This article systematically reviews and examines the historical evolution of Bambusae Succus as a medicinal material， covering aspects such as nomenclature， origin， geographical distribution， harvesting and processing methods， quality assessment， therapeutic effects and indications， by consulting ancient herbal texts， medical compendia， and modern literature. The aim is to provide a reference for the development and utilization of famous classical formulas containing this herb. Research indicated that Bambusae Succus was first documented in the Shennong Bencaojing during the Han dynasty， with Zhuli being the standard name used throughout history， alongside aliases like Zhuzhi， Zhuyou and Huoquan. Historically， the primary source of Bambusae Succus has been Phyllostachys nigra var. henonis（Danzhu）， although other species such as Pleioblastus amarus and Bambusa emeiensis have also been used medicinally. Ancient records predominantly noted its origin in Yizhou（present-day Chengdu and surrounding areas in Sichuan） and the Wuling region（between present-day Hunan， Guangdong， Guangxi and Jiangxi provinces）， while contemporary sources are mainly from regions south of the Yangtze River and southwestern China. Traditionally， Bambusae Succus was harvested from bamboo that had grown for exactly one year， today， it can be collected year-round without strict age requirements. Ancient preparation methods included direct fire roasting or dry distillation， whereas modern industrial production employs dry distillation， reflux extraction， and percolation. In terms of quality evaluation， ancient texts considered a sweet taste to be superior， while today， clarity and transparency are prioritized. Historically， Bambusae Succus was characterized as sweet and cold nature， targeting the lung and stomach meridians， with uses evolving from clearing heat and resolving phlegm to nourishing Yin， moistening dryness， and relaxing tendons and unblocking meridians. Modern descriptions classify it as sweet， bitter， and cold in nature， affecting the heart， liver， and lung meridians， with functions including clearing heat， resolving phlegm， and facilitating orifices. It is indicated for conditions such as stroke with phlegm confusion， lung heat with phlegm congestion， convulsions， epilepsy， excessive phlegm in febrile diseases， high fever with thirst， irritability during pregnancy， and tetanus， with more clearly defined applications. Based on the results of the research， it is recommended that when developing and utilizing famous classical formulas containing Bambusae Succus， the one-year-old Phyllostachys nigra var. Henonis， which has been highly praised throughout history， should be selected as the source material. Industrial production should adopt the dry distillation method. Furthermore， in-depth research should be conducted on the modern technological characterization of the traditional quality control indicator of sweet taste， and reasonable modern quality control standards should be established.

Neurofibromas are benign peripheral nerve sheath tumors. It is more common in neurofibromatosis type Ⅰ. However, isolated vagal nerve neurofibroma（VNN） of the neck is extremely rare, and only a few case reports have been reported. Its etiology and pathogenesis are not clear. The diagnosis is mainly based on pathological examination and immunohistochemistry, and surgical resection is the main treatment. This study reports a rare case of giant solitary vagus neurofibroma in the neck. The patient was a 29-year-old female who was found to have a mass on the right side of the neck by physical examination, which was considered to be a vagus nerve tumor by neck ultrasound and imaging examination. The tumor was completely removed during the operation, with the size of about 10.0 cm×2.5 cm, and the patient had no special discomfort. Postoperative pathology and immunohistochemistry confirmed neurofibroma. After surgery, the patient had right vocal cord paralysis, hoarseness, choking and paroxysmal cough. After swallowing function training and voice rehabilitation treatment in the department, the patient recovered satisfactorily. There was no complication and recurrence during the follow-up of 1 year. This article reviews the literature to improve the diagnosis and treatment of solitary vagus neurofibroma in the neck by combining its medical history, imaging features, pathology and immunohistochemistry, and surgical treatment.
Humans ; Female ; Adult ; Neurofibroma ; Vagus Nerve/pathology* ; Neck ; Cranial Nerve Neoplasms

