Depression is a common psychiatric disorder characterized by persistent low mood or mental disorders. Current treatments primarily focus on regulating neurotransmitter levels， but their effectiveness is limited. The mechanisms underlying its onset are complex， and there is no unified consensus. Abnormal signaling pathway transmission plays a crucial role in the development of depression， involving multiple pathways， including Toll-like receptor 4/nucleotide-binding oligomerization domain-like receptor protein 3 （TLR4/NLRP3）， nuclear factor-κB （NF-κB）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， mitogen-activated protein kinase/extracellular signal-regulated kinase （MAPK/ERK）， brain-derived neurotrophic factor/tyrosine kinase receptor B （BDNF/TrkB）， cyclic AMP/protein kinase A/cAMP response element-binding protein （cAMP/PKA/CREB）， and others. Traditional Chinese medicine（TCM） is based on a holistic approach and the principle of treatment based on the differentiation of syndromes， regulating the balance of multiple systems and organ functions from a macroscopic perspective. This approach has shown unique advantages in the treatment of depression. TCM attributes the onset of depression to dysfunction of the organ systems， involving liver Qi stagnation， heart spirit deficiency， kidney essence depletion， and spleen dysfunction. TCM compound treatments focus on soothing the liver， strengthening the spleen， calming the heart， and replenishing essence， with formulas such as Xiaoyaosan， Zishui Qinggan Yin， and Chahu Jia Guizhi Longgu Muli Tang. The active components of Chinese herbs mainly aim to tonify and regulate Qi， such as salidroside， ginsenoside Rb₁， astragaloside， and muscone. External TCM treatments， primarily acupuncture， aim to open the orifices and invigorate the spirit. Acupoints such as Baihui， Shenting， and Yintang are commonly used. Additionally， massage and moxibustion therapy can intervene in depression by regulating signaling pathways. This article reviews the core role of signaling pathways in the development of depression and the mechanism of TCM regulation of signaling pathways to intervene in depression， aiming to discover new therapeutic approaches that can improve the symptoms of depressed patients.

Objective:To explore the mechanism by which the combination of Dioscorea pill and gemcitabine induces apoptosis and epithelial-mesenchymal transition (EMT) in KATO-III cells.Methods:KATO-III cells were used as the experimental model and divided into four groups: control group, Dioscorea pill group, gemcitabine group, and Dioscorea pill combined with gemcitabine group. The cell proliferation was evaluated by CCK-8 assay, apoptosis was detected by flow cytometry, the expression changes of apoptosis-related proteins (such as Bcl-2, Bax, Caspase-3) were analyzed by Western blot, and EMT-related markers (such as E-cadherin, N-cadherin, Vimentin) were analyzed by immunofluorescence and Western blot.Results:Compared with the control group, the Dioscorea pill group, gemcitabine group, and combined treatment group all significantly inhibited the proliferation of KATO-III cells, with the combined treatment group showing the strongest apoptotic induction effect. Flow cytometry results showed that the apoptosis rate in the combined treatment group was significantly higher than that in the single drug groups ( P<0.05) . Western blot results indicated that in the combined treatment group, the expression levels of Bax and Caspase-3 were significantly upregulated, while the expression of Bcl-2 was significantly downregulated. Immunofluorescence and Western blot analysis revealed that combined treatment significantly inhibited the EMT process in KATO-III cells, as evidenced by increased expression of E-cadherin and decreased expression of N-cadherin and Vimentin. Conclusions:Dioscorea pill combined with gemcitabine enhances the anti-tumor effect by promoting apoptosis and inhibiting the EMT process in KATO-III cells. This combination provides a potential new strategy for the clinical treatment of gastric cancer.

