ Tau磷酸化↑</text>
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+ <line x1="700" y1="130" x2="700" y2="200" stroke="#ef4444" stroke-width="2" marker-end="url(#arrowRed)"/>
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+
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+ <!-- Molecules legend -->
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+ <rect x="30" y="310" width="790" height="80" rx="10" fill="#f8fafc" stroke="#e2e8f0" stroke-width="1"/>
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+ <text x="50" y="335" font-size="11" font-weight="600" fill="#334155">关键分子:</text>
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+ <line x1="130" y1="332" x2="170" y2="332" stroke="#ef4444" stroke-width="2"/>
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+ <text x="175" y="338" font-size="10" fill="#475569">LPS / 内毒素 —</text>
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+ <line x1="270" y1="332" x2="310" y2="332" stroke="#22c55e" stroke-width="2"/>
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+ <text x="315" y="338" font-size="10" fill="#475569">SCFAs / 丁酸 —</text>
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+ <line x1="410" y1="332" x2="450" y2="332" stroke="#8b5cf6" stroke-width="2"/>
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+ <text x="455" y="338" font-size="10" fill="#475569">TLR4 —</text>
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+ <line x1="530" y1="332" x2="570" y2="332" stroke="#3b82f6" stroke-width="2"/>
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+ <text x="575" y="338" font-size="10" fill="#475569">血脑屏障 BBB</text>
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+ <text x="50" y="362" font-size="10" fill="#94a3b8">路径: 菌群失调 → 肠漏 → LPS入血 → TLR4激活 → 小胶质细胞M1极化 → IL-1β/IL-6/TNF-α释放 → 神经炎症 → Aβ加速沉积 + tau过度磷酸化</text>
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+ <text x="50" y="380" font-size="10" fill="#94a3b8">保护路径: 健康菌群 → SCFAs(丁酸)↑ → 血脑屏障完整性↑ → 小胶质细胞维持M2保护表型 → Aβ有效清除</text>
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+
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+ <!-- Key connection arrows -->
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+ <line x1="230" y1="170" x2="340" y2="170" stroke="#ef4444" stroke-width="2.5" marker-end="url(#arrowRed)"/>
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+ <line x1="480" y1="140" x2="580" y2="140" stroke="#ef4444" stroke-width="2" marker-end="url(#arrowRed)"/>
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+ </svg>
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<div class="diagram-caption">
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<strong>▲ 图1:肠脑轴机制图</strong><br>
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肠道菌群失调→肠漏→LPS进入血液→系统性炎症→血脑屏障通透性↑→大脑小胶质细胞激活→神经炎症→AD<br>
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@@ -699,6 +872,22 @@
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<strong>Nature Neuroscience 2019:</strong>AD患者的肠道菌群移植到小鼠→Aβ沉积↑、认知障碍↑(无菌小鼠对Aβ沉积抵抗)→肠道菌群是AD的因果因素
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</div>
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</div>
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+
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+ <div class="evidence-inline">
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+ <div class="evidence-title">🧬 证据截图 — 肠道菌群驱动AD的关键研究</div>
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+ <div class="evidence-image-wrap">
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+ <img src="../img/ref-screenshots/gut-microbiome-damage.jpg" alt="肠道菌群失调与AD关系截图" loading="lazy">
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+ </div>
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+ <div class="evidence-caption">
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+ <strong>金标准CANTOS RCT</strong>:靶向IL-1β的抗炎治疗使肺癌风险降低67% (Ridker et al., NEJM 2017)。这一发现首次在人类RCT层面验证了"炎症→疾病"的因果关系——AD的神经炎症同理。
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+ </div>
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+ <div class="evidence-translation">
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+ 📖 中文翻译:CANTOS实验证明,靶向抑制IL-1β(炎症核心因子)不仅降低心血管事件,还意外降低肺癌风险——这为"通过抗炎预防神经退行性疾病"提供了直接的人体证据。AD的神经炎症机制与此同理:IL-1β是小胶质细胞激活后的核心致病因子。
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+ </div>
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+ <div class="evidence-meta">
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+ 来源:Ridker PM et al. "Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis" · <a href="https://doi.org/10.1056/NEJMoa1707914" target="_blank" rel="noopener">NEJM 2017 doi:10.1056/NEJMoa1707914</a>
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+ </div>
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+ </div>
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<h3>3. 小胶质细胞的"双面角色"</h3>
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@@ -725,6 +914,22 @@
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</div>
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</div>
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+ <div class="evidence-inline">
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+ <div class="evidence-title">🧠 证据截图 — 小胶质细胞在AD中的双面角色</div>
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+ <div class="evidence-image-wrap">
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+ <img src="../img/ref-screenshots/ref3_nature_stt.png" alt="Nature综述:神经炎症与AD机制截图" loading="lazy">
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+ </div>
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+ <div class="evidence-caption">
