Post-stroke depression （PSD） represents a common and debilitating complication following stroke， substantially impeding neurorehabilitation outcomes and exerting a profound negative impact on patients' quality of life， while concurrently contributing to increased mortality rates. Despite a growing understanding of PSD， contemporary clinical management continues to encounter multifaceted challenges. This systematic review synthesizes extant literature to delineate pathophysiological mechanisms underlying PSD and to identify evidence-based interventions. By establishing a theoretical foundation， it aims to optimize early diagnostic protocols and personalized therapeutic regimens， thereby enhancing rehabilitation and therapeutic outcomes in stroke patients. Through rigorous evaluation of 14 original studies， this analysis comprehensively examines genetic factors， neurobiological aberrations， immunological factors， and psychosocial stressors contributing to PSD onset and progression， offering critical insights for developing comprehensive treatment strategies.［Funded by Science and Technology Plan Project of Yunnan Provincial Department of Science and Technology （number， 202101AY070001-048）］

Ulcerative colitis (UC) is an idiopathic, relapsing, and etiologically complicated chronic inflammatory bowel disease. Despite substantial progress in the management of UC, the outcomes of mucosal barrier repair are unsatisfactory. In this study, phillygenin (PHI) treatment alleviated the symptoms of chronic colitis in mice, including body weight loss, severe disease activity index scores, colon shortening, splenomegaly, oxidative stress, and inflammatory response. In particular, PHI treatment ameliorated the tight junction proteins (TJs) reduction, fibrosis, apoptosis, and intestinal stem cell activity, indicating that PHI exerted beneficial effects on the intestinal mucosal barrier in mice with chronic colitis. In the NCM460 cells damage model, dextran sulfate sodium triggered the sequential induction of TJs reduction, fibrosis, and apoptosis. Takeda G protein-coupled receptor-5 (TGR5) dysfunction mediated NCM460 cell injury. Moreover, PHI treatment enhanced TJs and suppressed fibrosis and apoptosis to maintain NCM460 cell function, depending on TGR5 activation. PHI promoted TGR5 activation and elevated intracellular cyclic adenosine monophosphate levels in HEK 293T cells transfected with TGR5 expression plasmids. Cellular thermal shift assay and molecular docking studies confirmed that PHI directly binds to TGR5, indicating that PHI is an agonist of TGR5. The process of PERK-eIF2α pathway-mediated endoplasmic reticulum Ca²⁺ release was involved in NCM460 cell injury as well, which was associated with TGR5 dysfunction. When NCM460 cells were pretreated with PHI, the PERK-eIF2α pathway and elevated Ca²⁺ levels were blocked. In conclusion, our study demonstrated a novel mechanism that PHI inhibited the PERK-eIF2α-Ca²⁺ pathway through TGR5 activation to against DSS-induced TJs reduction, fibrosis, and apoptosis.

Objective To explore the safety and efficacy of using the"bare-support"technique via radial artery approach under local anesthesia for endovascular treatment of severe vertebral-basilar artery stenosis.Methods Patients were retrospectively and continuously enrolled from June 2021 to March 2023,admitted to the Department of Neurology at Zhongnan Hospital of Wuhan University,and underwent endovascular treatment for severe vertebral-basilar artery stenosis under local anesthesia via the radial artery approach using the"bare-support"technique.Baseline and clinical data,including sex,age,hypertension,diabetes,hyperlipidemia,coronary heart disease,atrial fibrillation,history of stroke,smoking history,preoperative the National Institutes of Health stroke scale(NIHSS)score,and preoperative modified Rankin scale score were collected from the patient.Surgical-related data were also collected,including site of stenosis(vertebral artery V4 segment,basilar artery,vertebral artery V4 segment+basilar artery),stenosis rate(70％-90％,＞90％-99％),target lesion vessel diameter,lesion vessel length,vertebral-subclavian angle,vertebral-subclavian distance,use of distal access catheter,anesthesia method(local anesthesia,general anesthesia),presence of isolated vertebral artery(opposite vertebral artery occlusion),whether the distal access catheter was shaped,position of the distal access catheter in the vertebral artery(vertebral artery V2 segment,V3 segment,V4 segment),endovascular treatment method(simple balloon dilation,balloon dilation+self-expanding stent,balloon dilation stent),intraoperative cerebral ischemia symptoms,severe intraoperative cerebral ischemia symptoms,and whether the surgical approach was changed.Gather clinical outcomes and follow-up status,including the surgery success rate(surgery completed via radial artery access with a residual stenosis rate of the target vessel less than 30％after endovascular treatment,and modified thrombectomy in cerebral infarction[mTICI]grade 3),neurological function impairment within 72hours after surgery,perioperative complications(disabling stroke,nondisabling stroke,puncture site complications),in-stent restenosis within six months post-surgery(≥50％narrowing reoccurring at the location or within 5 mm diameter of stent after previous stent placement or angioplasty)and stroke relapses(another stroke event after the first stroke).Base on whether the distal access catheter was shaped,the patients were divided into a shaping group and a non-shaping group.Compare the baseline and clinical data,as well as the vertebral-subclavian angle and distance between the groups.Results A total of 33 patients who underwent endovascular treatment for severe vertebral-basilar artery stenosis using the"bare stent"technique via the radial artery approach were included,comprising 29 males and 4 females,aged between 42 to 76 years,with an average age of(62±9)years.Among them,13 were in the shaping group,20 was in the non-shaping group.(1)No significant differences in clinical or baseline data were observed between the two groups(all P＞0.05).Compared with the non-shaping group,patients from the shaping group had significantly smaller vertebral-subclavian angle([62.80±21.57]° vs.[109.57±28.63]°,P＜0.01),and significantly longer vertebral-subclavian distance([13.58±7.35]mm vs.[6.13±4.31]mm,P=0.002).(2)Among the 33 cases,30(90.9％)were completed under local anesthesia,while 3 cases(9.1％)with isolated vertebral arteries experienced severe ischemic intolerance during surgery and were switched to general anesthesia.The success rate of endovascular treatment for severe vertebrobasilar artery stenosis via transradial artery approach was 93.9％(31/33),with only 2 cases switched to transfemoral approach due to difficulty in establishing the radial artery access also succeeded in completing the surgery.Neurological function impairment occurred in 5 cases(15.2％)within 72 hours postoperatively.The perioperative complication rate was 9.1％(3/33),including 1 case(3.0％)of disabling stroke and 2 cases(6.1％)of non-disabling stroke.No puncture site complications had occurred.During the 6-month follow-ups,in-stent restenosis occurred in 2 cases(6.1％),with no recurrence of stroke.Conclusions Endovascular treatment of severe vertebrobasilar artery stenosis using the"bare-support"technique via the radial artery under local anesthesia is safe and feasible.Larger prospective randomized controlled trials are needed to validate these findings.

