Depression is a high-incidence mental disorder with complex causes and multifaceted pathogenic mechanisms. Its pathogenesis has not yet been fully elucidated， which has hindered the development of novel and highly effective antidepressant drugs. This condition severely affects human physical and mental health while imposing a significant socio-economic burden. At present， several hypotheses exist regarding the pathogenesis of depression， including monoamine neurotransmitter imbalances， neurotrophic factor deficiencies， neural plasticity impairments， glutamate dysregulation， neuroinflammatory disorders， gut microbiota imbalances， and mitochondrial autophagy dysfunction. Currently， most clinical antidepressants are monoamine neurotransmitter reuptake inhibitors. Although they exhibit certain therapeutic effects， they are associated with significant drawbacks， such as severe adverse reactions and poor patient compliance. In contrast， traditional Chinese medicine （TCM）， characterized by its multi-targeted effects， mild efficacy， and minimal side effects， has demonstrated significant advantages in the treatment of depression. Chinese medicine Polygalae Radix possesses the functions of calming the mind， enhancing cognitive functions， harmonizing the heart and kidneys， and dispelling phlegm to open orifices. It is often included in compound prescriptions for the clinical treatment of depression. Based on current hypotheses regarding the pathogenesis of depression， this paper systematically reviews research progress on the antidepressant mechanisms of Polygalae Radix from multiple perspectives， including its active components， its use in herbal pairings， and its inclusion in TCM compound prescriptions. This review aims to provide a scientific basis for the clinical application of Polygalae Radix in antidepressant therapy and to serve as a reference for the modernization of its antidepressant research.

BACKGROUND: Spicy food consumption has been reported to be inversely associated with mortality from multiple diseases. However, the effect of spicy food intake on the incidence of vascular diseases in the Chinese population remains unclear. This study was conducted to explore this association. METHODS: This study was performed using the large-scale China Kadoorie Biobank (CKB) prospective cohort of 486,335 participants. The primary outcomes were vascular disease, ischemic heart disease (IHD), major coronary events (MCEs), cerebrovascular disease, stroke, and non-stroke cerebrovascular disease. A Cox proportional hazards regression model was used to assess the association between spicy food consumption and incident vascular diseases. Subgroup analysis was also performed to evaluate the heterogeneity of the association between spicy food consumption and the risk of vascular disease stratified by several basic characteristics. In addition, the joint effects of spicy food consumption and the healthy lifestyle score on the risk of vascular disease were also evaluated, and sensitivity analyses were performed to assess the reliability of the association results. RESULTS: During a median follow-up time of 12.1 years, a total of 136,125 patients with vascular disease, 46,689 patients with IHD, 10,097 patients with MCEs, 80,114 patients with cerebrovascular disease, 56,726 patients with stroke, and 40,098 patients with non-stroke cerebrovascular disease were identified. Participants who consumed spicy food 1-2 days/week (hazard ratio [HR] = 0.95, 95% confidence interval [95% CI] = [0.93, 0.97], P <0.001), 3-5 days/week (HR = 0.96, 95% CI = [0.94, 0.99], P = 0.003), and 6-7 days/week (HR = 0.97, 95% CI = [0.95, 0.99], P = 0.002) had a significantly lower risk of vascular disease than those who consumed spicy food less than once a week ( Ptrend <0.001), especially in those who were younger and living in rural areas. Notably, the disease-based subgroup analysis indicated that the inverse associations remained in IHD ( Ptrend = 0.011) and MCEs ( Ptrend = 0.002) risk. Intriguingly, there was an interaction effect between spicy food consumption and the healthy lifestyle score on the risk of IHD ( Pinteraction = 0.037). CONCLUSIONS Our findings support an inverse association between spicy food consumption and vascular disease in the Chinese population, which may provide additional dietary guidance for the prevention of vascular diseases.
Humans ; Male ; Female ; Prospective Studies ; Middle Aged ; Aged ; Vascular Diseases/etiology* ; Risk Factors ; China/epidemiology* ; Adult ; Proportional Hazards Models ; Cerebrovascular Disorders/epidemiology* ; East Asian People

Mitral valve replacement is one of the most common heart valve surgeries in China. In recent years, with the increase in degenerative valve diseases, older patients, and the progress of anti-calcification technology of biological valves, the proportion of mitral valve biological valve replacement has been increasing year by year. After the damage of traditional mitral valve biological valves, re-operation of valve replacement with thoracotomy is required. However, the adhesion between the heart and sternum, as well as the damage caused by cardiopulmonary bypass and cardiac arrest, can cause significant trauma to elderly patients and those with multiple organ dysfunction, leading to increased mortality and complication rates. In recent years, interventional valve surgery, especially transcatheter valve-in-valve surgery, has developed rapidly. This procedure can correct the damaged mitral valve function without stopping the heart, but there are still many differences between its technical process and conventional aortic valve replacement surgery. Therefore, organizing and writing multicenter expert recommendations on the technical process of transcatheter valve-in-valve surgery for damaged mitral valve biological valves is of great significance for the training and promotion of this technology.

