OBJECTIVE To study the mechanism of action of herb pair of Angelica sinensis-Poria cocos in intervening in allergic rhinitis. METHODS The core targets of herb pair of A. sinensis-P. cocos in intervening in allergic rhinitis were predicted through network pharmacology. Allergic rhinitis model of rats was established by intraperitoneal injection of aluminum hydroxide and ovalbumin mixture， and the rats were randomly divided into model group， loratadine group （positive control group， 0.9 mg/kg）， and low-， medium-， high-dose groups of herb pair of A. sinensis-P. cocos （3， 6 and 12 g/kg）， with 10 rats in each group. Another 10 healthy rats were used as the normal group. Each group of rats was intragastrically administered the corresponding liquid or normal saline once a day for 30 consecutive days. After the last administration， the behavioral scores of each group of rats were calculated， the levels of immunoglobulin E （IgE）， histamine， interleukin-4 （IL-4） in serum， and the protein expression levels of IL-6， tumor necrosis factor-α （TNF-α）， and prostaglandin-endoperoxide synthase 2 （PTGS2） in nasal mucosa tissue were detected. The pathological morphology changes of nasal mucosa tissue were observed. RESULTS Network pharmacology analysis revealed that IL-6， TNF and PTGS2 might play a key role in the intervention of allergic rhinitis by herb pair of A. sinensis-P. cocos， and the IL-17 and TNF signaling pathways might be the typical inflammatory signaling pathways intervened by herb pair of A. sinensis-P. cocos in allergic rhinitis. The results of animal experiments showed that compared with the model group， the behavioral score， the levels of IgE， histamine and IL-4， and the protein expressions of IL-6， TNF-α and PTGS2 in each administration group were decreased significantly （P＜0.05）， and there was a dose-dependent relationship with the herb pair of A. sinensis-P. cocos （P＜ 0.05）. CONCLUSIONS The herb pair of A. sinensis-P. cocos can effectively alleviate the symptoms of rats with allergic rhinitis， the mechanism of which may be related to the inhibition of the expressions of IL-6， TNF-α and PTGS2.

[Objective]To investigate the effects of puerarin regulation of purinergic receptor P2X ligand-gated ion channel 7(P2X7)/nucleotide-binding oligomeric domain receptor protein 3(NLRP3)pathway on mast cell activity in mice with allergic rhinitis(AR).[Methods]BALB/c mice were randomly divided into normal group,AR group,puerarin low-dose group,puerarin high-dose group,dexamethasone group,puerarin high-dose+P2X7 activator adenosine triphosphate(ATP)group,with 12 mice in each group.Except for normal group and the AR mouse models in the other groups received intraperitoneal ovalbumin-alum sensitization followed by intranasal ovalbumin challenge to induce AR.After successful modeling,the puerarin low-and high-dose groups were intragastrically administered with puerarin at 12.5 mg·kg-1 and 50 mg·kg-1 respectively;the dexamethasone group was intragastrically administered with dexamethasone at 1 mg·kg-1;the puerarin high-dose+ATP group was intragastrically administered with puerarin at 50 mg·kg-1,and simultaneously injected with ATP(7.5×10-3 mmol per mouse)via the tail vein;the normal group and the AR group were given equal amounts of 0.9%sodium chloride solution via both intragastric administration and tail vein injection.The treatment was performed once a day for 14 consecutive days.AR score,serum immunoglobulin E(IgE),leukotriene,histamine,tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and IL-1β levels were detected.Hematoxylin-eosin(HE)staining was used to detect nasal mucosa pathological Change.The number of mast cells,the number of degranulated mast cells and the degranulated rate were detected by toluidine blue staining.The mean optical density of Tryptase expression in nasal mucosa was detected by immunohistochemical staining.The expressions of P2X7,NLRP3,cleaved-Caspase-1 proteins in nasal mucosa were measured by Western blot.[Results]Compared with normal group,the nasal mucosal epithelium in AR group was significantly thickened,accompanied with a large number of inflammatory cell infiltration and significant mucosal interstitial edema.The levels of AR score,serum IgE,leukotriene,histamine and TNF-α,IL-18,IL-1β were raised(P<0.05).What's more,the number of mast cells and the number of degranulated mast cells were increased,with a corresponding rise in the degranulation rate(P<0.05).The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were all amplified(P<0.05).Compared with AR group,the pathological injury of nasal mucosa in puerarin low-dose group,puerarin high-dose group and dexamethasone group was reduced.The levels of AR score,serum IgE,leukotriene,histamine,TNF-α,IL-18 and IL-1β were decreased.Additionally,the number of mast cells and the number of degranulated mast cells were reduced,with a corresponding decrease in the degranulation rate.The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were also diminished(P<0.05).Compared with the puerarin high-dose group,the puerarin high-dose+ATP group showed more severe pathological damage to nasal mucosal tissues.The AR score,serum levels of IgE,leukotrienes,histamine,TNF-α,IL-18 and IL-1β were increased.Meanwhile,the number of mast cells and degranulated mast cells,the degranulation rate were significantly added,and the mean optical density of Tryptase expression,and the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa tissues were all amplified(P<0.05).[Conclusion]Puerarin may reduce the activity of mast cells in AR model mice by inhibiting the P2X7/NLRP3 pathway.

