Perimenopausal depression （PMD） is an affective disorder that occurs in women during the transition from sexual maturity to old age. It can induce various complications， such as insomnia and cognitive decline. The etiology of PMD is complex. Although multiple hypotheses have been proposed， there is still no unified theory that fully explains its pathogenesis. Research into its mechanisms relies heavily on animal experiments， and establishing reliable animal models is crucial for experimental studies. Appropriate animal models can better simulate human pathophysiological states， rapidly evaluate the efficacy and safety of drugs and intervention methods， grasp the essence of the disease， and uncover its intrinsic connections， thereby exploring more advanced intervention strategies. However， there is a lack of systematic review and summarization of literature related to model construction. Additionally， traditional Chinese medicine （TCM）， adhering to the principles of ''syndrome differentiation and treatment'' and ''holistic concept''， has shown significant efficacy in treating PMD. In recent years， research exploring and analyzing its therapeutic mechanisms has been increasing. Therefore， to gain a clearer and more comprehensive understanding of PMD animal modeling methods and the mechanisms of TCM， this paper reviewed Chinese and English literature on PMD animal models and mechanisms of TCM in PMD treatment. It summarized the construction methods of single-factor and multi-factor PMD models， and discussed the advantages and disadvantages of each modeling approach. Furthermore， it delved into the mechanisms of TCM intervention in PMD， revealing that TCM formulas primarily exert their effects by regulating the hypothalamic-pituitary-adrenal axis， hypothalamic-pituitary-ovarian axis， gut-brain axis， cell signaling pathways， neural circuits， hormone levels， and neurotransmitter levels. This review aims to provide a reference for future research in this field. In summary， by summarizing the progress in the methods for PMD animal model construction and the mechanisms of TCM， the paper seeks to offer new insights into the mechanistic research of TCM intervention in PMD.

Objective To explore the feasibility and reference value of allogeneic lung transplantation and postoperative monitoring in miniature pigs for lung transplantation research. Methods Two miniature pigs (R1 and R2) underwent left lung allogeneic transplantation. Complement-dependent cytotoxicity tests and blood cross-matching were performed before surgery. The main operative times and partial pressure of arterial oxygen (PaO₂) after opening the pulmonary artery were recorded during surgery. Postoperatively, routine blood tests, biochemical blood indicators and inflammatory factors were detected, and pathological examinations of multiple organs were conducted. Results The complement-dependent cytotoxicity test showed that the survival rate of lymphocytes between donors and recipients was 42.5%-47.3%, and no agglutination reaction occurred in the cross-matching. The first warm ischemia times of D1 and D2 were 17 min and 10 min, respectively, and the cold ischemia times were 246 min and 216 min, respectively. Ultimately, R1 and R2 survived for 1.5 h and 104 h, respectively. Postoperatively, in R1, albumin (ALB) and globulin (GLB) decreased, and alanine aminotransferase increased; in R2, ALB, GLB and aspartate aminotransferase all increased. Urea nitrogen and serum creatinine increased in both recipients. Pathological results showed that in R1, the transplanted lung had partial consolidation with inflammatory cell infiltration, and multiple organs were congested and damaged. In R2, the transplanted lung had severe necrosis with fibrosis, and multiple organs had mild to moderate damage. The expression levels of interleukin-1β and interleukin-6 increased in the transplanted lungs. Conclusions The allogeneic lung transplantation model in miniature pigs may systematically evaluate immunological compatibility, intraoperative function and postoperative organ damage. The data obtained may provide technical references for subsequent lung transplantation research.

Diabetic macular edema(DME), a serious complication of diabetic retinopathy(DR), is a chronic condition caused by multiple factors. Throughout its progression, inflammatory factors and vascular endothelial growth factor(VEGF)play a critical role. Anti-VEGF drugs have shown significant effectiveness in the treatment of DME; however, some patients may experience persistent DME after injection or require frequent injections. Dexamethasone intravitreal implants(DEX implants)serve as a sustained-release implant characterized by a reasonable release profile and high bioavailability. They offer safe, effective, and prolonged anti-inflammatory effects, aiding in the repair of retinal barrier and reduction of exudation. To further enhance patients' visual quality, exploring the efficacy of DEX implants in combination with existing treatment regimens has great clinical significance. This review primarily discusses the research advancements in DEX implants, focusing on their pharmacological properties, indications for use, and their combination with existing drugs and treatment methods. It also evaluates the advantages and disadvantages of combination therapy or switching to DEX implants compared to current standard treatments, aiming to provide guidance for personalized treatment options for patients with DME.

