Ferroptosis is a novel form of programmed cell death that plays a critical role in the body's disease resistance processes. Research has shown that ferroptosis plays a significant role in the pathogenesis of depression. Traditional Chinese medicine （TCM） has unique advantages in the prevention and treatment of depression， and the effective application of ferroptosis theory to guide TCM in the prevention and treatment of depression has become a current research hotspot. This article provides a summary and review of the regulatory mechanisms of ferroptosis， its relationship with depression， and the current research status of TCM in the prevention and treatment of depression based on ferroptosis. It has been found that the occurrence of ferroptosis is related to processes such as iron metabolism disorders， uncontrolled lipid peroxidation， and abnormal amino acid metabolism. Ferroptosis plays an important regulatory role in the onset， progression， and treatment of depression， offering new ideas for therapeutic approaches to the condition. Additionally， research on TCM interventions that regulate ferroptosis to exert antidepressant effects has identified several effective components， such as saikosaponin B₂， luteolin， quercetin， gallic acid， catalpol， turmerone， oxypaeoniflorin， and traditional compound formulas such as Dihuang Yinzi and Xiaoyaosan， as well as acupuncture and moxibustion. These interventions have been shown to exert antidepressant effects by regulating ferroptosis， providing scientific evidence and references for further research into ferroptosis theory and its application in guiding the prevention and treatment of depression through TCM.

Renal fibrosis （RF）， characterized by glomerulosclerosis and tubulointerstitial fibrosis， is a central pathological process in chronic kidney disease （CKD）. The nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 （NLRP3） inflammasome is closely linked to the occurrence and progression of RF. This review systematically elucidates the mechanisms of the NLRP3 inflammasome in RF， and summarizes the current research on the inhibition of NLRP3 inflammasome activation by single Chinese herbs， active components of traditional Chinese medicine， Chinese herbal compounds， and Chinese patent medicines for the prevention and treatment of RF. The existing studies have demonstrated that single Chinese herbs （Campanumoea lancifolia， Dioscorea zingiberensis）， active components of traditional Chinese medicine （morroniside， liquiritigenin， rosmarinic acid， magnoflorine， fucoidan， etc.）， Chinese herbal compounds （Bushen huoxue formula， Tongluo yishen decoction， Shizhi formula， Bixie fenqing drink）， and Chinese patent medicine （Suyin jiedu granule） can inhibit the activation of the NLRP3 inflammasome to counteract inflammatory damage. This affects multiple pathways（NLRP3/caspase-1/ gasdermin D， NLRP3/interleukin-1β/Smad， etc.） and related upstream and downstream targets of its activation， effectively reducing pyroptosis， mitigating oxidative stress， promoting mitochondrial autophagy， inhibiting fibroblast activation， and reducing excessive extracellular matrix deposition， thereby exerting anti-RF effects.

This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans ; Nasal Cavity/surgery* ; Nasal Surgical Procedures ; China ; Consensus ; Sinusitis/surgery* ; Dermal Fillers

Objective Based on the endoplasmic reticulum stress(ERS)inositol-requiring enzyme-1α(IRE1α)/apoptosis signal-regulated kinase 1(ASK1)/c-Jun N-terminal kinase(JNK)pathway to investigate the intervention effect of Ziziphi Spinosae Semen(ZSS)-Albiziae Flos(AF)on the depression model of rats,which were prepared by solitary rearing combined with chronic unpredictable mild stress(CUMS).Methods A total of 144 rats were randomly divided into normal group,model group,high-,medium-and low-dose groups of ZSS-AF,and Venlafaxine group.In addition to the normal group,the rats in other groups were isolated for 21 days combined with CUMS to prepare the depression model.The behavioral changes of rats were observed by open field test and Morris water maze test.The ultrastructural changes of hippocampal neurons were observed by transmission electron microscope.TUNEL staining was used to observe the apoptosis of nerve cells in hippocampus.The protein expression levels of IRE1α,phosphorylated(P)-IRE1α,ASK1,P-ASK1,JNK,P-JNK,B cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax)and cysteme aspartate specific protease-3(Caspase-3)in hippocampus were detected by Western Blot.The mRNA expression levels of IRE1α,ASK1,JNK,Bax,Bcl-2 and Caspase-3 in hippocampus were detected by Real-Time PCR.Results Compared with the normal group,the scores of horizontal movement and vertical movement in the open field test of rats in the model group were decreased(P＜0.01).In the water maze test,the escape latency was increased and the number of crossing the original platform was decreased(P＜0.01).The number of hippocampal apoptosis was increased(P＜0.01).The protein expression levels of P-IRE1 α/IRE1 α,P-ASK1/ASK1,P-JNK/JNK,Bax,Caspase-3 and mRNA expressions of IRE1α,ASK1,JNK,Bax,Caspase-3 in hippocampus were increased,while the protein and mRNA expression levels of Bcl-2 were decreased(P＜0.01).Compared with model group,the scores of horizontal movement and vertical movement in the open field test of rats in each dose ZSS-AF groups and Venlafaxine group were increased(P＜0.01).In the water maze test,the escape latency was decreased and the times of crossing the original platform was increased(P＜0.01).The number of hippocampal apoptosis was decreased(P＜0.01).The mRNA expression levels of P-IRE1α/IRE1α,P-ASK1/ASK1,P-JNK/JNK,Bax,Caspase-3 protein and IRE1α,ASK1,JNK,Bax,Caspase-3 in hippocampus were decreased,while the protein and mRNA expression levels of Bcl-2 were increased(P＜0.05,P＜0.01).The effect of medium-dose ZSS-AF group was better than that of high-and low-dose groups.Conclusion ZSS-AF may play an antidepressant role by regulating IRE1α/ASK1/JNK pathway of endoplasmic reticulum stress.