ObjectiveTo investigate the value of different noninvasive diagnostic models in the diagnosis of esophageal and gastric varices since there is a high risk of esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension， and to provide a basis for the early diagnosis of esophageal and gastric varices. MethodsA total of 108 patients with significant portal hypertension due to compensated hepatitis B cirrhosis who attended Guangdong Provincial Hospital of Traditional Chinese Medicine from November 2017 to November 2023 were enrolled， and according to the presence or absence of esophageal and gastric varices under gastroscopy， they were divided into esophageal and gastric varices group （GOV group） and non-esophageal and gastric varices group （NGOV group）. Related data were collected， including age， sex， imaging findings， and laboratory markers. The chi-square test was used for comparison of categorical data between groups； the least significant difference t-test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The receiver operating characteristic （ROC） curve was plotted to evaluate the diagnostic value of five scoring models， i.e.， fibrosis-4 （FIB-4）， LOK index， LPRI， aspartate aminotransferase-to-platelet ratio index （APRI）， and aspartate aminotransferase/alanine aminotransferase ratio （AAR）. The binary logistic regression method was used to establish a combined model， and the area under the ROC curve （AUC） was compared between the combined model and each scoring model used alone. The Delong test was used to compare the AUC value between any two noninvasive diagnostic models. ResultsThere were 55 patients in the GOV group and 53 patients in the NGOV group. Compared with the NGOV group， the GOV group had a significantly higher age （52.64±1.44 years vs 47.96±1.68 years， t=0.453， P<0.05） and significantly lower levels of alanine aminotransferase ［42.00 （24.00 — 17.00） U/L vs 82.00 （46.00 — 271.00） U/L， Z=-3.065， P<0.05］， aspartate aminotransferase ［44.00 （32.00 — 96.00） U/L vs 62.00 （42.50 — 154.50） U/L，Z=-2.351， P<0.05］， and platelet count ［100.00 （69.00 — 120.00）×10⁹/L vs 119.00 （108.50 — 140.50）×10⁹/L， Z=-3.667， P<0.05］. The ROC curve analysis showed that FIB-4， LOK index， LPRI， and AAR used alone had an accuracy of 0.667， 0.681， 0.730， and 0.639， respectively， in the diagnosis of esophageal and gastric varices （all P<0.05）， and the positive diagnostic rates of GOV were 69.97%， 65.28%， 67.33%， and 58.86%， respectively， with no significant differences in AUC values （all P>0.05）， while APRI used alone had no diagnostic value （P>0.05）. A combined model （LAF） was established based on the binary logistic regression analysis and had an AUC of 0.805 and a positive diagnostic rate of GOV of 75.80%， with a significantly higher AUC than FIB-4， LOK index， LPRI， and AAR used alone （Z=-2.773，-2.479，-2.206， and-2.672， all P<0.05）. ConclusionFIB-4， LOK index， LPRI， and AAR have a similar diagnostic value for esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension， and APRI alone has no diagnostic value. The combined model LAF had the best diagnostic efficacy， which provides a certain reference for clinical promotion and application.