ObjectiveTo explore the effect of modified Ditan Decoction （涤痰汤） on chronic intermittent hypoxia cognitive function and the potential function mechanism. MethodsTwenty-four Sprague-Dawley （SD） rats were randomly divided into a normal group， a model group， and a modified Ditan Decoction group， with eight rats in each group. Rats in the modified Ditan Decoction group were administered the decoction by gavage at 14.8 ml/（kg·d）， while the normal group and the model group received the same dose of normal saline. Thirty minutes after daily gavage， the rats in all three groups were placed in an intermittent hypoxia chamber. The oxygen concentration for the model group and the modified Ditan Decoction group was adjusted daily for 8 hours using a computer program to establish the model， while the normal group was exposed to the same airflow rate of ambient air. The intervention was continued for 12 weeks to establish a chronic intermittent hypoxia rat model. The Y-maze test was used to evaluate spatial working memory in the rats. Resting-state functional magnetic resonance imaging （rs-fMRI） was performed to detect whole-brain regional homogeneity （ReHo） and seed-based functional connectivity （FC）. Brain regions showing significant differences in rs-fMRI were selected for further analysis. Immunofluorescence was used to detect β-amyloid （Aβ） deposition and the number of ionized calcium-binding adapter molecule 1 （IBA1）-positive microglial cells. Immunohistochemistry was employed to assess the expression of synaptophysin （SYP）， the excitatory synapse marker vesicular glutamate transporter 1 （Vglut1）， and the inhibitory synapse marker vesicular γ-aminobutyric acid transporter （VGAT）. ResultsCompared with the normal group， the model group showed a reduced spontaneous alternation rate in the Y-maze test. The smoothed Z-score standardized regional homogeneity （SzReHo） value in the left entorhinal cortex significantly increased， and the FC value from this seed point to the left basal forebrain significantly reduced. Additionally， the model group exhibited significantly higher Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， decreased expression of SYP， Vglut1， and VGAT， along with an increased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. Compared to the model group， the modified Ditan Decoction group demonstrated an increased spontaneous alternation rate， a significantly reduced SzReHo value in the left entorhinal cortex， and a significantly increased FC value from this region to the left basal forebrain. Furthermore， this group showed significantly lower Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， increased levels of SYP， Vglut1， and VGAT， and a decreased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. ConclusionModified Ditan Decoction can reconstruct the projection from the left basal forebrain to the entorhinal cortex in chronic intermittent hypoxia， thereby reducing Aβ aggregation and excessive microglial activation in the left entorhinal cortex. This process improves the excitation/inhibition imbalance caused by synaptic remodeling， ultimately enhancing cognitive function in rats of chronic intermittent hypoxia.

Objective To study the effect and molecular mechanism of vitamin D(VitD)on Tfh cells of MRL/lpr lupus mice.Methods C57/B6 mice and MRL/lpr lupus mice were transfected with siRNA to construct VDR knockout mouse models.Splenic Tfh cells of C57/B6 mice and MRL/lpr lupus mice were divided into control group,lupus group and VDRsiRNA lupus group(treated with vitamin D 0,1 and 10 nmol·L-1,respectively)by siRNA transfection.The percentage of Tfh cells was detected by flow cytometry.MRL/lpr lupus mice Peyer node Tfh cells were randomly divided into 7 groups,blank control group,vitamin D dose groups of 1 and 10 nmol·L-1,paricalcitol group(VitD 10 nmol·L-1+PA),VDRsiRNA control group,VDRsiRNA group(VitD 10 nmol·L-1),CaN inhibitor group(VitD 10 nmol·L-1+CsA),and incubated for 72 h.The concentration of calcium ions in Tfh of each group was detected.The expressions of AT1R,NFAT,CaN and P-CaN in Tfh cells were determined by Western blotting.Results The percentage of Tfh cells decreased significantly with the increase of vitamin D dose.Vitamin D CaN reduce the intracellular calcium concentration of Tfh,up-regulate the expression of AT1 protein in Tfh cells,and down-regulate the expression of CAN,P-CaN and NFAT protein in a dose-dependent manner,and the effect is more obvious when combined with PA.Conclusion Vitamin D may regulate the activation of follicular T helper cells in MRL/lpr mice via the Ca-CaN-NFAT pathway.

