ObjectiveTo investigate the effects of Schisandrae Chinensis Fructus lignans on schizophrenia induced by dizocilpine maleate （MK-801） in mice and to clarify its mechanism. MethodsMale mice of 4-6 weeks old were randomized into blank， model， positive drug， and low-， medium-， and high-dose （40， 80， 160 mg·kg^-1， respectively） Schisandrae Chinensis Fructus lignans groups. The blank group was administrated with distilled water， and the other groups were injected with 0.5 mg·kg^-1 MK-801 to induce schizophrenia symptoms. Meanwhile， risperidone was injected at 0.2 mg·kg^-1 in the positive drug group， and mice in the intervention groups were injected with corresponding drugs for 14 consecutive days. The behavioral changes of mice were observed by autonomous activity test， open field test， forced swimming test， and water maze test. The levels of dopamine （DA） and 5-hydroxytryptamine （5-HT） in the brain and tumor necrosis factor-α （TNF-α） and nuclear factor-κB （NF-κB） in peripheral blood were quantified by enzyme-linked immunosorbent assay （ELISA）. The changes in the prefrontal lobe of mice were observed by hematoxylin-eosin staining， and the changes of the hippocampal tissue were observed by Nissl staining. The protein levels of silencing information regulatory factor 1 （SIRT1） and forkhead box protein O3a （FoxO3a） in the hippocampus of mice were determined by Western blot. ResultsCompared with the model group， low， medium， and high doses of Schisandrae Chinensis Fructus lignans reduced the total number of autonomous activities， total distance in the open field test， immobile time in the forced swimming test， and levels of TNF-α and NF-κB in peripheral blood （P<0.05）， while increasing the number of platform crossings in the water maze test and DA and 5-HT levels in the brain tissue （P<0.05）. Compared with the model group， risperidone and low， medium， and high doses of Schisandrae Chinensis Fructus lignans improve the neural cell morphology in the CA1 region， with full cells in neatly dense arrangement and exhibiting clear membrane boundary. Schisandrae Chinensis Fructus lignans inhibited the expression of SIRT 1 and FoxO3a in the hippocampus （P<0.05）. ConclusionTo sum up， Schisandrae Chinensis Fructus lignans may improve the behavior of schizophrenic mice by activating the SIRT1/FoxO3a signaling pathway to exert neuroprotective effects.

ObjectiveTo identify potential influencing factors of urate crystal deposition at ankle/foot in patients with hyperuricemia （HUA）， and to analyze the predictive value of inflammatory indicators for urate crystal deposition in patients with different traditional Chinese medicine （TCM） syndromes， so as to provide potential reference for clinical risk assessment and individualized TCM intervention. MethodsA retrospective study was carried out with the enrollment of 231 HUA patients from The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2021 and December 2024. The enrolled patients were further divided into a crystal deposition-positive group （143 cases） and a crystal deposition-negative group （88 cases） according to the results of dual-energy computed tomography （CT）. Sociodemographic data， living habits， serum uric acid levels， and inflammatory indicators of the enrolled patients were collcted， and TCM syndrome differentiation was performed. Furthermore， univariate analysis was used to compare inter-group differences in clinical characteristics. MMultivariate Logistic regression was applied to identify the influencing factors of urate crystal deposition. In addition， the receiver operating characteristic （ROC） curves were plotted to evaluate the predictive efficacy of inflammatory indicators for crystal deposition across different TCM syndromes. ResultsThere were statistically significant inter-group differences in the proportion of males， age， body mass index， proportion of mental labor， rate of low water intake， and rate of high-sugar beverage consumption （P<0.05），whereas no significant difference in low exercise intensity was found between the two groups. Furthermore， compared with the negative group， the positive group had higher serum uric acid level， neutrophil-to-lymphocyte ratio （NLR）， and platelet-to-lymphocyte ratio （PLR）， but lower systemic immune-inflammation index （SIRI） （P<0.05）. Regarding the distribution of TCM syndromes， the positive group was dominated by the dampness-heat accumulation syndrome （55/143，38.46%）， while the negative group was mainly characterized by the phlegm-turbidity obstruction syndrome （44/88，50.00%）. Multivariate Logistic regression analysis revealed that high-sugar beverage consumption， elevated NLR， and elevated PLR were risk factors for urate crystal deposition ［odd ratio （OR） = 8.002， 5.377， 1.034， respectively； 95% CI 1.572-40.732， 2.179-13.270， 1.013-1.054，all P<0.05］， while SIRI was a protective factor （OR = 0.869， 95% CI 0.778-0.971， P<0.05）. In the positive group， patients with the dampness-heat accumulation syndrome exhibited the highest NLR， while the lowest PLR and SIRI， showing statistically significant differences with those of other syndromes （all P<0.05）. In addition， ROC curve analysis indicated that for the dampness-heat accumulation syndrome， the combined "NLR + PLR" model had an area under the curve （AUC） of 0.901 （95% CI 0.850-0.951， P<0.01）， with a sensitivity of 89.1% and a specificity of 79.5%； for the blood stasis-heat obstruction syndrome， the combined "NLR + PLR" model had an AUC of 0.880 （95% CI 0.825-0.934， P<0.01）， with a sensitivity of 100.0% and a specificity of 67.3%； for the liver-kidney Yin-deficiency syndrome， the single PLR model had an AUC of 0.842 （95% CI 0.731-0.952， P<0.01）， with a sensitivity of 83.3% and a specificity of 84.0%. ConclusionUrate crystal deposition in HUA patients exhibits intimate associations with high-sugar beverage consumption as well as elevated NLR and PLR levels. Meanwhile， TCM syndrome differentiation has potential correlation with inflammatory characteristics. The inflammatory indicator-based prediction model constructed based on TCM syndromes exhibits good predictive value.