Objective:To explore the efficiency of radial collateral artery perforator flap to reconstruct defects of thumb web contracture release.Methods:The data of patients with moderate to severe thumb web contracture treated with radial collateral artery perforator flap from September 2018 to September 2022 in Department of Orthopedics-Hand Microsurgery of Xiangya Hospital, Central South University were analyzed retrospectively. A skin flap with the radial collateral artery perforating point as the center and the line connecting the deltoid muscle insertion point and the apex of the humeral lateral condyle as the axis were designed before surgery. During the operation, the skin scar in the thumb web area was first removed, and the contracted tissues such as deep fascia and muscles were loosened. Then, a skin flap was harvested along the design line and transferred to the recipient site. After vascular and nerve anastomosis under a microscope, the incision was intermittently sutured and a drainage tube was placed. The blood flow of the flap and complication were monitored closely. In the last follow-up, the distance and angle of thumb web were observed; the appearance, sensory recovery (excellent, good, moderate, and poor) and the hand function (S0 level to S4 level represented feeling no recovery to complete recovery) were evaluated.Results:A total of 8 patients were included, including 7 males and 1 female, aged 23-56 years (average of 40.3 years old). The distance of thumb web was 20-38 mm (average 26.9 mm), and the angle was 22°-36° (average 27.4°) before surgery. Five hands were classified as severe thumb web contracture, and 3 hands were moderate. The sizes of perforator flap were from 5.5 cm×3.5 cm-13.0 cm×6.5 cm. Seven flaps survived uneventfully and venous congestion occurred in 1 flap. After exploration, the flap survived completely. Primary healing of wounds occurred in the donor and recipient areas. Postoperative follow-up ranged from 6 months to 2.5 years (average 13.6 months). In the last follow-up, the distance of thumb web was 48-63 mm (average 57.1 mm), and the angle was 40°-52° (average 44.8°) post-operation. Thumb web function evaluation: excellent in 5 cases and good in 3 cases. All patients were satisfied with the thumb web. Sensory recovered to S3 in 3 cases, S2 in 4 cases and S1 in 1 case. The donor site healed well, leaving scars. There was no radial nerve damage, and elbow joint movement was normal.Conclusion:The radial collateral artery perforator flap has reliable blood supply, relatively simple operation and the appearance and function of thumb web restored well postoperatively. The application of radial collateral artery perforator flap is an effective procedure to repair the thumb web contracture.

Objective In order to address the issues of inconvenience,high medical costs,and lack of universality associated with traditional knee rehabilitation equipment,a portable intelligent wheelchair for knee rehabilitation was designed in this study.Methods Based on the analysis of the knee joint's structure and rehabilitation mechanisms,an electric pushrod-driven rehabilitation institution was developed.A multi-functional module was designed with a modular approach,and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer.A three-dimensional model was established using SolidWorks software.In conjunction with Adams and Ansys simulation software,kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components.A prototype was constructed to verify the equipment's actual performance.Results According to the prototype testing,the actual range of motion for the knee joint swing rod is 15.1°～88.9°,the angular speed of the swing rod ranges from-7.9 to 8.1°/s,the angular acceleration of the swing rod varies from-4.2 to 1.6°/s2,the thrust range of the electric pushrod is-82.6 to 153.1 N,and the maximum displacement of the load pedal is approximately 1.7 mm,with the leg support exhibiting a maximum deformation of about 1.5 mm.Conclusion The intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria,thus validating the rationality and feasibility of the structural design.