Objective:To explore the effect of Sugammadex sodium on muscle relaxant recovery and coagulation function after modified radical mastectomy for breast cancer.Methods:A total of 110 patients who underwent modified radical mastectomy in Shanxi Cancer Hospital from May. 2022 to May. 2024 were chosen and separated into two groups according to random number table method, with 55 cases in each group, receiving the same anesthesia scheme. Muscle relaxant was monitored by train-of-four stimulation (TOF) . After surgery, when the TOF count was ≥2, the study group was given Sugammadex sodium, and the control group was given neostigmine + atropine. Operation-related indexes and adverse reactions were recorded; The muscle relaxant residue was analyzed at 5, 15 and 30min after injection of muscle relaxant antagonists; Blood clot formation time (K value) , blood clot formation rate (Angle) , maximum blood clot intensity (MA value) and blood clot reaction time (R value) of the two groups were compared before (T1) and 5min (T2) , 15min (T3) and 30min (T4) after injection.Results:The extubation time and the first extubation time in the study group were shorter [ (4.10±1.05) min, (22.95±2.24) h vs. (13.28±2.96) min, (29.83±3.06) h] ( t=21.68, 13.46, all P < 0.05) . The muscle relaxation residual rates in the study group at 5min and 15min were lower [12.73% (7/55) , 0.00% (0/55) vs. 100.00% (55/55) , 63.64% (35/55) ] ( χ2=85.16, 51.33, P < 0.05) . There were no differences in K value, Angle value, MA value and R value between the two groups at T1, T2, T3 and T4 ( t K=0.17, 0.44, 0.14, 0.13, t Angle=0.93, 1.29, 1.04, 1.00, t MA=1.17, 1.72, 0.87, 1.03, t R=0.36, 0.08, 0.09, 0.37, all P > 0.05) . The incidence rates of postoperative nausea, vomiting and respiratory depression in the study group were lower [5.45% (3/55) , 7.27% (4/55) , 0.00% (0/55) vs. 18.18% (10/55) , 21.82% (12/55) , 10.91% (6/55) ] ( χ2/ Fisher=4.27, 4.68, -, all P < 0.05) . Conclusion:Sugammadex sodium can promote the recovery of muscle relaxant in patients after modified radical mastectomy for breast cancer, and has little effect on coagulation function, which can reduce the occurrence of postoperative adverse reactions.

Temporomandibular joint disc (TMJD) is a critical anatomical structure within the maxillofacial region. However, its self-repair ability is limited, which often leads to functional degradation. The development of tissue engineering technology provides a new treatment strategy for TMJD repair, in which the scaffold provides basic physical support and suitable cellular microenvironment. Scaffold materials include naturally derived scaffolds, decellularised extracellular matrix scaffolds and synthetic polymer scaffolds. Currently, advancements in material composite techniques, surface modification, and chemical modification, as well as the optimization of electrospinning and three-dimensional printing technologies, have significantly enhanced the overall performance of the scaffold. These improvements exhibit promising potential for the repair of TMJD with varying degrees of defects. This paper provides an overview of the progress in tissue engineering scaffold materials in repairing of TMJD, focusing on ideal biological properties, material types, scaffold optimization strategies and clinical application. It aims to serve as a reference for the development of scaffold materials and the clinical translation of tissue engineering.

Objective:To investigate the association between cardiovascular health(CVH) metrics and microvascular complications in patients with type 2 diabetes mellitus(T2DM).Methods:A cross-sectional study was conducted with 4 614 T2DM patients who received standardized metabolic disease management at the First Affiliated Hospital of Ningbo University from March 1st, 2018, to February 29th, 2024. Ideal CVH metrics were defined as non-smoking, non-drinking or moderate drinking, a healthy diet, regular physical activity, a healthy waist circumference, and adequate sleep duration. Microvascular complications included diabetic kidney disease(DKD), diabetic retinopathy(DR), and diabetic peripheral neuropathy(DPN). Logistic regression analysis was used to assess the relationship between CVH metrics and microvascular complications. Results:Patients with≤1, 2, 3, 4, or≥5 ideal CVH metrics were 378(8.2%), 933(20.2%), 1 480(32.1%), 1 218(26.4%), and 605(13.1%), respectively. A total of 2 736(59.3%) patients had at least one microvascular complication. Multivariate logistic regression analysis showed that compared to those with≤1 ideal CVH metric, patients with≥5 ideal CVH metric had an odds ratio( OR) of 0.55(95% CI 0.41-0.74, Ptrend<0.001) for microvascular complications, an OR of 0.51(95% CI 0.36-0.72, Ptrend<0.001) for DKD, and an OR of 0.54(95% CI 0.40-0.73, Ptrend<0.001) for DPN. No significant association was found for DR, with an OR of 1.31(95% CI 0.87-1.98, Ptrend=0.615). Conclusion:A great number of ideal CVH metrics was associated with a reduction in microvascular complications in T2DM patients, with variations across different types of microvascular complications.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.