Objective:To explore the clinical efficacy of immunoadsorption in highly sensitized kidney transplant (KT) candidates.Methods:From September 2019 to April 2023, the relevant clinical data were retrospectively reviewed for 26 highly sensitized KT recipients. Protein A immunoadsorption desensitization therapy was offered after KT. The effect of immunosorbent on reducing anti-human leukocyte antigen (HLA) antibodies was summarized. And operative success rate and postoperative complication incidence were calculated.Results:The mean number of treatment session was (10.76±5.53). The highest level of HLA-Ⅰ antibody mean fluorescence intensity (MFI) dropped from (17 921±4 442) to (7 333±6 434) with a decline of 59% and HLA-Ⅱ antibody MFI decreased from (21 135±5 245) to (10 989±7 627) with a decline of 48%. The differences were statistically significant (both P<0.001). All kidneys were harvested from cadavers. The complications were acute antibody mediated rejection (7 cases), perioperative pulmonary infection (3 cases) and myelosuppression (2 cases). The average follow-up period was (30.8±12.6) month. The graft survival rate was 88.5% (23/26) and the recipient survival rate 100% (26/26) . Conclusions:Immunoadsorption therapy can effectively reduce HLA antibody in highly sensitized KT candidates, thereby increasing the probability of successful KT. In terms of safety, immunosorbent therapy may boost the potential risks of infection and myelosuppression. It requires heightened attention.

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Co-delivery of chemotherapeutics and immunostimulant or chemoimmunotherapy is an emerging strategy in cancer therapy. The precise control of the targeting and release of agents is critical in this methodology. This article proposes the asynchronous release of the chemotherapeutic agents and immunostimulants to realize the synergistic effect between chemotherapy and immunotherapy. To obtain a proof-of-concept, a co-delivery system was prepared

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Atherosclerosis (AS) is a lipid-driven chronic inflammatory disease occurring at the arterial subendothelial space. Macrophages play a critical role in the initiation and development of AS. Herein, targeted codelivery of anti-miR 155 and anti-inflammatory baicalein is exploited to polarize macrophages toward M2 phenotype, inhibit inflammation and treat AS. The codelivery system consists of a carrier-free strategy (drug-delivering-drug, DDD), fabricated by loading anti-miR155 on baicalein nanocrystals, named as baicalein nanorods (BNRs), followed by sialic acid coating to target macrophages. The codelivery system, with a diameter of 150 nm, enables efficient intracellular delivery of anti-miR155 and polarizes M1 to M2, while markedly lowers the level of inflammatory factors and . In particular, intracellular fate assay reveals that the codelivery system allows for sustained drug release over time after internalization. Moreover, due to prolonged blood circulation and improved accumulation at the AS plaque, the codelivery system significantly alleviates AS in animal model by increasing the artery lumen diameter, reducing blood pressure, promoting M2 polarization, inhibiting secretion of inflammatory factors and decreasing blood lipids. Taken together, the codelivery could potentially be used to treat vascular inflammation.

Objective To evaluate the clinical application value of Xpert detection system of Clostridium difficile (C.difficile).Methods A total of 43 stool specimens from the patients with diarrhea were collected,and C.difficile in stool specimens were detected by the Xpert detection system,the toxigenic culture method,and the toxin detection method which detected the toxin of C.difficile by VⅥDAS automatic analyzer after anaerobic culture,respectively.The analytic performance of Xpert detection system was evaluted based on the toxigenic culture method as the gold standard.Meanwhile,the consistency of the results from different detection methods was compared.The ribotype 027 strain (ATCC BAA-1870) simulating the stool specimen was further used to verify the Xpert detection system.Results Based on the gold standard of the toxigenic culture method,the sensitivity,specificity,positive predictive value and negative predictive value of the Xpert detection system were 90.9％,93.8％,83.3％ and 96.8％,respectively.The Kappa values for the consistency between the Xpert detection system and the toxigenic culture method or the toxin detection method were 0.822 (P ＜ 0.05) and 0.419 (P ＜ 0.05),respectively.Moreover,the ribotype 027 strain simulating the stool specimen was verified by the Xpert detection system successfully.Conclusion The Xpert detection system may rapidly and accurately detect the C.difficile in stool specimens,especially the ribotype 027 strain with high toxicity.