BackgroundWith the exacerbation of population aging， the number of elderly patients with mental disorders has increased significantly. The high prevalence of pulmonary infection in the aging population has largely contributed to the increased medical burdens and mortality rate， so preventing pulmonary infection in elderly patients with mental disorders has become a critical challenge in clinical practice. www.crd.york.ac.uk/PROSPERO注册号：CRD42024553735 ObjectiveTo investigate the prevalence and influencing factors of pulmonary infection in elderly patients with mental disorders， so as to provide references for preventing the occurrence of pulmonary infection in this population. MethodsOn July 1， 2024， computer searches of CNKI， China Biomedical Literature Database （CBM）， Wanfang， PubMed， Web of Science， Embase， Cochrane Library and Ovid were conducted from the inception of each database to June 2024. Two researchers independently conducted literature screening， data extraction and quality assessment. Meta-analysis was performed using Stata 16.0. ResultsA total of 17 literature （14 in Chinese， 3 in English） involving 75 724 elderly patients with mental disorders were included. Meta analysis revealed that the incidence rate of pulmonary infection in elderly patients with mental disorders was 20.8% （95% CI： 0.154~0.263）. Subgroup analysis indicated that the incidence rates of pulmonary infection among patients with dementia， schizophrenia， depression and unspecified mental disorders were 21.9% （95% CI： 0.182~0.256）， 20.6% （95% CI： 0.129~0.283）， 18.4% （95% CI： 0.136~0.232） and 5.2% （95% CI： 0.430~0.062）， respectively. In terms of influencing factors， the following were identified as risk factors for pulmonary infection in elderly patients with mental disorders： comorbid diabetes mellitus （OR=1.29， 95% CI： 1.24~1.34）， prolonged bed rest （OR=2.41， 95% CI： 2.10~2.76）， dysphagia （OR=1.76， 95% CI： 1.53~2.03）， smoking history （OR=6.27， 95% CI： 5.97~6.59）， irrational use of antibiotics （OR=2.10， 95% CI： 1.79~2.45）， hypoalbuminemia （OR=1.57， 95% CI： 1.35~1.83）， duration of illness （OR=2.05， 95% CI： 1.79~2.36）， age （OR=9.04， 95% CI： 8.44~9.68）， length of hospital stay （OR=2.68， 95% CI： 1.65~4.34）， use of proton pump inhibitors （OR=1.10， 95% CI： 1.06~1.14）， history of chronic lung disease （OR=1.50， 95% CI： 1.43~1.57）， poor oral hygiene （OR=3.66， 95% CI： 1.01~13.23）， comorbid tumors （OR=3.12， 95% CI： 2.18~4.48）， more than two somatic complications （OR=4.01， 95% CI： 1.08~14.86）， invasive procedures （OR=3.31， 95% CI： 1.81~6.04） and disorders of consciousness （OR=5.57， 95% CI： 2.18~14.24）. ConclusionElderly patients with mental disorders suffer a relatively high prevalence rate of pulmonary infection， and its prevalence rate varies among different types of mental disorders， with the highest rate being observed in patients with dementia. The factors contributing to the development of pulmonary infection are found to include age， duration of illness， smoking history， comorbid somatic complications， dysphagia， disorders of consciousness， hypoalbuminemia， prolonged bed rest， oral hygiene status， irrational use of antibiotics， use of proton pump inhibitor， length of hospital stay and invasive procedures. ［www.crd.york.ac.uk/PROSPERO number： CRD42024553735］

Depression is a severe mental illness. Although existing antidepressant medications have shown efficacy in many patients, a significant proportion show poor responses to current treatments, necessitating the need for novel therapeutic approaches. Photobiomodulation (PBM), an emerging physical therapy, has recently shown promising efficacy in the treatment of depression, as indicated by two systematic reviews, and is characterized by high safety and good tolerability. However, challenges remain in areas such as light delivery techniques and optimization of treatment parameters. This review summarizes the antidepressant mechanisms of PBM, various methods of light transmission, and recent research progress on its application in the treatment of depression. It also discusses issues related to safety, tolerability, and impact of specific parameters, aiming to provide insights and recommendations for future research on PBM as a therapy for depression.