Current formulation of objective performance criteria （OPC） in traditional Chinese medicine （TCM） faces methodological challenges， including poor reporting quality， insufficient standardization of methods， limited comparability of study populations， and inadequate consideration of the genetic and environment particularities of ethnic minority populations. In response to these issues， this paper proposes optimization strategies for setting OPC in TCM， with particular attention to ethnic minority medicine. These include improving methodological techniques and statistical descriptions， ensuring transparency in meta-analyses and data sources； standardizing the estimation of point estimates and confidence intervals， and incorporating multidisciplinary expert consensus for value determination； introducing local real-world data from the same period， especially cohort study evidence， to compensate for the lack of high-quality randomized controlled trial data. Through process transparency and dynamic updating mechanisms， the credibility of OPC method can be enhanced， thereby providing methodological support for strengthening evidence-based research capacity in this field.

Objective To investigate the expression characteristics, prognostic value, and correlation with immune infiltration of vasoactive intestinal peptide receptor 2 (VIPR2) in esophageal adenocarcinoma (ESAD). Methods Transcriptome data of 80 ESAD and 10 normal tissues were retrieved from the TCGA database. Immune-related differential genes were identified by integrating the ImmPort database. Cox regression analysis was applied to evaluate the prognostic significance of VIPR2. GSVA and ssGSEA were employed to assess the association between VIPR2 and immune-cell infiltration. Functional enrichment was performed using GO, KEGG, and GSEA. Results VIPR2 expression was significantly downregulated in ESAD tissues (P<0.05). High VIPR2 expression was associated with prolonged overall survival (HR=0.246, P=0.047), serving as an independent prognostic factor. Fifteen immune-cell types, including CD8⁺ T cells, NK cells, and dendritic cells, showed significantly higher infiltration in the VIPR2-high group, whereas Th17-cell abundance was decreased (P<0.05). Enrichment analyses revealed that VIPR2 participated in multiple tumor-immune pathways and was positively correlated with PD-1 and CTLA-4 expression (P<0.01). Conclusion VIPR2 may serve as a potential biomarker in the prognostic assessment and could modulate the tumor-immune microenvironment in ESAD.

Objective To analyze the forensic clinical appraisal of personal injury caused by dexamethasone poisoning and provide reference for similar cases.Methods A retrospective analysis was conducted on 16 individuals exposed to dexamethasone-adulterated drinking water in a poisoning case.The age,gender,adverse reactions,and clinical manifestations of the appraised individuals were examined based on interview records and clinical medical histories.Results Among the 16 appraised individuals,7 were male and 9 were female,aged 29-50 years.The primary clinical manifestations involved the nervous,respiratory,digestive,and muscular systems,as well as the skin and other organs.After discontinuation of the"hormone water,"5 individuals experienced adverse clinical outcomes.Conclusion Forensic clinical examination in dexamethasone poisoning cases should be performed after the completion of clinical treatment,with particular attention to damage in specific organs.The appraisal must comprehensively consider poisoning duration,dosage,treatment measures,detoxification process,and individual variability.Such cases warrant close attention in judicial practice,and relevant authorities should improve appraisal standards to better meet forensic needs.