Objective:To explore the mechanism by which the combination of Dioscorea pill and gemcitabine induces apoptosis and epithelial-mesenchymal transition (EMT) in KATO-III cells.Methods:KATO-III cells were used as the experimental model and divided into four groups: control group, Dioscorea pill group, gemcitabine group, and Dioscorea pill combined with gemcitabine group. The cell proliferation was evaluated by CCK-8 assay, apoptosis was detected by flow cytometry, the expression changes of apoptosis-related proteins (such as Bcl-2, Bax, Caspase-3) were analyzed by Western blot, and EMT-related markers (such as E-cadherin, N-cadherin, Vimentin) were analyzed by immunofluorescence and Western blot.Results:Compared with the control group, the Dioscorea pill group, gemcitabine group, and combined treatment group all significantly inhibited the proliferation of KATO-III cells, with the combined treatment group showing the strongest apoptotic induction effect. Flow cytometry results showed that the apoptosis rate in the combined treatment group was significantly higher than that in the single drug groups ( P<0.05) . Western blot results indicated that in the combined treatment group, the expression levels of Bax and Caspase-3 were significantly upregulated, while the expression of Bcl-2 was significantly downregulated. Immunofluorescence and Western blot analysis revealed that combined treatment significantly inhibited the EMT process in KATO-III cells, as evidenced by increased expression of E-cadherin and decreased expression of N-cadherin and Vimentin. Conclusions:Dioscorea pill combined with gemcitabine enhances the anti-tumor effect by promoting apoptosis and inhibiting the EMT process in KATO-III cells. This combination provides a potential new strategy for the clinical treatment of gastric cancer.

The aberrant activation of the nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 （NLRP3） inflammasome as an essential component of the innate system is implicated in the pathogenesis of several human inflammatory diseases. Studies have confirmed its association with digestive system diseases such as ulcerative colitis， Crohn's disease， and acute pancreatitis， suggesting that the NLRP3 inflammasome plays a role in the initiation and progression of these diseases. Based on the mechanism of NLRP3 inflammasome activation and the pathways that mediate the inflammatory response， this article introduced the relationship between the NLRP3 inflammasome and the pathogenesis of multiple digestive system diseases and the Chinese and western medical therapies. Traditional Chinese medicine （TCM） has demonstrated definite effects on the NLRP3 inflammasome-mediated digestive system diseases. Some single Chinese medicines or TCM prescriptions can treat digestive system diseases by activating or inhibiting NLRP3 inflammasome activation. NLRP3 inflammasome can receive a variety of endogenous and exogenous stimulatory signals， which can initiate， activate， and mediate inflammatory responses. The inflammasome formation and downstream inflammatory cytokines are involved in not only the inflammatory responses but also the development and progression of multiple digestive system diseases. Therefore， the NLRP3 inflammasome can serve as an ideal target for disease treatment. The future rediscovery and in-depth studies of multiple inflammasomes will shed new light on the treatment of multiple digestive system diseases.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To investigate the effects of different phototherapy intensities on the levels of malondialdehyde, a peroxidation product of intralipid, vitamin C and vitamin E in parenteral nutrition for premature infants.Methods:The parenteral nutrition for premature infants was prepared under strict aseptic condition and was divided into four groups based on different phototherapy intensities in simulated clinical settings, which were indoor light group, single-, double-, and three-sided phototherapy group. According to whether the nutrient solution shielded for light or not, each group was further divided into two subgroups: exposure or non-exposure group. The levels of malondialdehyde, vitamin C and vitamin E in all groups before phototherapy and 6, 12, 18, and 24 h after phototherapy were measured. Ten samples of parenteral nutrient solutions were prepared for each group, of which 2 ml were extracted for test at different time points. Repeated measurement analysis of variance was used for data analysis and the results were adjusted using Greenhouse-Geisser method if failed in Mauchly sphere test.Results:With the increase of phototherapy time, the malondialdehyde level increased in the exposure and the non-exposure subgroups in the one-sided phototherapy group [before phototherapy: (3.777±0.112) vs (3.746±0.141) nmol/ml; phototherapy for 6 h: (3.808±0.122) vs (3.715±0.145) nmol/ml; 12 h: (4.546±0.138) vs (4.507±0.136) nmol/ml; 18 h: (6.116±0.151) vs (5.239±0.156) nmol/ml; 24 h: (7.569±0.136) vs (5.300±0.200) nmol/ml; all P<0.05], but the level of vitamin C [before phototherapy: (62.507±0.205) vs (62.341±0.144)μg/ml; phototherapy for 6 h: (51.211±0.086) vs (58.128±0.076) μg/ml; 12 h: (43.288±0.084) vs (55.351±0.050) μg/ml; 18 h: (35.758±0.113) vs (51.215±0.093) μg/ml; 24 h: (33.473±0.075) vs (48.473±0.080)μg/ml] and vitamin E decreased [before phototherapy: (4.101±0.132) vs (4.084±0.141) μg/ml; phototherapy for 6 h: (3.761±0.119) vs (3.904±0.075) μg/ml; 12 h: (3.654±0.092) vs (3.729±0.087) μg/ml; 18 h: (3.385±0.102) vs (3.582±0.119) μg/ml; 24 h: (3.313±0.127) vs (3.438±0.113) μg/ml, all P<0.05]. The same situation was also observed in indoor light group, double-, and three-sided phototherapy groups. The malondialdehyde level at different time in the exposure subgroups were higher but the vitamin C and vitamin E levels were lower than those in the non-exposure subgroups, regardless of the phototherapy intensities (all P<0.001). (2) The analysis of all exposure phototherapy subgroups showed that the higher the intensity of light therapy, the higher the malondialdehyde level, and the lower the level of vitamin C and vitamin E, with statistical significance differences in any pairwise comparison. Analysis of all non-exposure subgroups showed statistically significant differences in the malondialdehyde level in any pairwise comparison (all P<0.05) except for the comparison between indoor light group and single-sided phototherapy group ( F=2.383. P=0.140). Moreover, the greater the phototherapy intensities, the lower vitamin C level, with statistically significant differences in any pairwise comparison. And statistical significance differences were observed in the vitamin E level in any pairwise comparison (all P<0.05) except for the comparison between double- and three-sided phototherapy groups ( F=1.358, P=0.259). Conclusions:Phototherapy can increase the malondialdehyde level in parenteral nutrient solution for premature infants and the degree of intralipid peroxidation, but can also lead to vitamin C and vitamin E loss in the parenteral nutrient and weaken its antioxidant capacity.

