Research on the mechanisms of depression is currently a focus of the field of neuroscience.The degeneration of brain plasticity(e.g.,decrease in volume,structural degradation,and functional disorder of the hippocampus,PFC,and CG)leads to depression.Exercise is an important means of improving the symptoms of depression.Current research confirms the importance of improving the volume,structure,and function of the hippocampus,PFC,and CG,in this process,but related research has focused solely on changes to the volume of certain brain regions or connectivity functions.Thus,we lack a comprehensive understanding of the antidepressant mechanisms that improve brain plasticity with exercise.Therefore,this study aimed to explore the roles of brain plasticity in the occurrence of depression and improvements to depression through exercise,promoting a more comprehensive understanding the role of brain plasticity in depression.We also provide new ideas for exercise intervention in depression.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

With the aging of population， osteoporosis has become one of the main diseases endangering the health of the elderly in China. Therefore， the research on osteoporosis has become a hot spot. Since Chinese medicines demonstrate significant therapeutic effects on osteoporosis， this issue is attracting increasing attention from researchers， especially in the deciphering of the molecular mechanism. This paper introduces the mechanism of the prevention and treatment of osteoporosis by Chinese medicines via the mitogen-activated protein kinase （MAPK） signaling pathway， aiming to provide a theoretical basis for deciphering the mechanism of Chinese medicines in the treatment of osteoporosis and promoting their clinical application. MAPK signaling pathway mainly involves p38 MAPK， extracellular signal-regulated kinase 1/2 （ERK1/2）， c-Jun N-terminal kinase （JNK）， and extracellular signal-regulated kinase 5 （ERK5）. Studies have shown that these proteins play a role in the progression of osteoporosis by regulating cell proliferation， differentiation， and apoptosis. Chinese medicines as a unique therapy with Chinese characteristics has definite efficacy， high safety， and mild side effects. Researchers have proved by experiments that the extracts or compounds of Chinese medicines can significantly mitigate osteoporosis by regulating the proteins involved in the MAPK signaling pathway. Therefore， this article reviews the relevant studies with focus on these proteins.

In recent years， with the changes of population structure and the aggravation of aging， the prevalence of osteoporosis is increasing year by year. Osteoporosis poses great impacts on the body and family life of the patients and increases the burden on the society. Therefore， the research on osteoporosis is urgent and significant. The imbalance between osteoblasts， osteocytes， and osteoclasts causes abnormal bone metabolism， which destroys the fine structure of bone and increases bone fragility， thus increasing the risk of fracture. Although the pathogenesis of osteoporosis is complex， researchers have confirmed that the imbalance of the endocrine system directly or indirectly promotes the occurrence and development of osteoporosis. Traditional Chinese medicine （TCM） is a treasure of Chinese traditional culture and plays a key role in safeguarding the public health. With unique therapeutic effects and advantages， TCM has been widely accepted. Chinese medicines， moxibustion， acupuncture and other TCM therapies have play a unique role in the treatment of osteoporosis. Particularly， TCM prevention and treatment of osteoporosis by regulating the endocrine system has received extensive attention. By reviewing relevant literature， this paper introduces the research progress in the TCM modulation of bone metabolism and alleviation of bone loss by regulating estrogen， calcitonin， and parathyroid hormone in the endocrine system and affecting the hypothalamus capable of regulating these hormones， aiming to provide ideas for the TCM treatment of osteoporosis.

Objective:To observe the efficacy and safety of teriprizumab combined with bevacizumab in above the second line treatment of high-level microsatellite instability (MSI-H) type metastatic colorectal cancer (mCRC) patients.Methods:From February 2019 to September 2019, 56 patients with MSI-H mCRC admitted to the Third Affiliated Hospital of Guangdong Medical University were selected and divided into control group and test group by random number table method, with 28 cases in each group. The control group was treated with bevacizumab, and the test group was treated with teriprizumab combined with bevacizumab. The objective response rate (ORR), disease control rate (DCR), progression-free survival, overall survival and incidence of adverse reactions were compared between the two groups.Results:The ORR and DCR of the test group were 60.71% (17/28) and 75.00% (21/28) respectively, higher than 28.57% (8/28) and 46.63% (13/28) of the control group, with statistically significant differences ( χ2=5.85, P=0.016; χ2=4.79, P=0.029). The median progression-free survival of patients in the control group and the test group were 3.5 months and 5.8 months respectively, with a statistically significant difference ( χ2=9.83, P=0.003). The median overall survival of patients in the control group and the test group were 12.1 months and 16.2 months respectively, with a statistically significant difference ( χ2=6.13, P=0.007). There were no significant diffe-rences in the incidences of hematological reaction (17.86% vs. 14.29%, χ2=0.13, P=0.716), cardiovascular injury (10.71% vs. 14.29%, χ2=0.16, P=0.686), liver and kidney function injury (25.00% vs. 21.43%, χ2=0.10, P=0.752), gastrointestinal reaction (28.57% vs. 35.71%, χ2=0.33, P=0.567), skin and mucosal injury (7.14% vs. 10.71%, χ2=0.35, P=0.553), nervous system disease (3.57% vs. 14.29%, χ2=2.25, P=0.134), endocrine reaction (3.57% vs. 10.71%, χ2=1.29, P=0.256), alopecia (14.29% vs. 17.86%, χ2=0.13, P=0.716) and fatigue (25.00% vs. 28.57%, χ2=0.27, P=0.605) between the control group and the test group. Conclusion:The combination of teriprizumab and bevacizumab can improve the short-term and medium-long-term efficacy of patients with MSI-H mCRC, which is safe and reliable.