Objective To observe the value of clinical and CT radiomics features for predicting microsatellite instability-high(MSI-H)status of gastric cancer.Methods Totally 150 gastric cancer patients including 30 cases of MSI-H positive and 120 cases of MSI-H negative were enrolled and divided into training set(n=105)or validation set(n=45)at the ratio of 7∶3.Based on abdominal vein phase enhanced CT images,lesions radiomics features were extracted and screened,and radiomics scores(Radscore)was calculated.Clinical data and Radscores were compared between MSI-H positive and negative patients in training set and validation set.Based on clinical factors and Radscores being significant different between MSI-H positive and negative ones,clinical model,CT radiomics model and clinical-CT radiomics combination model were constructed,and their predictive value for MSI-H status of gastric cancer were observed.Results Significant differences of tumor location and Radscore were found between MSI-H positive and negative patients in both training and validation sets(all P＜0.05).The area under the curve(AUC)of clinical model,CT radiomics model and combination model for evaluating MSI-H status of gastric cancer in training set was 0.760,0.799 and 0.864,respectively,of that in validation set was 0.735,0.812 and 0.849,respectively.AUC of clinical-CT radiomics combination model was greater than that of the other 2 single models(all P＜0.05).Conclusion Clinical-CT radiomics combination model based on tumor location and Radscore could effectively predict MSI-H status of gastric cancer.

Objective:To compare the testing effects of different testing methods in the functional inspection of precision surgical scissors and needle holders.Methods:By consulting relevant literature and professional books,three testing methods and materials for precision surgical scissors and needle holders were selected.The cutting performance of the precision surgical scissors were tested by gauze cloth,cotton wool,and silicone film method in the Interlock surgical instrument testing set.The clamping performance of precision needle holder was tested by using light,needle clips,and thread clamping method in the Interlock surgical instrument testing set.100 pieces of precision surgical scissors and needle holders which were qualified for cleaning and disinfection in the hospital were selected for effectiveness testing,and a self-made satisfaction questionnaire to investigate the satisfaction of surgeons with the use of instruments.Results:After 100 precision surgical scissors tested using three methods of gauze,cotton wool,and silicone film,the qualified number of cutting performance was 94,76,and 58,respectively,the difference was statistically significant(x2=36.526,P<0.05).The satisfaction rate of surgeons with the use of precision surgical scissors passed the silicone film test was the highest at 100%,followed by cotton wool cloth at 82.0%,and the gauze method at the worst at 67.0%,the difference was statistically significant(x2=48.439,P<0.05).After 100 precision needle holders were tested by using three methods of light irradiation,needle clamping,and wire clamping,the qualified number of clamping performance was 96,78,and 62,respectively,the difference was statistically significant(x2=38.160,P<0.05).The satisfaction rate of surgeons with the precision needle holders passed the clamp line test was the highest at 100.0%,followed by the clamp needle at 79.0%,and the worst under light at 62.0%,the difference was statistically significant(x2=57.705,P<0.05).Conclusion:The function and quality of precision surgical scissors and needle holders tested by the test objects in Interlock Surgical Instrument Test Suite can objectively and accurately reflect the functional status of surgical scissors and needle holders,provide reference for regular maintenance and upkeep of instruments,and ensure safe use of instruments.

Objective:To explore the efficiency of radial collateral artery perforator flap to reconstruct defects of thumb web contracture release.Methods:The data of patients with moderate to severe thumb web contracture treated with radial collateral artery perforator flap from September 2018 to September 2022 in Department of Orthopedics-Hand Microsurgery of Xiangya Hospital, Central South University were analyzed retrospectively. A skin flap with the radial collateral artery perforating point as the center and the line connecting the deltoid muscle insertion point and the apex of the humeral lateral condyle as the axis were designed before surgery. During the operation, the skin scar in the thumb web area was first removed, and the contracted tissues such as deep fascia and muscles were loosened. Then, a skin flap was harvested along the design line and transferred to the recipient site. After vascular and nerve anastomosis under a microscope, the incision was intermittently sutured and a drainage tube was placed. The blood flow of the flap and complication were monitored closely. In the last follow-up, the distance and angle of thumb web were observed; the appearance, sensory recovery (excellent, good, moderate, and poor) and the hand function (S0 level to S4 level represented feeling no recovery to complete recovery) were evaluated.Results:A total of 8 patients were included, including 7 males and 1 female, aged 23-56 years (average of 40.3 years old). The distance of thumb web was 20-38 mm (average 26.9 mm), and the angle was 22°-36° (average 27.4°) before surgery. Five hands were classified as severe thumb web contracture, and 3 hands were moderate. The sizes of perforator flap were from 5.5 cm×3.5 cm-13.0 cm×6.5 cm. Seven flaps survived uneventfully and venous congestion occurred in 1 flap. After exploration, the flap survived completely. Primary healing of wounds occurred in the donor and recipient areas. Postoperative follow-up ranged from 6 months to 2.5 years (average 13.6 months). In the last follow-up, the distance of thumb web was 48-63 mm (average 57.1 mm), and the angle was 40°-52° (average 44.8°) post-operation. Thumb web function evaluation: excellent in 5 cases and good in 3 cases. All patients were satisfied with the thumb web. Sensory recovered to S3 in 3 cases, S2 in 4 cases and S1 in 1 case. The donor site healed well, leaving scars. There was no radial nerve damage, and elbow joint movement was normal.Conclusion:The radial collateral artery perforator flap has reliable blood supply, relatively simple operation and the appearance and function of thumb web restored well postoperatively. The application of radial collateral artery perforator flap is an effective procedure to repair the thumb web contracture.