Objective:To observe the effect of long-term follow-up of cerebral aneurysm embolization and to explore the related factors of aneurysm recurrence.Methods:A total of 142 cases of intracranial aneurysm rupture embolization patients treated in the Yuebei People′s Hospital from August 2000 to August 2013 were selected as the study objects. All of them underwent embolization treatment, and digital subtraction angiography (DSA), CT angiography (CTA) and magnetic resonance angiography (MRA) were performed after surgery. The follow-up period was 10 years, and the long-term outcome was evaluated using the Stroke Modified Rankin Scale (mRS) score. The results of immediate postoperative angiography and long-term follow-up in different embolization groups were analyzed. The risk factors of recurrence after ruptured cerebral aneurysm embolization were analyzed by single factor and independent risk factors were analyzed by multiple factor.Results:Of 142 patients (161 aneurysms), 106 were embolized by simple embolization and 55 were embolized by stent-assisted embolization. There was no significant difference in the results of immediate embolization between simple embolization and stent assisted embolization ( P>0.05). The proportion of giant aneurysms in the stent-assisted embolization group was higher than that in the simple embolization group ( P<0.05). Follow-up results showed that among the 142 patients, 106 had mRS score 0, 27 had mRS score 1, 5 had mRS score 2, and 4 had mRS score 4. The good clinical prognosis rate was 93.7%(133/142). Of the 161 aneurysms, 36 recurred, with a recurrence rate of 22.4%(36/161). Univariate analysis showed that aneurysm size, cervical tumor and embolization degree were risk factors for cerebral aneurysm recurrence (all P<0.05). The results of multi-factor analysis showed that aneurysm size was an independent risk factor for cerebral aneurysm recurrence ( P<0.05). Conclusions:The long-term follow-up after embolization of cerebral aneurysms is good, but cerebral aneurysms still have the possibility of recurrence. Aneurysm size is an independent risk factor for aneurysm recurrence. Timely detection of cerebrovascular changes can be treated in time to avoid cerebrovascular accidents.

Objective:To investigate the efficacy of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE)combined with Apatinib Mesylate and Camrelizumab in the treatment of older patients with hepatocellular carcinoma and portal vein tumor thrombus(PVTT).Methods:A total of 80 older patients with hepatocellular carcinoma and PVTT, admitted to the Second People's Hospital of Pinghu City from January 2020 to December 2023, were selected as the study subjects.Among them, 40 patients receiving DEB-TACE combined with Apatinib Mesylate and Camrelizumab constituted the experimental group, while the other 40 patients receiving Apatinib Mesylate combined with Camrelizumab formed the control group.The response evaluation criteria in solid tumors(RECIST)were employed to assess the clinical efficacy of both groups.Overall survival(OS)and progression-free survival(PFS)were compared, and univariate and multivariate Cox regression analyses were used to analyze the influencing factors of OS in patients.Results:The objective response rate(ORR)and disease control rate(DCR)of the experimental group were significantly higher than those of the control group[60.0%(24/40) vs.32.5%(13/40), 80.0%(32/40) vs.50.0%(20/40), χ2=6.085, 0.013, P=0.013, 0.004]. The median OS and PFS of the experimental group were significantly greater than those of the control group(18.3 months vs.12.2 months, Log-rank χ2=6.470, P=0.011; 8.2 months vs.5.7 months, Log-rank χ2=11.106, P=0.001). Multivariate Cox proportional regression analysis indicated that ALBI grade( HR=1.356, 95% CI: 1.159-1.588, P=0.006), extrhepatic metastasis( HR=1.133, 95% CI: 1.015-1.265, P=0.009), and DEB-TACE( HR=1.921, 95% CI: 1.293-2.854, P=0.001)were independent prognostic factors in older patients with hepatocellular carcinoma and PVTT. Conclusions:The combination of DEB-TACE, Apatinib Mesylate, and Camrelizumab in the treatment of older patients with hepatocellular carcinoma and PVTT can significantly enhance clinical efficacy and extend patient survival.