Objective To explore the potential clinical value of the ratio of glycated albumin to albumin(GA/ALB)in the occurrence of heart failure(HF)among patients with coronary atherosclerotic heart disease(CHD).Methods A total of 337 CHD patients admitted to the Department of Cardiology in Shanxi Provincial People's Hospital from July 2023 to June 2024 were selected in this study.CHD patients were divided into HF group and non-HF group based on whether they progressed to HF.The clinical data and laboratory parame-ters of the two groups were compared.Restricted cubic spline curve was used to analyze the relationship be-tween GA/ALB levels and the risk of HF in CHD patients.Receiver operating characteristic curve was applied to evaluate the diagnostic efficacy of GA/ALB,GA,platelet to lymphocyte ratio(PLR),and monocyte to lym-phocyte ratio(MLR)in CHD patients with the occurrence of HF.Logistic regression was used to explore the relationship between serum GA/ALB levels and the risk of CHD patients occurrence of HF,and to analyze the degree of influence and stability of subgroup variables on results.Results There were statistically significant differences in GA/ALB,GA,PLR,MLR,and other indicators between the HF group and the non-HF group in CHD patients(P＜0.05).A non-linear relationship was observed between GA/ALB levels and the risk of HF in CHD patients.When the value of GA/ALB multiplied by 10 was less than 5.751,the risk of HF in CHD pa-tients increased with the increase of GA/ALB levels(P＜0.001).GA/ALB was an effective predictor for HF occurrence in CHD patients.Multivariable Logistic regression model showed that GA/ALB was an independ-ent risk factor for CHD patients with occurrence of HF.Subgroup analysis also confirmed the stability of GA/ALB in predicting the occurrence of HF in CHD patients.Conclusion GA/ALB is an independent risk factor for the occurrence of HF in CHD patients,and monitoring GA/ALB levels provides predictive value for the oc-currence of HF in these patients.

Objective To investigate the roles and mechanism of deoxycholic acid(DCA)in mediating the neuroinflammatory responses induced by hypobaric hypoxia.Methods C57BL/6J mice were randomly divided into thecontrol group(Con),tauroursodeoxycholic acid(TUDCA)group,hypoxia group(Hyp)and hypoxia+TUDCA group(Hyp+TUDCA).The mice were exposed in a hypoxic chamber for 48 h,which could mimic the high altitude environment.The levels of total bile acids(BA),lithocholic acid(LCA)and deoxycholic acid(DCA)in the serum and colon of mice were detected using enzyme-linked immunosorbent assay(ELISA),so were levels of DCA in the cortex,hippocampus and hypothalamus.The role of DCA in inducing neuroinflammation and IL-1β and TNF-α expressions was evaluated by knocking down the DCA receptor,farnesoid X receptor(FXR)in the N9 microglial cells and by administrating TUDCA to mice followed by hypoxia exposure.Real-time quantitative PCR(qPCR)and immunofluorescence staining were used to detect the activation of microglia and expression levels of interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)in the cortex of mice in each group.Results Hypoxia exposure increased DCA levels in the colon,serum and cortex.Under the same conditions,cortical microglia were activated,along with the elevation of IL-1β and TNF-α levels.DCA treatment increased the expression levels of FXR,IL-1β and TNF-α in N9 microglial cells.Knocking down the expression level of FXR inhibited DCA-induced IL-1β and TNF-α expressions in N9 cells.Furthermore,administration of TUDCA inhibited microglial activation and elevation of IL-1β in the cortex induced by hypoxia.Conclusion DCA can serve as a mediator in neuroinflammation by activating FXR in the cortex under hypoxia exposure.TUDCA administration can be used to mitigate neuroinflammation induced by hypoxia.

Depression is a severe mental illness. Although existing antidepressant medications have shown efficacy in many patients, a significant proportion show poor responses to current treatments, necessitating the need for novel therapeutic approaches. Photobiomodulation (PBM), an emerging physical therapy, has recently shown promising efficacy in the treatment of depression, as indicated by two systematic reviews, and is characterized by high safety and good tolerability. However, challenges remain in areas such as light delivery techniques and optimization of treatment parameters. This review summarizes the antidepressant mechanisms of PBM, various methods of light transmission, and recent research progress on its application in the treatment of depression. It also discusses issues related to safety, tolerability, and impact of specific parameters, aiming to provide insights and recommendations for future research on PBM as a therapy for depression.

Recent studies have revealed a strong association between the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and its associated pathways and neuroinflammation in schizophrenia. The activation of the NLRP3-inflammasome and aberrations in its associated pathways may be related to a certain extent to the psychotic symptoms of schizophrenia, neurotransmission dysfunction, impaired prepulse inhibition, and behavioural deficits observed in schizophrenic patients. A variety of antipsychotics can ameliorate neuroinflammation in schizophrenia by inhibiting NLRP3 inflammatory vesicles or blocking their associated pathways. This article summarizes and discusses the research findings related to NLRP3 inflammatory vesicles and their pathways in schizophrenic patients and their relevant animal models. It aims to explore the possibility and efficacy of treating schizophrenia by regulating the NLRP3 inflammatory vesicles and associated signaling pathways.

