ObjectiveTo explore the mechanism of herb-partitioned moxibustion at umbilicus in treating primarydysmenorrhea based on metabonomics.MethodTwenty patients with primary dysmenorrhea were randomized into two groups to respectively receive herb-partitioned moxibustion at umbilicus and moxa-stick moxibustion at umbilicus. After treatment for 3 menstrualcycles, Visual Analogue Scale (VAS) was used to evaluate abdominal pain, and LC-MS-based metabonomics analysis was adopted to detect the change of plasma metabolites.ResultAfter intervention, the VAS scores decreased with the menstrual cycles in both groups. The decrease of VAS score in herb-partitioned moxibustion group was more significant than that in moxa-stick moxibustion group (P<0.05); herb-partitioned moxibustion at umbilicus up-regulated the contents of 20α-dihydroprogesterone, pregnenolone, prostaglandin E2and?-propalanine, and down-regulated the contents of estrone and prostaglandin H2in plasma; moxa-stick moxibustion decreased the content of 5’-pyridoxal phosphate.ConclusionThe two methods both can improve abdominal pain in primary dysmenorrhea, while herb-partitioned moxibustion can produce a more significant efficacy than moxa-stick moxibustion, and its effect is possibly realized via regulating estrone, progesterone, and prostaglandin.

Objective To assess intraplaque hemorrhage before carotid artery stenting (CAS)by use of 3D-MPRAGE and DWI sequence.Methods Thirty-two symptomatic patients who had carotid artery plaque suspected by color Doppler ultrasonography and prepared for CAS underwent 3.0T carotid high-resolution MR scans,including regular sequence,T1-weighted gradient echo three-di-mensional magnetization prepared (3D-MPRAGE ) sequence,diffusion-weighted imaging (DWI ) sequences.According to 3D-MPRAGE sequence hemorrhage and non-hemorrhage groups were divided,and measured the mean ADC values of the two groups, hemorrhage and non-hemorrhage part in the hemorrhage group.Meanwhile preoperative cerebral hemorrhage group underwent brain DWI scans.Independent samples t-test analysis was utilized by SPSS V20.0 statistical software.Results High-resolution MRI dis-played 40 plaques,fourteen hemorrhagic plaques showed by 3D-MPRAGE sequence.The mean ADC values of hemorrhage and no-hemorrhage group were(1 233.5±283.5)× 10 -6 mm2/s,(1 688.9 ± 449.6)× 10 -6 mm2/s respectively,the difference of both was significant (t=3.43,P <0.05).The mean ADC values of hemorrhage and non-hemorrhage parts in the hemorrhage group mean ADC values were (934.0 ± 387.9)× 10-6 mm2/s,(1 313.9 ± 295.0)× 10-6 mm2/s respectively;the difference of both was statistically significant (t=2.92,P < 0.05 ).The difference of mean ADC values between non-hemorrhage part in the hemorrhage group and hemorrhage group was statistically significant (t=2.80,P <0.05).Conclusion 3D-MPRAGE and DWI sequences can be evaluated intraplaque hemorrhage before CAS,and provided a reliable basis for timely clinical interventions to prevent stroke.

In traditional Chinese medicine,Lonicerae Japonicae Flos is commonly used as anti-inflammatory,antiviral,and antipyretic herbal medicine,and geo-authentic herbs are believed to present the highest quality among all samples from different regions.To discuss the current situation and trend of geo-authentic Lonicerae Japonicae Flos,we searched Chinese Biomedicine Literature Database,Chinese Journal Full-text Database,Chinese Scientific Journal Full-text Database,Cochrane Central Register of Controlled Trials,Wanfang,and PubMed.We investigated all studies up to November 2015 pertaining to quality assessment,discrimination,pharmacological effects,planting or processing,or ecological system of geo-authentic Lonicerae Japonicae Flos.Sixty-five studies mainly discussing about chemical fingerprint,component analysis,planting and processing,discrimination between varieties,ecological system,pharmacological effects,and safety were systematically reviewed.By analyzing these studies,we found that the key points of geo-authentic Lonicerae Japonicae Flos research were quality and application.Further studies should focus on improving the quality by selecting the more superior of all varieties and evaluating clinical effectiveness.