With the aging of the Chinese society and the population, the incidence of hip fractures in the elderly is increasing significantly. Elderly patients have various basic diseases and decreased organ compensatory capacity, which increase the risks related to surgery and anesthesia, increase the incidence of postoperative complications and mortality, and affect the recovery process of patients. Malnutrition is one of the main causes of hip fractures in elderly patients, and it is also a major factor predicting the prognosis of patients. Elderly patients with hip fractures are considered at high risk of malnutrition. Malnutrition can lead to adverse clinical outcomes, such as increased mortality and complications, prolonged hospital stays, and increased hospital costs. Elderly patients with hip fracture should be routinely screened for nutritional risk. Those with malnutrition or nutritional risk, should be given nutritional support treatment. And conduct assessments and optimizations of nutritional support treatmentby observing the prognosis indicators such as complication rate, mortality, and rehabilitation status. At present, orthopedic surgeons who are the main body of elderly hip fracture treatment do not pay enough attention to the nutritional status of patients. Many elderly hip fracture patients undergo surgery while their malnutrition status has not improved. Therefore, it is important to improve their prognosis that strengthen the perioperative nutritional management of elderly patients with hip fracture. Domestic research on the nutritional status of elderly hip fracture patients started late. Many medical institutions have not carried out routine nutritional screening and active nutritional support treatment for elderly hip fracture patients, and there is also a lack of relevant clinical research and data statistics in the nutritional support and treatment of elderly patients with hip fractures. This article describes the current research status of nutritional risk screening and nutritional support treatment for elderly patients with hip fracture at home and abroad. However, due to differences in ethnicity, lifestyle, religious culture, and eating habits in various regions, foreign research data may not be suitable for domestic patients. Therefore, this article provides a reference for the research on perioperative nutritional screening and nutritional treatment of elderly hip fracture patients, and establishes a nutritional management plan suitable for elderly hip fracture patients in China.

Objective Hepatitis C virus patients are often accompanied by insulin resistance and diabetes.To probe the relative factors of abnormal glycometabolism in chronic HCV infections.Methods A total of 1 039 treatment-naive patients that were confirmed chronic HCV infected were enrolled in the study.The demographics,biochemical index parameters and other data about liver function and HCV viral load were got from infectious disease department of Jurong Pepole's Hospital in China.Results A total of 140 (13.5％) patients were diagnosed with some forms of abnormal glycometabolism.The body mass index (BMI) (x2 =9.231,P =0.010),waist circumference (x2 =7.984,P =0.018),systolic blood pressure (x2 =16.366,P ＜0.001),diastolic blood pressure (x2 =13.970,P =0.001),alanine aminotransferase(ALT) (x2 =4.809,P =0.028),HCV-RNA viral load (t =-3.818,P ＜0.001) were significantly different between non-diabetic HCV patients and abnormal glycometabolism patients.Multivariate logistic regression analysis showed that ALT(OR =2.986,95％ CI:1.171-7.615) and HCV-RNA viral load (OR =2.061,95％ CI:1.165-3.644) were found as risk factors in multivariate regression analysis for patients with chronic hepatitis C who had abnormal glucose metabolism.Conclusions Chronic hepatitis C patients with higher ALT and HCV-RNA level were more probably to suffer from abnormal glycometabolism.In order to find potentially novel risk factors of HCV with abnormal glucose metabolisn,further studies about genetic and other clinical factors need to be processed.