[Objective]To investigate the effects of puerarin regulation of purinergic receptor P2X ligand-gated ion channel 7(P2X7)/nucleotide-binding oligomeric domain receptor protein 3(NLRP3)pathway on mast cell activity in mice with allergic rhinitis(AR).[Methods]BALB/c mice were randomly divided into normal group,AR group,puerarin low-dose group,puerarin high-dose group,dexamethasone group,puerarin high-dose+P2X7 activator adenosine triphosphate(ATP)group,with 12 mice in each group.Except for normal group and the AR mouse models in the other groups received intraperitoneal ovalbumin-alum sensitization followed by intranasal ovalbumin challenge to induce AR.After successful modeling,the puerarin low-and high-dose groups were intragastrically administered with puerarin at 12.5 mg·kg-1 and 50 mg·kg-1 respectively;the dexamethasone group was intragastrically administered with dexamethasone at 1 mg·kg-1;the puerarin high-dose+ATP group was intragastrically administered with puerarin at 50 mg·kg-1,and simultaneously injected with ATP(7.5×10-3 mmol per mouse)via the tail vein;the normal group and the AR group were given equal amounts of 0.9%sodium chloride solution via both intragastric administration and tail vein injection.The treatment was performed once a day for 14 consecutive days.AR score,serum immunoglobulin E(IgE),leukotriene,histamine,tumor necrosis factor-α(TNF-α),interleukin-18(IL-18)and IL-1β levels were detected.Hematoxylin-eosin(HE)staining was used to detect nasal mucosa pathological Change.The number of mast cells,the number of degranulated mast cells and the degranulated rate were detected by toluidine blue staining.The mean optical density of Tryptase expression in nasal mucosa was detected by immunohistochemical staining.The expressions of P2X7,NLRP3,cleaved-Caspase-1 proteins in nasal mucosa were measured by Western blot.[Results]Compared with normal group,the nasal mucosal epithelium in AR group was significantly thickened,accompanied with a large number of inflammatory cell infiltration and significant mucosal interstitial edema.The levels of AR score,serum IgE,leukotriene,histamine and TNF-α,IL-18,IL-1β were raised(P<0.05).What's more,the number of mast cells and the number of degranulated mast cells were increased,with a corresponding rise in the degranulation rate(P<0.05).The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were all amplified(P<0.05).Compared with AR group,the pathological injury of nasal mucosa in puerarin low-dose group,puerarin high-dose group and dexamethasone group was reduced.The levels of AR score,serum IgE,leukotriene,histamine,TNF-α,IL-18 and IL-1β were decreased.Additionally,the number of mast cells and the number of degranulated mast cells were reduced,with a corresponding decrease in the degranulation rate.The mean optical density of Tryptase expression,as well as the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa were also diminished(P<0.05).Compared with the puerarin high-dose group,the puerarin high-dose+ATP group showed more severe pathological damage to nasal mucosal tissues.The AR score,serum levels of IgE,leukotrienes,histamine,TNF-α,IL-18 and IL-1β were increased.Meanwhile,the number of mast cells and degranulated mast cells,the degranulation rate were significantly added,and the mean optical density of Tryptase expression,and the expressions of P2X7,NLRP3 and cleaved-Caspase-1 in nasal mucosa tissues were all amplified(P<0.05).[Conclusion]Puerarin may reduce the activity of mast cells in AR model mice by inhibiting the P2X7/NLRP3 pathway.

Repetitive transcranial magnetic stimulation (rTMS) has become an essential method in psychiatric disorders. However, many problems occurred in clinical application. This article interpreted the Association Standard T/CMEAS 011-2023'Operating Specifications for Repetitive Transcranial Magnetic Stimulation in Clinical Applications on Psychiatric Disorders′ released by the Chinese Medicine Education Association. The main content included a range of applications, normative references, terms and definitions, site specifications, equipment specifications, ability specifications of rTMS operators and rTMS process specifications.This article provided suggestions for clinical applications of rTMS on psychiatric disorders.

Repetitive transcranial magnetic stimulation (rTMS) has become an essential method in psychiatric disorders. However, many problems occurred in clinical application. This article interpreted the Association Standard T/CMEAS 011-2023'Operating Specifications for Repetitive Transcranial Magnetic Stimulation in Clinical Applications on Psychiatric Disorders′ released by the Chinese Medicine Education Association. The main content included a range of applications, normative references, terms and definitions, site specifications, equipment specifications, ability specifications of rTMS operators and rTMS process specifications.This article provided suggestions for clinical applications of rTMS on psychiatric disorders.