Objective:To investigate the value of triglyceride glucose index(TyG)and monocyte to high-density lipoprotein choles-terol ratio(MHR)in the diagnosis of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated by heart fail-ure(HF),as well as the correlation of TyG and MHR with cardiac function in AECOPD patients.Methods:A retrospective analysis was performed for the clinical data of 298 AECOPD patients who were admitted to The First Hospital of Lanzhou University from January 2020 to December 2021,and according to the clinical manifestation,B-type natriuretic peptide/N-terminal B-type natriuretic peptide precursor,and echocardiography,the 298 AECOPD patients were divided into HF group with 127 patients and non-HF group with 171 patients.Related clinical indicators were compared between the two groups,and a regression analysis was used to identify the pos-sible risk factors for HF in AECOPD patients.The receiver operat-ing characteristic(ROC)curve analysis was used to investigate the value of TyG and MHR alone or in combination in the diagnosis of AECOPD complicated by HF,and a correlation analysis was used to investigate the correlation of TyG and MHR with cardiac function parameters(ejection fraction,ventricular wall thickness,cardiac chamber size,and valve regurgitation velocity)and pulmonary artery pressure in AECOPD patients.Results:The binary logistic regres-sion analysis showed that fasting blood glucose,absolute monocyte count,high-density lipoprotein cholesterol(HDL-C),arrhythmia,TyG,and MHR were independent risk factors for HF in AECOPD patients,and the HF group had significantly higher levels of TyG and MHR than the non-HF group(P<0.001).TyG had an area under the ROC curve(AUC)of 0.805(95%CI=0.754-0.856,P<0.001)in the diagnosis of AECOPD complicated by HF,and MHR had an AUC of 0.762(95%CI=0.707-0.817,P<0.001),while TyG combined with MHR had an AUC of 0.870(95%CI=0.828-0.912,P<0.001).The correlation analysis showed that TyG was negatively correlated with left ventricular ejection fraction and left ventricular fractional shortening and was positively correlated with end-diastolic interven-tricular septal thickness,mitral regurgitation velocity,and left ventricular end-diastolic posterior wall thickness,while MHR was nega-tively correlated with left ventricular stroke volume and left ventricular fractional shortening and was positively correlated with end-diastolic interventricular septal thickness,right ventricular anteroposterior diameter,right ventricular superior-inferior diameter,right ventricular transverse diameter,tricuspid regurgitation velocity,left ventricular end-diastolic posterior wall thickness,and pulmonary artery pressure.Conclusion:Fasting blood glucose,absolute monocyte count,HDL-C,arrhythmia,TyG,and MHR are independent risk factors for AECOPD complicated by HF.Both TyG and MHR have a certain value in the diagnosis of HF,and the combination of TyG and MHR has a better efficacy than each indicator alone in the diagnosis of AECOPD complicated by HF.TyG is correlated with the cardiac function parameters such as left ventricular ejection fraction,ventricular wall thickness,and mitral regurgitation velocity in patients with AECOPD and may have a stronger correlation with the left ventricle;MHR is correlated with right ventricular chamber size,tricuspid regurgitation velocity,and pulmonary artery pressure and may have a stronger correlation with the right ventricle.

Abnormal cerebral perfusion impacts not only short-term brain function but may also cause irrevers-ible neurological deficits,significantly affecting patient prognosis.In intensive care units(ICU),patients often exhibit he-modynamic instability,intracranial pathologies,and impaired cerebrovascular autoregulation,which may result in cere-bral perfusion disorders,particularly cerebral hypoperfusion.Cerebral perfusion is determined by three key factors:blood pressure,intracranial pressure,and cerebrovascular regulatory function.Given that ICU patients have various types of un-derlying primary diseases,there is a need for unified standards regarding optimal blood pressure maintenance for all pa-tients and specific patient categories.Furthermore,cerebral perfusion-oriented blood pressure management requires indi-vidualized approaches for each patient.Therefore,the monitoring and integration of these parameters during ICU diagnos-tic and therapeutic processes are particularly crucial.

Objective:To explore the effects of anshen jieyu decoction on hippocampal morphology and regulation of PI3K/AKT signalling pathway with hypothalamic-pituitary-adrenal axis expression in CUMS depressed rats.Methods:Rats were divided into a control group(Control),CUMS model group(CUMS),and ASJYD treatment group(CUMS+ASJYD).Rats in the CUMS and CUMS+ASJYD groups were exposed to 10 different chronic stressors to induce depressive-like behaviors.After modeling,the CUMS+ASJYD group received ASJYD via gavage.Depressive-like behaviors were assessed using the sucrose preference test and open field test.Serum levels of adrenocorticotropic hor-mone(ACTH)and corticosterone(CORT)were measured by ELISA.Hippocampal neuronal morphological changes were observed via Nissl staining,mitochondrial ultrastructure was examined using transmission electron microscopy,and hippocampal PI3K and AKT protein phosphorylation levels were detected by Western blot.Results:Compared with the Control group,the CUMS group showed significantly reduced sucrose consumption,preference rate,total travel distance in the open field,and central zone activity time(P＜0.01).Serum ACTH and CORT levels were elevated(P＜0.01),with disorganized hippocampal cell arrangement,reduced cell count,mitochondrial swelling,cristae blurring/rupture observed under electron microscopy,and decreased phosphorylation levels of PI3 K and AKT proteins(P＜0.01).After ASJYD treatment,the CUMS+ASJYD group exhibited significant improvements in sucrose consumption,preference rate,locomotor activity,and central zone exploration(P＜0.01),accompanied by reduced ACTH/CORT expression,alleviated hippocampal pathology,restored mitochondrial integrity with clear cristae,and increased PI3K/AKT phosphorylation(P＜0.01).Conclusion:Anshen Jieyu decoction significantly improved the depression-like be-haviour of CUMS rats,which may be achieved by down-regulating the hyperactive hypothalamic-pituitary-adrenal axis,regulating the expression of PI3K/AKT signaling pathway,and ameliorating the damage to hippocampal neurons and mi-tochondria.