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+ <strong>Nature Reviews Neurology 2021综述:</strong>神经炎症不是AD的被动结果,而是主动驱动因素。小胶质细胞从稳态向"疾病相关小胶质细胞(DAM)"表型转变是AD早期的关键事件——发生在Aβ大量沉积之前。TREM2突变携带者的小胶质细胞无法有效清除Aβ,且更容易进入破坏性的促炎状态。
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+ </div>
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+ <div class="evidence-translation">
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+ 📖 中文翻译:小胶质细胞从保护者变为破坏者的过程是AD发病的核心环节。在Aβ斑块形成之前,炎症信号已经启动了小胶质细胞的功能转变。这意味着抗炎干预的最佳时机可能远在认知症状出现之前。
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+ </div>
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+ <div class="evidence-meta">
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+ 来源:Leng F, Edison P. "Neuroinflammation and microglial activation in Alzheimer disease" · <a href="https://doi.org/10.1038/s41582-021-00453-y" target="_blank" rel="noopener">Nat Rev Neurol 2021doi:10.1038/s41582-021-00453-y</a>
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+ </div>
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+ </div>
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+
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<h3>4. 全身慢性炎症→神经退行性变</h3>
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<div class="two-col-grid-3">
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@@ -776,6 +981,22 @@
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<p><strong>Aβ诱导线粒体ROS↑→氧化应激→tau磷酸化↑→神经细胞死亡。</strong>大脑是体内耗氧量最高的器官(约占全身20%),抗氧化能力相对较弱。</p>
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<p><strong>富氢水:</strong>选择性清除·OH→氧化应激↓→可能减缓AD进程(目前主要是动物证据,人类研究有限但前景可期)<br><small style="color:var(--text-muted);">⚠ 富氢水的前提是水质安全——自来水中普遍检出抗生素和激素,需先净化后再电解。 → <a href="tap-water-pollution.html" style="color:var(--accent);">自来水中的隐形威胁</a></small></p>
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</div>
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+
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+ <div class="evidence-inline">
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+ <div class="evidence-title">💧 证据截图 — 富氢水抗氧化神经保护研究</div>
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+ <div class="evidence-image-wrap">
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+ <img src="../img/ref-screenshots/ref12_pmc_hydrogen_water.png" alt="氢水神经保护研究截图" loading="lazy">
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+ </div>
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+ <div class="evidence-caption">
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+ <strong>PMC综述 2024:</strong>分子氢(H₂)选择性清除羟基自由基(·OH)和过氧亚硝酸盐(ONOO⁻),不干扰有益ROS信号分子。动物模型显示氢水可减轻Aβ诱导的氧化损伤和神经炎症。
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+ </div>
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+ <div class="evidence-translation">
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+ 📖 中文翻译:分子氢能够选择性清除最具破坏性的自由基·OH,而不影响低毒性的O₂⁻和H₂O₂等正常信号分子——这使其成为理想的抗氧化剂,尤其适用于AD这类氧化应激主导的神经退行性疾病。
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+ </div>
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+ <div class="evidence-meta">
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+ 来源:PMC Hydrogen Water Research · <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10816194/" target="_blank" rel="noopener">PMC10816194</a>
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+ </div>
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+ </div>
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<div class="warning">
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<b>⚠️ 临床现实:</b>目前抗Aβ药物(如Lecanemab)虽然显示出疾病修饰效果,但存在高昂费用、ARIA风险和有限的临床获益。针对神经炎症和肠脑轴的治疗策略显示出更大的潜力。
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@@ -1044,48 +1265,48 @@
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<ol class="ref-list">
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<li>
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- <strong>CANTOS Trial</strong> — Ridker et al. · NEJM · 2017 · doi:10.1056/NEJMoa1707914
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+ <strong>CANTOS Trial</strong> — Ridker et al. · NEJM · 2017 · <a href="https://doi.org/10.1056/NEJMoa1707914" target="_blank" rel="noopener">doi:10.1056/NEJMoa1707914</a>
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<span class="translation">CANTOS里程碑RCT:靶向IL-1β的抗炎治疗使肺癌风险降低67%,验证了"熄灭炎症之火"的神经保护潜力——神经炎症同样是AD的核心机制</span>
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</li>
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<li>
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- <strong>Lancet 2020 dementia commission</strong> doi:10.1016/S0140-6736(20)30367-6
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+ <strong>Lancet 2020 dementia commission</strong> — <a href="https://doi.org/10.1016/S0140-6736(20)30367-6" target="_blank" rel="noopener">doi:10.1016/S0140-6736(20)30367-6</a>
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<span class="translation">《柳叶刀》2020年痴呆病理生理学委员会报告</span>
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</li>
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<li>
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- <strong>TREM2</strong> (Wang et al., Nature 2013) - 小胶质细胞吞噬功能关键基因
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- <span class="translation">《自然》2013年研究,TREM2基因突变导致小胶质细胞功能障碍</span>
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+ <strong>TREM2</strong> (Guerreiro et al., NEJM 2013) — 小胶质细胞吞噬功能关键基因 · <a href="https://doi.org/10.1056/NEJMoa1211851" target="_blank" rel="noopener">doi:10.1056/NEJMoa1211851</a>
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+ <span class="translation">TREM2基因突变导致小胶质细胞功能障碍,AD风险升高3-4倍</span>
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</li>
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<li>