Objective:To analyze the influenza vaccination status of chronic disease management patients in Qingpu district of Shanghai and the vaccination characteristics of different characteristic populations, so as to provide scientific basis for improving the influenza vaccination rate of chronic disease patients in the community.Methods:By comparing the data of Shanghai chronic disease management information system, immunization planning information system and medical association platform, 89 453 subjects who met the inclusion and exclusion criteria in Qingpu district were selected as the research objects. The vaccination coverage rate of the study subjects was calculated according to gender, age group, urban and rural distribution, occupation, chronic disease type and quantity, and the vaccination coverage rate of different subgroups was compared to analyze the influencing factors of vaccination coverage rate.Results:Most of the 89 453 patients with chronic diseases were 60 years old and above (71.93%). Patients with hypertension, diabetes, chronic obstructive pulmoriary disease (COPD) and three chronic diseases accounted for 87.12%, 28.67%, 8.71% and 1.83%, respectively. Influenza vaccination coverage in the 2016/2017 flu season was low, at 0.32%. Influenza vaccination coverage rate of women (0.37%) was higher than that of men (0.27%), which was 1.41 times respectively(95% CI: 1.16, 1.72) that of men patients. The coverage rate of influenza vaccination for the 70-79 year-old group was the highest (0.74%), which was 1.74 times respectively(95% CI: 1.39, 2.19) that of 60-69 year-old patients. The vaccination coverage rate of government departments and institutions was the highest (1.14%), which was 12.58 times respectively(95% CI: 4.52, 34.99) that of retirees. The vaccination rate of COPD patients (3.68%) was 2.50 times (95% CI: 1.66, 3.77) higher than that of patients without COPD.Conclusions:Influenza vaccination rate for chronic disease management patients in Qingpu district of Shanghai is low. Gender, occupation, age and types of chronic diseases are the influencing factors. Patients with chronic disease management should be included in the priority vaccination targets for influenza vaccines, and vaccination intervention for occupational chronic diseases such as non-retired agriculture and forestry patients, especially male patients, should be strengthened to improve influenza vaccination coverage rate.

