Coronary heart disease is a chronic and lifelong disease， which places a dual burden on the physiological and psychological well-being of patients， and can easily lead to psychological distress and affect their prognosis and quality of life. This article provides a systematic review， in which the current status， evaluation tools， influencing factors and intervention methods of psychological distress in patients with coronary heart disease are explored， aiming to provide key information beneficial for identifying and preventing psychological distress， and to improve the overall management and treatment effectiveness of coronary heart disease patients. In this paper， 18 articles were included， and the demographic， physiological， psychological and social factors affecting the psychological distress of patients with coronary heart disease were systematically analyzed， thus to provide a deeper understanding of psychological distress and offering references for formulating targeted intervention strategies.

ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Objective:To explore the efficacy and safety of embolization of anterior cranial fossa dural arteriovenous fistula (ACF-DAVF) via different arterial approaches, and provide evidence for individualized treatment of ACF-DAVF. Methods:A retrospective study was performed; 25 patients with ACF-DAVF admitted to Department of Cerebrovascular Surgery, Neurosurgery Center, Zhujiang Hospital, Southern Medical University from January 2020 to December 2023 were enrolled. Vascular approaches, including the anterior cerebral artery ( n=7), facial artery ( n=3), middle meningeal artery ( n=8), ophthalmic artery ( n=6), and vein ( n=1), were selected based on angioarchitectural features and microcatheter accessibility. Fistula and proximal draining vein occlusions were confirmed by immediate post-embolization digital subtraction angiography (DSA), and perioperative complications were recorded. At a 6-month follow-up, prognoses were assessed by modified Rankin Scale (mRS), and DSA or MRA was performed to detect the recurrence of ACF-DAVF. Results:Six patients had complete embolization and 2 patients had near-total embolization of the fistula and proximal draining vein immediately after embolization via middle meningeal artery approach; 4 patients achieved complete embolization and 2 patients achieved near-total embolization via ophthalmic artery approach; 6 patients achieved complete embolization and one patient achieved near-total embolization via anterior cerebral artery approach; 3 patients achieved complete embolization via facial artery approach; one patient achieved complete embolization via venous approach. No perioperative intracranial hemorrhage or central retinal artery occlusion was noted. Follow-up for 6 months was performed in 25 patients: mRS score was 0 in 19 patients, 1 in 2 patients, and 2 in 4 patients; DSA in 19 patients and MRA in 6 patients indicated no ACF-DAVF recurrence. Conclusion:Based on the angioarchitectural features and microcatheter accessibility, individualized selection of vascular approaches for ACF-DAVF embolization can achieve better efficacy and safety.

Objective:To explore the implementation effect of the"four-step teaching of encouraging and sharing"combined anchor-based teaching mode in the course of laboratory diagnostics under the background of automatic laboratory.Methods:The"four-step teaching of encouraging and sharing"combined anchor-based teaching mode conducted teaching in course of laboratory diagnostics through carefully designed"anchors",self-directed learning,a second"anchor"placement,and outcome sharing.A total of 224 medical students of the 2021 and 2022 grades,who majored Chinese medicine in Beijing University of Chinese Medicine and conducted their internships in the Laboratory of Dongfang Hospital,Beijing University of Chinese Medicine from April 2023 to April 2025,were selected.According to different teaching modes,the 108 medical students of 2022 grade were divided into the combined teaching group that adopted the"four-step teaching of encouraging and sharing"combined anchor-based teaching mode to conduct teaching,and 116 medical students of 2021 grade were divided into the conventional teaching group that adopted conventional teaching mode to conduct teaching.After completed the courses,the comprehensive competency of these students of two groups during the internship were measured,and the application effect of the"four-step teaching of encouraging and sharing"combined anchor-based teaching mode was assessed by self-made survey questionnaire.Results:The scores of theoretical knowledge test and clinical case analysis assessment of the students of combined teaching group were respectively(44.19±2.36)and(48.20±1.52),all of which were higher than(38.36±2.14)and(37.56±2.47)of conventional teaching group,and the differences of them between two groups were statistically significant(t=28.72,55.71,P<0.05),respectively.In the combined teaching group,91.67%of the students expressed a preference for the"four-step teaching of encouraging and sharing"combined anchor-based teaching mode.Conclusion:Under the background of automatic laboratory,the"four-step teaching of encouraging and sharing"combined anchor-based teaching mode of laboratory diagnostics can effectively enhance students'transfer ability for knowledge,and strengthen their self-directed learning awareness,and lay a solid foundation for training clinical practice abilities of medical students.