Objective To evaluate the effect of hypoxic-ischemic time on reduction of hypoxic-ischemic brain injury by sevoflurane postconditioning in neonatal rats.Methods Two hundred and ten 7-day-old Sprague-Dawley rats (105 male,105 female),weighing 13-17 g,were randomly divided into 7groups (n=30 each) using a random number table:sham operation group (group Sham),hypoxia-ischemia group (group HI),and sevoflurane postconditioning at different hypoxic-ischemic time point groups (P0,P3,P6,P 12 and P24 groups).Immediately after ligation of the left common carotid artery,and at 3,6,12 and 24 h after ligation,the rats inhaled the mixed gas containing 2％ sevoflurane for 30 min in P0,P3,P6,P13 and P24 groups,respectively.The fatality was recorded within 7 days after establishment of the model.At 7 days after establishment of the model,the rats were sacrificed,the brains were removed,and the right and left cerebral hemispheres were weighed separately,and the left/right cerebral hemisphere weight ratio was calculated.The hippocampal CA1 region and posterior cingulate gyrus were isolated,and the ratio of density of normal neurons in the left to the right was calculated.Results Compared with group Sham,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly decreased,and the fatality rate was increased in the other six groups (P＜0.05).Compared with group HI,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal ncurons were significantly increased in P0,P3 and P6 groups (P＜0.05),and no significant change was found in the parameters mentioned above in P12 and P24 groups (P＞0.05).Compared with group P6,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly increased in P0 and P3 groups (P＜ 0.05).There was no significant difference in the parameters mentioned above between group P0 and group P3 (P＞0.05).Conclusion Sevoflurane postconditioning performed within 6 h of hypoxia-ischemia can reduce hypoxic-ischemic brain injury,and it provides no cerebral protection if exceeding 12 h.

Objective To investigate the value of magnetic resonance (MR)diffusion kurtosis imaging (DKI)in diagnostic classi-fication of astrocytic tumors.Methods 31 patients with astrocytic tumors confirmed by operation and pathology were collected,in-cluding low-grade tumors (WHO gradeⅠ and Ⅱ)in 14 and high-grade ones (WHO grade Ⅲ and Ⅳ)in 1 7.Routine MRI and DKI scan were preoperatively conducted using Siemens 3.0T MR scanner.Mean kurtosis (MK),radial kurtosis (RK)and axial kurtosis (AK)values were calculated in the solid portion of the tumors and the contralateral normal white matter.Results The MK,RK and AK values in tumors were lower than those in contralateral normal white matter,and were significantly higher in high-grade tumors than those in low-grade ones (P <0.05).Conclusion The MK,RK and AK values obtained by DKI reflect the histological structure changes of the astrocytic tumors.DKI is helpful for the diagnostic classification of astrocytic tumors,exhibiting more value in optimi-zing the treatment.

Objective To investigate the value of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) based on ISHIM sequence in the grading of astrocytic tumor.Methods We collected excised tumors confirmed by histological diagnosis from 42 patients including high-grade astrocytic tumors (10 WHO grade Ⅲ,18 WHO grade Ⅳ),and 14 low-grade astrocytic tumors (1 WHO grade Ⅰ and 13 WHO grade Ⅱ).All patients underwent conventional MR imaging,ISHIM IVIM-DWI,and contrast-enhanced MR imaging.Parameters of tumor parenchyma region,peripheral edema regions and the contralateral normal brain white matter sites were measured,and the statistical analysis was conducted.Results The D value in tumor parenchyma region was significantly lower,but the D* and f values were higher in high-grade astrocytic tumor when compared with lowgrade one and all had statistical significance;in tumor peripheral edema region,D value was lower in high-grade astrocytic tumor than that in low-grade one,and the difference had statistical significance but there was no significant difference in terms of the D* and f values.There was no significant difference of the D,D* and f values in contralateral normal brain white matter sites in both high-and low-grade astrocytic tumor.Conclusion The D,D* and f values measured by ISHIM IVIM-DWI are helpful to the judgment of tumor grade and it has greatapplication value in the differential diagnosis of high-and low-grade astrocytic tumor.