Since the outbreak of COVID-19, the hospital is faced with such challenges as sustained input in patient screening, referral and rescue, supportive medical supplies including the management of personal protective supplies and the maintenance of medical equipment. In the face of increasing workload, the medical materials support team of the hospital took the following measures in the principles of " discovering new sources of supplies and minimizing consumption" . These measures taken include proactive supply procurement strategy, prioritizing allocations based on risk exposure, uniform distribution of supplies based on inventory and usage, and traceable management for donated supplies; optimal and central deployment of equipments, emergency installation, pre-maintenance and emergency repairs for equipments; efficient and safe sterilization of reusable materials and equipments using sterilizers; enhanced personnel training and management to keep updating the medical supplies capacity of the team. All these efforts have contributed significantly to the orderly work of epidemic control.

Objective To evaluate the influence different of operation opportunity on clinical effects of laparoscopic cholecystectomy in the treatment of patients with acute gallstone pancreatitis.Methods A retrospective analysis was made on 93 patients with acute gallstone pancreatitis,laparoscopic cholecystectomy was performed in all patients.And the patients were divided into research group(early:within 48 h)and control group(delay:over 8 to 12 weeks)by operation opportunity.The operation index,biochemical index,quality of life,recurrence and complication occurrence between the two group were compared.Results There were no significant differences in the amount of blood loss and operation time between the two groups(t=0.332,0.486,all P>0.05).The hospital stay of the research group was lower than that of the control group[(11.43±2.65)d vs.(20.51±3.42)d],the difference was statistically significant(t=14.245,P<0.05).7 d after operation,the biochemical indicators of the two groups were all decreased,and had significant differences compared with 1 d after operation(t=17.184,35.209,12.018,7.452,16.045,36.124,12.337,7.038,all P<0.05).But there was no significant difference in biochemical index between the two groups at 7 d and 1 d after operation(t=0.431,0.663,0.664,1.118,0.085,0.156,0.283,0.262,all P>0.05).The life quality of the two groups were greatly improved after treatment,and had significant difference compared with before treatment(t=5.017,7.028,6.124,3.095,6.023,6.995,6.184,3.128,all P<0.05).There were no significant differences in the incidence rates of recurrence and complications(4.44% vs 2.08%,6.67% vs.10.42%)between the two groups(x2=0.412,0.081,all P>0.05).Conclusion Early laparoscopic cholecystectomy can shorten the length of stay in patients with acute gallstone pancreatitis ,and with good clinical effects and safety.

OBJECTIVETo evaluate the reliability and accuracy of arcuate fasciculus (AF) navigation for AF localization and reconstruction.

METHODSReconstruction of the AF and assessment of the aphasia quotient (AQ) were performed in 43 cases before and after surgical removal of lesions in the language area of the brain. The minimal distance between the AF and the lesion (D(1)), preoperative AQ (AQ(1)), the minimal distance between the AF and the surgical cavity (D(2)), and the postoperative AQ (AQ(2)) were measured. Linear correlation analysis was conducted between D(1) or D(2) and the corresponding AQ(1) or AQ(2) to assess the relationship between the AF and language function. The language function of each patient was evaluated postoperatively.

RESULTSThe AF was successfully reconstructed in all the cases. The tractography results of the identical AF generated by 3 different users showed good congruency. A positive linear correlation was demonstrated between D(1) and AQ(1) (P<0.001) and between D(2) and AQ(2) (P=0.001). Only two patients (4.7%) showed language deficits at postoperative follow-up.

CONCLUSIONAF navigation is a reliable and accurate technique for AF reconstruction and localization and helps to preserve the language function after surgical removal of lesions in the language area of the brain.

Adolescent ; Adult ; Diffusion Tensor Imaging ; Female ; Humans ; Language Disorders ; diagnosis ; Male ; Middle Aged ; Nerve Fibers ; Neuronavigation ; Reproducibility of Results ; Young Adult