Objective To observe the effects of Qigui Buxue Decoction combined with timed press-needle therapy on myelosuppression and cancer-related fatigue in chemotherapy patients with non-small cell lung cancer(NSCLC)of lung-spleen qi deficiency type.Methods A total of 124 NSCLC patients with lung-spleen qi deficiency type admitted to the Department of Radiotherapy and Chemotherapy at Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province from January 2022 to June 2024 were selected as the study subjects.The patients were randomly divided into an observation group and a control group using a random number table,with 62 cases in each group.Both groups received platinum-based two-drug combination chemotherapy.The control group received timed press-needle therapy in addition to chemotherapy,while the observation group received Qigui Buxue Decoction in addition to the control group's treatment.The treatment course was 3 weeks,with a total of 2 courses.After 2 courses of treatment,changes in blood routine,lymphocyte subsets(CD3+,CD4+,CD8+,NK cells),CD4+/CD8+ratio,and the incidence of myelosuppression were observed.Changes in Piper Fatigue Scale and Karnofsky Performance Scale(KPS)scores before and after treatment were compared between the two groups.Results(1)After treatment,the white blood cell count in the observation group significantly improved(P＜0.05),and the observation group showed significantly better improvement in white blood cell count compared to the control group,with a statistically significant difference(P＜0.05).(2)After treatment,the levels of CD3+,CD4+,CD4+/CD8+,and NK cells in both groups significantly improved(P＜0.05),and the observation group showed significantly better improvement in these levels compared to the control group,with a statistically significant difference(P＜0.05).(3)The incidence of myelosuppression in the observation group was 58.06%(36/62),while it was 77.42%(48/62)in the control group.The incidence of myelosuppression in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,the Piper Fatigue Scale scores,including behavioral,emotional,physical,and total scores,significantly improved in both groups(P＜0.05),and the observation group showed significantly better improvement in these scores compared to the control group,with a statistically significant difference(P＜0.05).The cognitive scores of the Piper Fatigue Scale showed slight improvement in both groups,but there was no statistically significant difference compared to before treatment(P＞0.05).(5)After treatment,the KPS scores and TCM syndrome scores significantly improved in both groups(P＜0.05),and the observation group showed significantly better improvement in these scores compared to the control group,with a statistically significant difference(P＜0.05).Conclusion Qigui Buxue Decoction combined with timed press-needle therapy can effectively improve myelosuppression,enhance immune function,and alleviate cancer-related fatigue in NSCLC patients with lung-spleen qi deficiency type after chemotherapy,thereby improving their quality of life.This approach is worthy of clinical promotion.

OBJECTIVES: To explore the relationship between white matter injury (WMI) and cerebral perfusion in preterm infants using arterial spin labeling (ASL). METHODS: A total of 293 preterm infants (gestational age <34 weeks) hospitalized at the Third Affiliated Hospital of Zhengzhou University between June 2022 and June 2024 were included. After achieving clinical stability, the infants underwent brain magnetic resonance imaging (MRI) and ASL. Based on MRI findings, infants were classified into WMI (n=66) and non-WMI (n=227) groups. Cerebral perfusion parameters were compared between groups, and the association between WMI and perfusion alterations was evaluated. RESULTS: The WMI group showed a higher incidence of mild intraventricular hemorrhage (IVH) than the non-WMI group (P<0.05). Significantly lower cerebral perfusion was observed in the WMI group across bilateral frontal, temporal, parietal, and occipital lobes, as well as the basal ganglia and thalamus (P<0.05). After adjusting for gestational age, corrected gestational age at ASL scan, and mild IVH, WMI remained significantly associated with reduced regional perfusion (P<0.05). CONCLUSIONS WMI in preterm infants correlates with localized cerebral hypoperfusion. ASL-detected perfusion abnormalities may provide novel insights into WMI pathogenesis.
Humans ; White Matter/blood supply* ; Infant, Newborn ; Spin Labels ; Infant, Premature ; Female ; Male ; Cerebrovascular Circulation ; Magnetic Resonance Imaging