Objective A survival outcome prediction model for postoperative pancreatic cancer patients was constructed by applying large-scale data based on the new version of American Joint Committee on Cancer(AJCC)staging using different machine learning algorithms.Methods Based on the Surveillance,Epidemiology,and End Results(SEER)database,synthetic minority over-sampling technique(SMOTE)and synthetic minority over-sampling technique and edited nearest neighbors(SMOTE-ENN)algorithms were used to process unbalanced data,random forest,support vector machine,decision tree,and extreme gradient boosting(XGBoost)algorithms were used to build and compare prognostic models,and Shapley additive explanation(SHAP)was introduced to interpret the models.Results The SMOTE-ENN combined with XGBoost model had the best performance(accuracy rate was 86.2％,precision rate was 95.2％,recall rate was 71.2％,F1 value was 0.762,area under the curve was 0.884,Brier score was 0.108).The calibration curve and decision curve respectively showed that this model had good calibration effect and high clinical application value.In addition,SHAP analysis showed that the most important impact on prognostic outcomes was N stage.Conclusion The XGBoost model has the best performance and can be used as a new high-performance postoperative prognosis prediction model under AJCC staging that conforms to the current clinical staging system,providing theoretical support for predicting postoperative patient survival outcomes and formulating personalized treatment plans.

Objective:To evaluate the effect of acupuncture on postoperative delirium (POD) in diabetic patients undergoing surgery under general anesthesia.Methods:In this randomized controlled trial, 92 diabetic patients of either sex, aged 30-80 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective surgery under general anesthesia, were divided into 2 groups ( n=46 each) using a table of random numbers: control group (group C) and acupuncture group (group A). Group A received acupuncture at the Baihui (GV20), Shenting (GV24) and Sishencong (EX-HN1) acupoints before anesthesia. The needles were retained for 30 min, with manual stimulation applied every 10 min for 10 s each time. After 4 stimulations, routine anesthesia was carried out. Group C received routine anesthesia only. Regional cerebral oxygen saturation was recorded on admission to the operating room (T 0), after anesthesia induction (T 1), at the start of surgery (T 2), at the end of surgery (T 3), and immediately after tracheal extubation (T 4). The POD developed within 3 days after surgery was assessed. The occurrence of needle-related adverse effects such as fainting, subcutaneous bleeding, and local paresthesia was recorded. Results:Compared with group C, the incidence of POD was significantly reduced, and the regional cerebral oxygen saturation was increased at T 1, 4 in group A ( P<0.05). Conclusions:Acupuncture can decrease the development of POD in diabetic patients undergoing surgery under general anesthesia, which is related to an increase in regional cerebral oxygen saturation.

Objective:To investigate the efficacy of drug-eluting beads transcatheter arterial chemoembolization (DEB-TACE)combined with Apatinib Mesylate and Camrelizumab in the treatment of older patients with hepatocellular carcinoma and portal vein tumor thrombus(PVTT).Methods:A total of 80 older patients with hepatocellular carcinoma and PVTT, admitted to the Second People's Hospital of Pinghu City from January 2020 to December 2023, were selected as the study subjects.Among them, 40 patients receiving DEB-TACE combined with Apatinib Mesylate and Camrelizumab constituted the experimental group, while the other 40 patients receiving Apatinib Mesylate combined with Camrelizumab formed the control group.The response evaluation criteria in solid tumors(RECIST)were employed to assess the clinical efficacy of both groups.Overall survival(OS)and progression-free survival(PFS)were compared, and univariate and multivariate Cox regression analyses were used to analyze the influencing factors of OS in patients.Results:The objective response rate(ORR)and disease control rate(DCR)of the experimental group were significantly higher than those of the control group[60.0%(24/40) vs.32.5%(13/40), 80.0%(32/40) vs.50.0%(20/40), χ2=6.085, 0.013, P=0.013, 0.004]. The median OS and PFS of the experimental group were significantly greater than those of the control group(18.3 months vs.12.2 months, Log-rank χ2=6.470, P=0.011; 8.2 months vs.5.7 months, Log-rank χ2=11.106, P=0.001). Multivariate Cox proportional regression analysis indicated that ALBI grade( HR=1.356, 95% CI: 1.159-1.588, P=0.006), extrhepatic metastasis( HR=1.133, 95% CI: 1.015-1.265, P=0.009), and DEB-TACE( HR=1.921, 95% CI: 1.293-2.854, P=0.001)were independent prognostic factors in older patients with hepatocellular carcinoma and PVTT. Conclusions:The combination of DEB-TACE, Apatinib Mesylate, and Camrelizumab in the treatment of older patients with hepatocellular carcinoma and PVTT can significantly enhance clinical efficacy and extend patient survival.