Objective: To assess the efficacy and safety of combining traditional Chinese medicine (TCM), specifically Chinese herbal medicine (CHM), with Western medicine (WM), compared to WM alone to treat breast cancer endocrine therapy-related osteoporosis (BCET-OP) by meta-analysis. Methods: Thirty-eight randomized controlled trials involving 2170 participants were analyzed. Eight databases were searched for articles published between inception and December 2023. Quality assessment was performed using the Risk of Bias 2 tool. Results: Significant increases were observed in the TCM-WM group in lumbar vertebrae bone mineral density (BMD) (P < .001, mean difference (MD) = 0.07, 95% confidence interval (CI): 0.06 to 0.08), lumbar vertebrae T-score (P = .0005, MD = 0.21, 95%CI: 0.09 to 0.33) and collum femoris BMD (P = .01, MD = 0.10, 95%CI: 0.02 to 0.19). No significant difference was observed between the groups in the collum femoris T-score and estradiol levels. Bone gla-protein levels were significantly increased in the TCM-WM group (P = .0002, MD = 0.52, 95%CI: 0.25 to 0.79). Beta-CrossLaps decreased significantly in the TCM-WM group (P = .0008, MD = −0.10, 95%CI: −0.16 to −0.04). No significant difference was observed between the TCM-WM and WM groups in alkaline phosphatase, in procollagen type I N-terminal propeptide, and in the Kupperman index. The visual analog score (VAS) was decreased in the TCM-WM group compared to the WM group (P < .001, MD = −1.40, 95%CI: −1.94 to −0.87). No significant difference in adverse events was observed between the two groups. Conclusion Combining CHM with WM in patients with BCET-OP significantly improved BMD, T-score, and certain bone turnover markers and reduced the VAS score, indicating potential benefits for bone health and related pain. Adverse event analysis revealed no differences between the groups, supporting the feasibility of the combination therapy. However, further research, particularly in diverse populations, is required.

Psychogenic non-epilepsy seizures (PNES) are defined as paroxysms with clinical symptoms similar to epilepsy without epileptiform discharges. It is often misdiagnosed as epilepsy. Misdiagnosis not only delays the time for patients with PNES to get correct diagnoses and treatments, but also may increase the risk of adverse effects from improper use of antiseizure medications. The diagnostic method of PNES is video electroencephalogram monitoring, but there is no consensus on the optimal duration of monitoring. At the same time, the use of diverse physiological signals, brain imaging, laboratory examination, and the application of machine learning provide new perceptions for the precise identification of PNES and epilepsy. This article reviewed the progress of precise differential diagnosis between PNES and epilepsy.

Glioma is one of the most common primary intracranial tumors, accounting for 80% of malignant brain tumors. The conventional treatment of glioma is surgical resection followed by temozolomide chemotherapy, but the drug resistance will gradually appear that results in a poor prognosis of the patient. Berberine is an alkaloid extracted from Coptis Rhizoma, which has a wide range of pharmacological activities. It exerts its pharmacological effects on glioma such as inhibiting tumor growth through controlling different molecular and cellular pathways. In this article, the application of berberine in the treatment of glioma and the research progress of specific molecular mechanism are reviewed.

Patients with primary membranous nephropathy(PMN)tend to develop thrombosis,especially in the early phase of the disease.The pathogenesis of thrombosis is multifactorial,with hypoalbuminemia being widely regarded as an inde-pendent risk factor.Other factors include proteinuria,M-type phospholipase A2 receptor antibody,and D-dimer.Although prophy-lactic anticoagulation therapy is frequently used in clinical practice to prevent thrombosis in PMN patients,there are still many un-resolved issues regarding the optimal prevention of thrombosis in this condition.The timing of prophylactic anticoagulation,the threshold of serum albumin level,and the choice of treatment regimen are still lacking consensus.This article reviewed the relevant literature on these topics,aiming to establish a standard for thrombosis prevention and treatment for this population in the future and provide guidance for clinical practice.