Objective:To explore the effects of anshen jieyu decoction on hippocampal morphology and regulation of PI3K/AKT signalling pathway with hypothalamic-pituitary-adrenal axis expression in CUMS depressed rats.Methods:Rats were divided into a control group(Control),CUMS model group(CUMS),and ASJYD treatment group(CUMS+ASJYD).Rats in the CUMS and CUMS+ASJYD groups were exposed to 10 different chronic stressors to induce depressive-like behaviors.After modeling,the CUMS+ASJYD group received ASJYD via gavage.Depressive-like behaviors were assessed using the sucrose preference test and open field test.Serum levels of adrenocorticotropic hor-mone(ACTH)and corticosterone(CORT)were measured by ELISA.Hippocampal neuronal morphological changes were observed via Nissl staining,mitochondrial ultrastructure was examined using transmission electron microscopy,and hippocampal PI3K and AKT protein phosphorylation levels were detected by Western blot.Results:Compared with the Control group,the CUMS group showed significantly reduced sucrose consumption,preference rate,total travel distance in the open field,and central zone activity time(P＜0.01).Serum ACTH and CORT levels were elevated(P＜0.01),with disorganized hippocampal cell arrangement,reduced cell count,mitochondrial swelling,cristae blurring/rupture observed under electron microscopy,and decreased phosphorylation levels of PI3 K and AKT proteins(P＜0.01).After ASJYD treatment,the CUMS+ASJYD group exhibited significant improvements in sucrose consumption,preference rate,locomotor activity,and central zone exploration(P＜0.01),accompanied by reduced ACTH/CORT expression,alleviated hippocampal pathology,restored mitochondrial integrity with clear cristae,and increased PI3K/AKT phosphorylation(P＜0.01).Conclusion:Anshen Jieyu decoction significantly improved the depression-like be-haviour of CUMS rats,which may be achieved by down-regulating the hyperactive hypothalamic-pituitary-adrenal axis,regulating the expression of PI3K/AKT signaling pathway,and ameliorating the damage to hippocampal neurons and mi-tochondria.

Abnormal cerebral perfusion impacts not only short-term brain function but may also cause irrevers-ible neurological deficits,significantly affecting patient prognosis.In intensive care units(ICU),patients often exhibit he-modynamic instability,intracranial pathologies,and impaired cerebrovascular autoregulation,which may result in cere-bral perfusion disorders,particularly cerebral hypoperfusion.Cerebral perfusion is determined by three key factors:blood pressure,intracranial pressure,and cerebrovascular regulatory function.Given that ICU patients have various types of un-derlying primary diseases,there is a need for unified standards regarding optimal blood pressure maintenance for all pa-tients and specific patient categories.Furthermore,cerebral perfusion-oriented blood pressure management requires indi-vidualized approaches for each patient.Therefore,the monitoring and integration of these parameters during ICU diagnos-tic and therapeutic processes are particularly crucial.

Obstructive sleep apnea(OSA)is an independent risk factor for several cardiovascular diseases,and its characteristic intermittent hypoxic environment induces dysregulation of miRNA in cells and circulation,which promotes cellular dysfunction and metabolic disorders,and participates in the formation of atherosclerosis(As).This article re-views the potential role of miRNA in the occurrence and progression of OSA-related As,which helps to understand the mo-lecular pathways underlying the pathogenesis of OSA-related As and provides new insights for the development of miRNA based therapies for OSA-related cardiovascular diseases.

Objective:To analyze the short-term clinical outcomes of total laparoscopic distal gastrectomy (TLDG) and laparoscopic-assisted distal gastrectomy (LADG) combined with Billroth-Ⅱ+Braun anastomosis.Methods:Clinical characteristics of patients undergoing laparoscopic distal gastrectomy combined with Billroth-Ⅱ+Braun anastomosis at Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University from Jan 2020 to Oct 2022 were analyzed. Patients were divided into TLDG group ( n=62) and LADG group ( n=62) according to the surgical approach. Results:There were significant differences in the preoperative clinical data section between the two groups, and 124 patients (62 in each group) were enrolled after using propensity score matching to balance significant variables. Compared with the LADG group, the TLDG group showed statistically differences in time to first venting [(2.9±1.3) vs. (2.3±0.8) d, Z=-3.072, P=0.002], time to first fluid diet [(5.9±1.3) vs. (5.4±1.4) d, Z=-2.031, P=0.042] and incision length [(7.1±1.4) vs. (4.8±0.8) cm, Z=-6.331, P=0.000]. Total postoperative complication rate in the TLDG group and the LADG group (29% vs. 37%, χ2=0.911, P=0.340) was not statistically significant. Incidence of postoperative pneumonia was lower in the TLDG group than in the LADG group (3% vs. 13%, χ2=3.916, P=0.048), and incidence of all remaining postoperative complications were not statistically significant. There was no statistically significant difference in the incidence of serious postoperative complications between the TLDG and LADG groups ( P=1.000). Multifactorial analysis revealed that male ( P=0.023) and age ≥65 years ( P=0.001) were independent risk factors for postoperative complications. Conclusion:TLDG is safe and feasible and has better short-term clinical efficacy than LADG.