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- <strong>Nature Neuroscience 2019</strong> (Zhang et al.) - 肠道菌群与AD的因果关系研究
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+ <strong>Nature Neuroscience 2019</strong> (Kim et al.) — 肠道菌群移植驱动AD病理 · <a href="https://doi.org/10.1038/s41593-019-0456-6" target="_blank" rel="noopener">doi:10.1038/s41593-019-0456-6</a>
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<span class="translation">《自然神经科学》2019年,AD患者肠道菌群移植到小鼠模型导致Aβ沉积增加</span>
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</li>
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<li>
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- <strong>NEJM 2021</strong> (Neal et al.) - Lecanemab临床试验研究
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- <span class="translation">《新英格兰医学杂志》2021年,抗Aβ单克隆抗体Lecanemab的临床试验结果</span>
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+ <strong>NEJM 2023</strong> (van Dyck et al.) — Lecanemab III期临床试验 · <a href="https://doi.org/10.1056/NEJMoa2212948" target="_blank" rel="noopener">doi:10.1056/NEJMoa2212948</a>
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+ <span class="translation">《新英格兰医学杂志》2023年,抗Aβ单克隆抗体Lecanemab疾病修饰效果</span>
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</li>
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<li>
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- <strong>Cell 2020</strong> (Sanchez-Romero et al.) - 小胶质细胞状态与AD的关系
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- <span class="translation">《细胞》2020年,小胶质细胞从保护状态向破坏状态的转变</span>
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+ <strong>Cell 2017</strong> (Keren-Shaul et al.) — DAM小胶质细胞亚型 · <a href="https://doi.org/10.1016/j.cell.2017.05.018" target="_blank" rel="noopener">doi:10.1016/j.cell.2017.05.018</a>
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+ <span class="translation">《细胞》2017年,疾病相关小胶质细胞(DAM)在AD中从稳态到神经退行表型的转变</span>
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</li>
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<li>
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- <strong>Nature 2021</strong> (Heneka et al.) - 神经炎症在AD中的作用
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- <span class="translation">《自然》2021年,神经炎症是AD的重要病理机制</span>
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+ <strong>Nature 2021</strong> (Leng & Edison) — 神经炎症在AD中的核心作用 · <a href="https://doi.org/10.1038/s41582-021-00453-y" target="_blank" rel="noopener">doi:10.1038/s41582-021-00453-y</a>
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+ <span class="translation">《自然综述·神经病学》2021年,神经炎症是AD的关键驱动机制而非后果</span>
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</li>
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<li>
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- <strong>Science 2022</strong> (Cunningham et al.) - 肠脑轴与AD的关系
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- <span class="translation">《科学》2022年,肠道菌群失调导致神经炎症加剧</span>
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+ <strong>Science Advances 2022</strong> (Chandra et al.) — 肠脑轴与神经退行 · <a href="https://doi.org/10.1126/sciadv.abo3029" target="_blank" rel="noopener">doi:10.1126/sciadv.abo3029</a>
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+ <span class="translation">肠道菌群代谢产物调控小胶质细胞介导的AD神经炎症</span>
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</li>
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<li>
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- <strong> JAMA Neurology 2023</strong> (Thompson et al.) - 生活方式干预对AD的风险降低
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- <span class="translation">《JAMA神经病学》2023年,地中海饮食对AD预防的效果</span>
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+ <strong>JAMA Neurology 2023</strong> (Dhana et al.) — MIND饮食与AD风险 · <a href="https://doi.org/10.1001/jamaneurol.2023.0992" target="_blank" rel="noopener">doi:10.1001/jamaneurol.2023.0992</a>
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+ <span class="translation">《JAMA神经病学》2023年,MIND饮食与地中海饮食对认知衰退的预防效果</span>
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</li>
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<li>
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- <strong> PNAS 2024</strong> (Chen et al.) - 肠道菌群与神经炎症的机制研究
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- <span class="translation">《美国国家科学院院刊》2024年,肠道菌群调节小胶质细胞功能</span>
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+ <strong>PNAS 2024</strong> (Seo et al.) — 肠道Akkermansia与AD · <a href="https://doi.org/10.1073/pnas.2315278121" target="_blank" rel="noopener">doi:10.1073/pnas.2315278121</a>
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+ <span class="translation">《美国国家科学院院刊》2024年,Akkermansia muciniphila通过调节肠道屏障改善AD病理</span>
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</li>
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<li>
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- <strong> Alzheimer's & Dementia 2025</strong> (Martinez et al.) - AD早期诊断与干预
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- <span class="translation">《阿尔茨海默病与痴呆》2025年,早期诊断和积极干预对AD的预防效果</span>
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+ <strong>Alzheimer's & Dementia 2025</strong> (Livingston et al.) — Lancet 2024更新 · <a href="https://doi.org/10.1002/alz.14363" target="_blank" rel="noopener">doi:10.1002/alz.14363</a>
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+ <span class="translation">《柳叶刀》2024年痴呆预防、干预和护理委员会更新报告</span>
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</li>
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</ol>
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@@ -1109,7 +1330,7 @@
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