Objective To investigate the effect and mechanism of shikonin on the proliferation,migration,invasion and apoptosis of human gastric cancer MGC803 cells.Methods The MGC803 cells in the logarithmic growth phase were randomly divided into the blank control group,shikonin group,shikonin+insulin-like growth factor-1(IGF-1)group,and shikonin+LY294002 group.Cells in the blank control group were cultured in drug-free medium,cells in the shikonin group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1,cells in the shikonin+IGF-1 group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1 and IGF-1 with a final concentration of 10 μmol·L-1,and cells in the shikonin+LY294002 group were cultured in the medium containing shikonin with a final concentration of 10 μmol·L-1 and LY294002 with a final concentration of 30 μmol·L-1.After 24 h of culture,the cell proliferation was detected by cell counting kit-8,the cell apoptosis was detected by flow cytometry,the cell migration was detected by scratch assay,and the cell invasion was detected by Transwell assay.The expression levels of B cell lymphoma-2(Bcl-2),Bcl-2 related X protein(Bax),cytochrome C(Cyt C),cleaved caspase-3,cleaved caspase-9,phosphoinositide 3 kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(PKB),and phosphorylated PKB(p-PKB)proteins were measured by using Western blot.Results The MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin group were significantly higher than those in the blank control group(P＜0.05);the MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin+IGF-1 group were significantly lower than those in the shikonin group(P＜0.05);and the MGC803 cell proliferation inhibition rate and apoptosis rate in the shikonin+LY294002 group were significantly higher than those in the shikonin group(P＜0.05).The MGC803 cell scratch healing rate and the number of invasive cells in the shikonin group were significantly lower than those in the blank control group(P＜0.05);the MGC803 cell scratch healing rate and the number of invasive cells in the shikonin+IGF-1 group were significantly higher than those in the shikonin group(P＜0.05);and the MGC803 cell scratch healing rate and the number of invasive cells in the shikonin+LY294002 group were significantly lower than those in the shikonin group(P＜0.05).The relative expression level of Bcl-2 protein in MGC803 cells in the shikonin group was significantly lower than that in the blank control group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly higher than those in the blank control group(P＜0.05);the relative expression level of Bcl-2 protein in MGC803 cells in the shikonin+IGF-1 group was significantly higher than that in the shikonin group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly lower than those in the shikonin group(P＜0.05);and the relative expression level of Bcl-2 protein in MGC803 cells in the shikonin+LY294002 group was significantly lower than that in the shikonin group(P＜0.05),while the relative expression levels of Bax,Cyt C,cleaved caspase-3 and cleaved caspase-9 proteins and the Bax/Bcl-2 ratio were significantly higher than those in the shikonin group(P＜0.05).The relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin group were significantly lower than those in the blank control group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin group and the blank control group(P＞0.05);the relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin+IGF-1 group were significantly higher than those in the shikonin group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin+IGF-1 group and the shikonin group(P＞0.05);and the relative expression levels of p-PI3K and p-PKB proteins and the ratios of p-PI3K/PI3K and p-PKB/PKB in MGC803 cells in the shikonin+LY294002 group were significantly lower than those in the shikonin group(P＜0.05),and there was no statistically significant difference in the relative expression levels of PI3K and PKB proteins in MGC803 cells between the shikonin+LY294002 group and the shikonin group(P＞0.05).Conclusion Shikonin can inhibit the proliferation,migration and invasion and promote the apoptosis of human gastric cancer MGC803 cells,which may be related to its inhibition of the PI3K/PKB signaling pathway.

