ObjectiveTo investigate the therapeutic effects and potential mechanisms of Atractylodes chinensis volatile oil microemulsion in relieving depression， thus establishing a theoretical foundation and a new approach for developing it as a novel adjunctive antidepressant. MethodsSixty SD male rats were assigned into four groups： control， model （chronic unpredictable mild stress）， positive drug （flupentixol hydrochloride， 1.8 mg·kg^-1）， and low-， medium-， high-dose （16.2， 32.4， 64.8 mg·kg^-1） A. chinensis volatile oil microemulsion. The sucrose preference test， open field test， tail suspension test， and forced swimming test were conducted to measure the sucrose preference rate， total exercise distance， average speed， resting time， tail suspension time， and swimming immobility time before and after treatment. The morphology of the rat brain tissue was visualized by hematoxylin-eosin （HE） staining. The levels of 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and cortisol （CORT） in the hippocampal tissue were measured by enzyme-linked immunosorbent assay （ELISA）. Real-time PCR was used to detect mRNA level differences of cyclic adenosine monophosphate （cAMP）， protein kinase A （PKA）， cyclic adenosine monophosphate response element-binding protein （CREB）， brain-derived neurotrophic factor （BDNF）， and tyrosine kinase B （TrkB） in the hippocampus. Western blot was employed to assess protein level variations of cAMP， PKA， CREB， BDNF， and TrkB in the same tissue samples. ResultsCompared with that in the blank group， the body mass of rats in low-， medium-， high-dose A. chinensis volatile oil emulsion groups decreased （P<0.05）， indicating that the modeling was successful. Compared with the model group， medium-， high-dose A. chinensis volatile oil emulsion shortened the tail suspension time， swimming immobility time， and resting time （P<0.05， P<0.01）， while increasing the sucrose preference rate， total exercise distance， and average speed （P<0.01）. No significant changes were observed in the low-dose A. chinensis volatile oil emulsion group. ELISA results indicated that CORT concentrations in the hippocampal tissue of medium and high-dose A. chinensis volatile oil emulsion groups decreased （P<0.01）. In the high-dose group， 5-HT and NE concentrations increased （P<0.05， P<0.01）， while they had no significant changes in the low-dose group. Real-time PCR results revealed that the mRNA levels of cAMP， PKA， and CREB in the hippocampus of the medium-dose Beicangzhu volatile oil emulsion group increased （P<0.05， P<0.01）， and those of cAMP， PKA， CREB， BDNF， and TrkB were upregulated in the high-dose Beicangshu volatile oil microemulsion group （P<0.01）. Western blot and immunofluorescence results demonstrated that the protein levels of cAMP， PKA， and TrkB in the hippocampal tissue of the low-dose A. chinensis volatile oil microemulsion group were up-regulated （P<0.05）. The medium-dose Beicangzhu volatile oil emulsion group exhibited increases in protein levels of cAMP， PKA， BDNF， and TrkB （P<0.05， P<0.01）， while the high-dose group showed elevationsin protein levels of cAMP， PKA， CREB， BDNF， and TrkB （P<0.05， P<0.01）. ConclusionBeicangzhu volatile oil emulsion demonstrates certain antidepressant efficacy by inhibiting CORT expression， upregulating the expression of 5-HT， NE， cAMP， PKA， CREB， BDNF， and TrkB， activating the CREB/BDNF signaling pathway to improve the cerebral protection.