Objective To investigate the safety and feasibility of Minocycline Hydrochloride Ointment and metronidazole membrane in the treatment of periodontal abscess.Methods80 cases of patients with periodontal abscess in our hospital from May 2014 to May 2016 were selected, these patients were randomly divided into Minocycline Hydrochloride Ointment group (n=40) and metronidazole membrane group (n=40) two groups, the periodontal probing depth, gingival bleeding index, plaque index, attachment loss, clinical efficacy, the incidences of adverse reactions and recurrence of the two groups were statistically analyzed.ResultsThe periodontal probing depth, gingival bleeding index, plaque index, attachment loss of the Minocycline Hydrochloride Ointment group were significantly lower (P<0.05), the total treatment efficiency 95% (38/40) was significantly higher than the metronidazole membrane group 77.5% (31/40) (P<0.05), the recurrence rate 2.5% (1/40) was significantly lower than the metronidazole membrane group 15% (6/40) (P<0.05), but the difference of the incidences of adverse reactions 10% (4/40), 7.5% (3/40) between the two groups was not significant.ConclusionMinocycline Hydrochloride Ointment metronidazole membrane in the treatment of periodontal abscess has higher safety and feasibility than metronidazole membrane, so is worthy of promotion in the clinical.

Objective To explore the influence factors for femoral head necrosis after treatment of femoral neck fractures with dynamic hip screw (DHS) and anti-rotation screw.Methods A retrospective case series analysis was made on the clinical data of 106 cases of femoral neck fractures who had undergone fixation with DHS and anti-rotation screw between May 2010 and May 2015.There were 59 males and 47 females,with an average age of 57.0 years (range,27-76 years).By Garden classification,there were 27 cases of type Ⅱ,51 cases of type Ⅲ and 28 cases of type Ⅳ.All cases were divided into femoral head necrosis group (18 cases) and none-necrosis group (88 cases) according to the radiographs of the fractured hip at the follow-up.Univariate analyses and a multivariate logistic regression analysis were made to test whether the following factors were significantly associated with femoral neck necrosis:sex,age,Garden classification,Pauwels classification,Singh index,injury-to-surgery time interval,reduction methods,reduction quality,complete weight-bearing time,implant removal and the time cost of implant removal surgery.Results All the 106 patients obtained a mean follow-up of 49 months (range,26-76 months).Femoral head necrosis occurred in 18 cases (17.0％).In univariate analyses,Garden classification,reduction quality,implant removal and long time of the implant removal surgery were significantly associated with femoral head necrosis (P ＜ 0.01).In multivariate logistic regression analysis,high level of Garden classification(95％ CI 0.008,0.998,P ＜ 0.05),implant removal and long time of the implant removal surgery (95％ CI 0.000,0.143,P ＜ 0.01) were found to have a significant effect on femoral head necrosis development.Conclusions Fracture displacement,removal of internal fixation and broadening the screw canal,which cand hinder the blood supply of femoral head,will enhance the rate of femoral head necrosis.As a result,it needs prudent consideration to remove internal fixation after internal fixation with DHS combined with anti-rotation screw for femoral neck fractures.When it is difficult to remove the anti-rotation screw,it is better to give up,rather than to force a removal.

Objective To analyze the anesthetic effect of Compound Articaine on Children's dental pulp without pain, and provide reference for clinical treatment.Methods124 patients with children with dental pulp disease in hospital from February 2015 to May 2016 were selected, patients were randomly divided into observation group and control group, every group with 62 cases.Control group patients were given Lidocaine anesthesia, observation group patients were taken trentment of compound articaine anesthesia, anesthetic effect of patients were compared.Changes in heart rate, blood pressure, adverse effects, and patient pain were recorded before and after anesthesia.ResultsThe total effective rate (96.8%) in the observation group was significantly higher than that in the control group (80.9%) (P<0.05).Observation group (79%) was significantly higher than the control group (1.6%,P<0.05), the observation group of severe pain rate (58.1%) was significantly lower than the control group (11.3%) (P<0.05),The heart rate and blood pressure in the observation group were no significant change, In the control group, the diastolic blood pressure (71.7±10.8) mmHg was significantly lower in the observation group (74.5±12.8) mmHg and the heart rate (80.2±8.8)/min was significantly higher than that in the observation group (76.2±8.3).Two groups of patients in the treatment of adverse reactions, including tachycardia, dizziness, headache, observation group of adverse reaction rate and the control group was not significantly different.ConclusionCompound articaine anesthesia was the implementation of children's dental painless treatment, can reduce the pain of patients, maintain the blood pressure and heart rate stable, has the use value.