Objective To explore the clinical efficacy of arthroscopy combined with cubital tunnel expansion and plasty in the treatment of patients with elbow osteoarthritis and cubital tunnel syndrome.Methods A total of 101 patients with elbow osteoarthritis and cubital tunnel syndrome who were admitted to the Department of Orthopedics,Cangzhou Hospital of Integrated TCM-WM Hebei from September 2020 to August 2023 were selected as the research subjects.According to different surgical methods,the patients were divided into an observation group(n=51)and a control group(n=50).The surgical method in the observation group was arthroscopy combined with cubital tunnel expansion and plasty,and the surgical method in the control group was conventional cubital tunnel expansion and plasty.The operation time,intraoperative blood loss,length of hospital stay,and complications were observed and recorded for both groups.The mayo elbow performance score(MEPS)was used to assess elbow function,the activities of daily living(ADL)scale was used to evaluate daily living ability,and the visual analogue scale(VAS)was used to assess pain levels preoperatively and at 6 months postoperatively.Elbow range of motion,including pronation,supination,and flexion-extension,was measured using a goniometer.Nerve recovery was evaluated by measuring compound muscle action potential(CMAP)of the abductor digiti minimi,ulnar nerve conduction velocity(NCV),and motor evoked potential latency(MEPLP)using a Keypoint electromyography device.Results The operation time and length of hospital stay in the observation group were significantly shorter than those in the control group,and the intraoperative blood loss and complications were significantly less than those in the control group(P＜0.05).Before operation,there were no statistically significant differences in MEPS scores,ADL scores and VAS scores between the observation group and the control group(P＞0.05);6 months after operation,the MEPS scores and ADL scores of patients in the observation group were signifi-cantly higher than those in the control group,and the VAS scores were significantly lower than those in the control group(P＜0.05).Before operation,there were no statistically significant differences in pronation,supination and flexion-extension between the observation group and the control group(P＞0.05);6 months after operation,the pronation,supination and flexion-extension of patients in the two groups were significantly higher than those before operation(P＜0.05),but there were no statistically significant differences in pronation,supination and flexion-extension between the observation group and the control group(P＞0.05).Before operation,there were no statistically significant differences in CMAP,NCV and MEPLP between the observation group and the control group(P＞0.05);6 months after operation,the CMAP and NCV of patients in the observation group were significantly higher than those in the control group,and the MEPLP ratio was significantly lower than that in the control group(P＜0.05).Conclusion Conventional cubital tunnel expansion and plasty and arthroscopy combined with cubital tunnel expansion and plasty can improve the range of motion of the elbow in patients with elbow osteoar-thritis and cubital tunnel syndrome,but the latter features less damage and faster recovery,is better in improving elbow function and daily living ability,reducing pain,and adjusting electromyographic examination indicators,and has fewer complications.

Recent studies have revealed a strong association between the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and its associated pathways and neuroinflammation in schizophrenia. The activation of the NLRP3-inflammasome and aberrations in its associated pathways may be related to a certain extent to the psychotic symptoms of schizophrenia, neurotransmission dysfunction, impaired prepulse inhibition, and behavioural deficits observed in schizophrenic patients. A variety of antipsychotics can ameliorate neuroinflammation in schizophrenia by inhibiting NLRP3 inflammatory vesicles or blocking their associated pathways. This article summarizes and discusses the research findings related to NLRP3 inflammatory vesicles and their pathways in schizophrenic patients and their relevant animal models. It aims to explore the possibility and efficacy of treating schizophrenia by regulating the NLRP3 inflammatory vesicles and associated signaling pathways.

ObjectiveTo investigate the transformation mechanism and content variation of saponins from Polygalae Radix before and after being boiled with licorice juice and water. MethodSimulated licorice juice boiled products and simulated water boiled products of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ were prepared by simulated processing technology， and analyzed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UPLC-Q-Exactive Orbitrap/MS）. Then the contents of onjisaponin B， onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin in Polygalae Radix， licorice-boiled Polygalae Radix and water-boiled Polygalae Radix were determined by UPLC-triple quadrupole tandem mass spectrometry（UPLC-QQQ-MS/MS）. ResultDuring the boiling process with licorice juice and water， onjisaponin B could be hydrolyzed to produce 4-methoxycinnamic acid， desacylsenegin Ⅲ， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin Z could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin TF， polygalasaponin ⅩⅩⅧ and tenuifolin， onjisaponin F could be hydrolyzed to produce 3，4，5-trimethoxycinnamic acid， onjisaponin G， polygalasaponin ⅩⅩⅧ and tenuifolin， and polygalasaponin ⅩⅩⅧ was hydrolyzed to produce tenuifolin. After being boiled with licorice juice or water， the content of onjisaponin B decreased significantly（P<0.05， P<0.01）， but the contents of onjisaponin Z， onjisaponin F， polygalasaponin ⅩⅩⅧ and tenuifolin increased significantly（P<0.05， P<0.01） in Polygalae Radix. Compared with the water-boiled products， the contents of onjisaponin Z and tenuifolin increased significantly（P<0.05， P<0.01）， and the change of tenuifolin content was the most significant in the licorice-boiled products.However， there was no significant difference in the content of onjisaponin B， onjisaponin F and polygalasaponin ⅩⅩⅧ between the water-boiled products and the licorice-boiled products. ConclusionBeing boiled with licorice juice or water can hydrolyze onjisaponin B， onjisaponin Z， onjisaponin F and polygalasaponin ⅩⅩⅧ， and generate secondary glycosides and aglycones（organic acids） through deglycosylation， which leads to obvious changes in the contents of onjisaponins after Polygalae Radix being processed.It is inferred that licorice juice can promote the hydrolysis of some onjisaponins in Polygalae Radix to onjisaponin Z and tenuifolin.This study provides an experimental basis for revealing processing mechanism of Polygalae Radix.