ObjectiveThe effects of two microbial fertilizers （Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer） on the growth and development， the accumulation of active ingredients， and the microbial community diversity of rhizosphere soil of Atractylodes chinensis were investigated. MethodsA field experiment was carried out with two-year-old Atractylodes chinensis as the test material. Plant samples were collected during the wilt stage （September 26， 2023） to determine the general agronomic traits of Atractylodes chinensis. High-performance liquid chromatography （HPLC） was utilized to evaluate the effects of microbial fertilizers on the synthesis and accumulation of four active ingredients （atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ） in Atractylodes chinensi. PacBio Sequel sequencing technology was used to explore the differences in bacterial community structures and diversity in the rhizosphere soil of Atractylodes chinensis treated with different microbial fertilizers. ResultsThe two microbial fertilizers had significant growth-promoting effects on Atractylodes chinensis. Compared with those of the CK group， the stem diameter， stem and leaf dry and fresh weight， and rhizome dry and fresh weight of Atractylodes chinensis significantly increased by 0.47-1.07 times （P<0.05） after the application of the Bacillus subtilis fertilizer （16 kg/667 m²）， and those significantly increased by 0.62-0.96 times （P<0.05） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer （1.5 kg/667 m²）. The effect on plant height was not significant. The application of two microbial fertilizers was beneficial to the accumulation of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.01）， and the effect of the Bacillus subtilis fertilizer on the accumulation of active ingredients of Atractylodes chinensis was better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The results of high-throughput sequencing showed that compared with the CK group， the Bacillus subtilis fertilizer （8 kg/667 m²） could significantly increase the diversity of rhizosphere bacterial species by regulating the Simpson index and Shannon index （P<0.05）， and the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer significantly reduced the bacterial diversity （P<0.05）. The relative abundance of dominant bacteria was compared at the phylum and genus levels. The relative abundance of Proteobacteria （45.73%） and Burkholderia_Caballeronia_Paraburkholderia （9.98%） significantly increased after the application of the Bacillus subtilis fertilizer （P<0.01）， and the relative abundance of Acidobacteriota （20.53%） and Sphingomonas （3.63%） increased significantly （P<0.01） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The relative abundance of beneficial bacteria in the Bacillus subtilis fertilizer was slightly higher than that in the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. Pearson correlation analysis showed that Burkholderia_Caballeronia_Paraburkholderia and Sphingomonas were positively correlated with the content of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.05）. ConclusionThe application of the Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer can increase the yield of medicinal materials and promote the synthesis and accumulation of active ingredients by regulating the rhizosphere microecological diversity of Atractylodes chinensis， and the application effect of the Bacillus subtilis fertilizer is better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer.

Objective To explore the effect of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regu-lating the Rac1/Akt/NF-κB signaling pathway.Methods The ovarian cancer cell line SKOV3 and the human normal ovarian epithelial cell line IOSE-80 were divided into the following groups:control,low-dose phloretin,medium-dose phloretin,high-dose phloretin,PM A,and high-dose phloretin+PMA.Morphological changes were observed under a microscope.Cell viability and apoptosis were assessed using the CCK-8 assay,colony formation assay,and flow cytometry.Western blotting was performed to detect the expression of proteins related to the Rac1/Akt/NF-κB signaling pathway.Tumor-bearing nude mice were established,tumor weights were measured,and the expres-sion levels of Rae1 and Akt in tumor tissues were analyzed.Results Compared with the control group,SKOV3 cells treated with low-,medium-,and high-dose phloretin showed reduced survival rate,colony formation,and expression of p-NF-κB p65/NF-κB p65,p-Akt/Akt,and Rac 1 in a dose-dependent manner.However,PM A reversed the inhibitory effects of high-dose phloretin on the malignant progression of ovarian cancer.In vivo experiments demonstrated that phloretin significantly inhibited tumor growth and reduced Akt and Rae1 expres-sion in tumor tissues(P＜0.05).Conclusion Phloretin suppresses the malignant progression of ovarian cancer by inhibiting the Rae1/Akt/NF-κB signaling pathway.

Objective To analyze the impact of the basic medical insurance outpatient mutual aid policy on the utilization of medical services.Methods Data indicators related to the utilization of medical services from a tertiary hospital in Wuhan,Hubei Province,from January 2022 to December 2023 were collected.Interrupted time series analysis was used to examine the changing trends of outpatient visits,hospitalizations,and average cost per outpatient visit before and after the implementation of the outpatient mutual aid policy.The Granger causality test and vector autoregressive model were also used to analyze the association between outpatient and inpatient services.Results The outpatient mutual aid policy significantly increased the number of outpatient visits,hospitalizations,and day surgeries in the sample medical institutions(P＜0.05),but had limited impact on the average cost per outpatient visit and hospitalization.Conclusion Outpatient mutual aid can effectively promote the utilization of outpatient services,but attention needs to be paid to potential moral hazard issues and strengthen the supervision of medical insurance funds.