OBJECTIVE To explore the main factors influencing the blood concentration of duloxetine， and provide a scientific basis for the individualized use of duloxetine. METHODS Retrospective analysis was conducted on 434 inpatients with depressive disorders at the First Hospital of Hebei Medical University， who were treated with duloxetine and underwent blood concentration monitoring between January 2022 and April 2024. The study examined the impact of various factors， including gender， age， body mass index （BMI）， gene phenotypes， combined medication， drug type （original/generic）， and genotyping results of gene single nucleotide polymorphism loci， on blood concentration and the concentration-to-dose （C/D） after dose adjustment. RESULTS The blood concentration of duloxetine was 76.65 （45.57， 130.31） ng/mL， and C/D was 0.96 （0.63， 1.60） ng·d/（mL·mg）. The blood concentration of duloxetine was positively correlated with the daily dose of administration （R2＝0.253 7， P＜0.001）. Blood concentration of duloxetine in 38.94% of patients exceeded the recommended range specified in the guidelines. Gender， age， BMI， combined use of CYP2D6 enzyme inhibitors， and CYP2D6 and CYP1A2 phenotypes had significant effects on C/D of duloxetine （P＜0.05）. CONCLUSIONS The patient’s age， gender， BMI， combined medication， and genetic phenotypes are closely related to the blood concentration of duloxetine.

Thermal analysis technology has emerged as a pivotal tool for the identification and quality control of traditional Chinese medicine （TCM） owing to its advantages of high sensitivity and capability for simultaneous multi-parameter detection. The application progress on thermogravimetric analysis （TGA）, differential thermal analysis （DTA）, and differential scanning calorimetry （DSC） in four key areas: authenticity identification of herbal medicines, optimization of processing techniques, evaluation of extract thermal stability, and construction of quality evaluation systems were summarized. Thermal analysis technology enables rapid authentication of medicinal materials by establishing a thermal fingerprint. When integrated with hyphenated techniques （e.g., FTIR and GC-MS）, it facilitates in-depth analysis of compositional differences in complex matrices. In Future, the development of thermal analysis databases and multi-technology integration will be expected to further promote the standardization of TCM quality control.

Objective To establish a sandwich enzyme-linked immunosorbent assay (ELISA) method for the quantitative detection of Chromogranin A (CHGA) in saliva, and to explore its preliminary application in the testing of saliva samples. Methods Recombinant human CHGA protein was used to immunize BALB/c mice, and monoclonal antibodies (mAbs) were prepared and screened using conventional hybridoma technology. A double-antibody sandwich ELISA detection method was constructed, and the matrix effect of saliva samples was optimized. This method was then applied to detect the concentration of CHGA in the saliva of stressed individuals. Results Twenty-one stable hybridoma cell lines secreting high affinity anti-human CHGA antibodies were obtained. A pair of detection antibodies with the best effect was selected, and the optimal coating concentration was determined to be 10 μg/mL, with the optimal dilution of detection antibodies being 1:32 000. The accuracy and reproducibility of this method were verified, with both intra-batch and inter-batch variation coefficients less than 15×, and the recovery rate between 80× and 120×. The matrix effect was further optimized to make it suitable for saliva sample detection. Saliva samples from individuals in different stress states were collected, and the CHGA levels were detected using the method established in this study, indicating its potential to reflect the intensity of stress. Conclusion A reliable saliva CHGA ELISA detection method has been successfully established, and its potential as a biomarker in stress-related research has been preliminarily explored.
Saliva/metabolism* ; Enzyme-Linked Immunosorbent Assay/methods* ; Humans ; Animals ; Mice, Inbred BALB C ; Mice ; Chromogranin A/immunology* ; Antibodies, Monoclonal/immunology* ; Female ; Male ; Reproducibility of Results ; Adult