Objective:To explore the application effect of ultrasound evaluation of atelectasis in general anesthesia.Methods:Eighty patients who underwent general anesthesia surgery at the Second Affiliated Hospital of Wannan Medical College from January 2019 to December 2020 were selected as the study subjects. The gold standard was chest CT diagnosis of perioperative atelectasis, and they were divided into atelectasis group (39 cases) and control group (41 cases). Twelve regional images, including left upper anterior chest, left lower anterior chest, right upper anterior chest, right lower anterior chest, left upper chest, left lower chest, right upper chest, right upper chest, right lower chest, right upper chest, right lower chest, right upper chest, right lower chest, right lower chest, right lower chest, left upper chest, right lower chest, left upper chest, right lower chest, left upper posterior region, left lower chest, left lower posterior region, left lower posterior region, right upper posterior region, and right lower posterior region, were collected by pulmonary ultrasound (LUS) at time points T 1 after entering the room, 30 minutes after tracheal intubation (T 2), 30 minutes after extubation (T 3), 24 hours after surgery (T 4), and 48 hours after surgery (T 5), And an improved semi quantitative scoring method for evaluating lung ventilation was used to compare the LUS scores of the two groups at 5 time points. Results:There was no statistically significant difference in LUS scores between the two groups of patients in different lung zones at T 1 (all P>0.05); There are varying degrees of differences in LUS scores for the same lung partition at different times (all P<0.05). There was no statistically significant difference in LUS scores between T 2 and T 5 for left upper anterior chest, left lower anterior chest, right upper anterior chest, left upper chest, right upper chest, left upper posterior region, and right upper posterior region (all P>0.05); The LUS scores of the T 2-T 5 atelectasis group in the lower left chest, lower right chest, lower left posterior area, and lower right posterior area were higher than those of the control group (all P<0.05). Conclusions:LUS can be used to evaluate atelectasis during general anesthesia and has broad clinical application and promotion value.

Objective:To explore the feasibility for reconstruction of soft tissue defects in limbs and trunk with perforator pedicled kite flap, and to summarise its clinical efficacy.Methods:A retrospective study was conducted on 14 patients with soft tissue defects and admitted to the Department of Hand Microsurgery of Xiangya Hospital, Central South University from January 2016 to September 2023. Among the 14 patients (6 males and 8 females), 7 had defects in calf, 2 in sacrococcygeal area, 2 in the back and 3 in forearm. All of the defects were reconstructed with the perforator pedicled kite flaps, of which 6 flaps had the pedicles of single perforator, 3 of 2 perforators, 4 of 3 perforators and 1 of 5 perforators. Single V-Y advancement flaps were used for defect reconstruction in 8 patients, and double V-Y advancement flaps were used in 6 patients. The size of the defects ranged from 2.2 cm×1.8 cm to 8.0 cm×16.0 cm, and the size of the flaps ranged from 3.0 cm×5.5 cm to 9.0 cm×23.0 cm. All donor sites were closed directly. Postoperative follow-up was conducted at outpatient clinic, by telephone reviews and WeChat after surgery, to observe the flap survival and postoperative complications.Results:All flaps survived completely. All the flaps and donor sites healed primarily. The postoperative follow-up lasted for 3 to 36 (mean, 14.5) months. Thirteen flaps presented with soft texture, good appearance, with similar texture to the surrounding skin and without obvious swelling. The patients were satisfied with the aesthetic outcomes. One patient had a local ulcer with exudation at the recipient site and the ulcer healed after removal of the steel plate and thoroughly debridement.Conclusion:With a perforator pedicled kite flap, vascular anastomosis or sacrifice of a second donor site can be avoided. A perforator pedicled kite flap can be applied to many recipient sites, with a simple surgical procedure and a good postoperative appearance. It is an ideal flap for reconstruction of small to medium-sized soft tissue defects in trunk and limbs. More studies are required to evaluate the feasibility of the flap to be applied in local hospitals.