Two novel skeleton sesquiterpenoids (1 and 6), along with four new iphionane-type sesquiterpenes (2-5) and six new cyperane-type sesquiterpenes (7-11), were isolated from the whole plant of Artemisia hedinii (A. hedinii). The two novel skeleton compounds (1 and 6) were derived from the decarbonization of iphionane and cyperane-type sesquiterpenes, respectively. Their structures were elucidated through a comprehensive analysis of spectroscopic data, including high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) and 1D and 2D nuclear magnetic resonance (NMR) spectra. The absolute configurations were determined using electronic circular dichroism (ECD) spectra, single-crystal X-ray crystallographic analyses, time-dependent density functional theory (TDDFT) ECD calculation, density functional theory (DFT) NMR calculations, and biomimetic syntheses. The biomimetic syntheses of the two novel skeletons (1 and 6) were inspired by potential biogenetic pathways, utilizing a predominant eudesmane-type sesquiterpene (A) in A. hedinii as the substrate. All compounds were evaluated in LX-2 cells for their anti-hepatic fibrosis activity. Compounds 2, 8, and 10 exhibited significant activity in downregulating the expression of α-smooth muscle actin (α-SMA), a protein involved in hepatic fibrosis.
Artemisia/chemistry* ; Sesquiterpenes/chemical synthesis* ; Molecular Structure ; Humans ; Liver Cirrhosis/genetics* ; Biomimetics ; Plant Extracts/pharmacology*

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.

Objective To analyze the impact of the basic medical insurance outpatient mutual aid policy on the utilization of medical services.Methods Data indicators related to the utilization of medical services from a tertiary hospital in Wuhan,Hubei Province,from January 2022 to December 2023 were collected.Interrupted time series analysis was used to examine the changing trends of outpatient visits,hospitalizations,and average cost per outpatient visit before and after the implementation of the outpatient mutual aid policy.The Granger causality test and vector autoregressive model were also used to analyze the association between outpatient and inpatient services.Results The outpatient mutual aid policy significantly increased the number of outpatient visits,hospitalizations,and day surgeries in the sample medical institutions(P＜0.05),but had limited impact on the average cost per outpatient visit and hospitalization.Conclusion Outpatient mutual aid can effectively promote the utilization of outpatient services,but attention needs to be paid to potential moral hazard issues and strengthen the supervision of medical insurance funds.

Objective To explore the effect of phloretin on the proliferation,apoptosis,and tumorigenicity of ovarian cancer cells by regu-lating the Rac1/Akt/NF-κB signaling pathway.Methods The ovarian cancer cell line SKOV3 and the human normal ovarian epithelial cell line IOSE-80 were divided into the following groups:control,low-dose phloretin,medium-dose phloretin,high-dose phloretin,PM A,and high-dose phloretin+PMA.Morphological changes were observed under a microscope.Cell viability and apoptosis were assessed using the CCK-8 assay,colony formation assay,and flow cytometry.Western blotting was performed to detect the expression of proteins related to the Rac1/Akt/NF-κB signaling pathway.Tumor-bearing nude mice were established,tumor weights were measured,and the expres-sion levels of Rae1 and Akt in tumor tissues were analyzed.Results Compared with the control group,SKOV3 cells treated with low-,medium-,and high-dose phloretin showed reduced survival rate,colony formation,and expression of p-NF-κB p65/NF-κB p65,p-Akt/Akt,and Rac 1 in a dose-dependent manner.However,PM A reversed the inhibitory effects of high-dose phloretin on the malignant progression of ovarian cancer.In vivo experiments demonstrated that phloretin significantly inhibited tumor growth and reduced Akt and Rae1 expres-sion in tumor tissues(P＜0.05).Conclusion Phloretin suppresses the malignant progression of ovarian cancer by inhibiting the Rae1/Akt/NF-κB signaling pathway.

Objective To compare the differences in the average transaction costs per-referral patients under different models of Integrated Delivery Systems(IDS).Methods Using a typical case sampling method,it selected referred patients from three IDS models:the county medical alliance in D City(Qinghai Province),the urban medical consortium in J District(Zhengzhou City,Henan Province),and the health management coalition in N County(Shandong Province).Structured questionnaires collected demographics,average transaction costs per-referral and cost perceptions.t-tests and ANOVA assessed cost differences;generalized linear regression identified influencing factors.Results Among 915 patients,the average transaction costs per-referral were 1 035.05 yuan(county alliance),195.31 yuan(urban consortium),and 700.97 yuan(health management coalition),with statistically significant differences(P＜0.05).The urban consortium exhibited lower time costs and specialized input costs.Key influencing factors included older age(county alliance),education level,employment status,and referral travel time(urban consortium),as well as urban-rural disparities(health management coalition).Patients'cost perceptions significantly differed across models(P＜0.05).Conclusion The urban medical consortium demonstrated the lowest patient the average transaction costs,highlighting its institutional advantage in minimizing financial burdens.