Ulcerative colitis(UC)is an idiopathic,relapsing,and etiologically complicated chronic inflammatory bowel disease.Despite substantial progress in the management of UC,the outcomes of mucosal barrier repair are unsatisfactory.In this study,phillygenin(PHI)treatment alleviated the symptoms of chronic colitis in mice,including body weight loss,severe disease activity index scores,colon shortening,splenomegaly,oxidative stress,and inflammatory response.In particular,PHI treatment ameliorated the tight junction proteins(TJs)reduction,fibrosis,apoptosis,and intestinal stem cell activity,indicating that PHI exerted beneficial effects on the intestinal mucosal barrier in mice with chronic colitis.In the NCM460 cells damage model,dextran sulfate sodium triggered the sequential induction of TJs reduction,fibrosis,and apoptosis.Takeda G protein-coupled receptor-5(TGR5)dysfunction mediated NCM460 cell injury.Moreover,PHI treatment enhanced TJs and suppressed fibrosis and apoptosis to maintain NCM460 cell function,depending on TGR5 activation.PHI promoted TGR5 activation and elevated intracellular cyclic adenosine monophosphate levels in HEK 293T cells transfected with TGR5 expression plasmids.Cellular thermal shift assay and molecular docking studies confirmed that PHI directly binds to TGR5,indicating that PHI is an agonist of TGR5.The process of PERK-eIF2α pathway-mediated endo-plasmic reticulum Ca2+release was involved in NCM460 cell injury as well,which was associated with TGR5 dysfunction.When NCM460 cells were pretreated with PHI,the PERK-eIF2α pathway and elevated Ca2+levels were blocked.In conclusion,our study demonstrated a novel mechanism that PHI inhibited the PERK-eIF2α-Ca2+pathway through TGR5 activation to against DSS-induced TJs reduction,fibrosis,and apoptosis.

Objective To explore the safety and efficacy of using the"bare-support"technique via radial artery approach under local anesthesia for endovascular treatment of severe vertebral-basilar artery stenosis.Methods Patients were retrospectively and continuously enrolled from June 2021 to March 2023,admitted to the Department of Neurology at Zhongnan Hospital of Wuhan University,and underwent endovascular treatment for severe vertebral-basilar artery stenosis under local anesthesia via the radial artery approach using the"bare-support"technique.Baseline and clinical data,including sex,age,hypertension,diabetes,hyperlipidemia,coronary heart disease,atrial fibrillation,history of stroke,smoking history,preoperative the National Institutes of Health stroke scale(NIHSS)score,and preoperative modified Rankin scale score were collected from the patient.Surgical-related data were also collected,including site of stenosis(vertebral artery V4 segment,basilar artery,vertebral artery V4 segment+basilar artery),stenosis rate(70％-90％,＞90％-99％),target lesion vessel diameter,lesion vessel length,vertebral-subclavian angle,vertebral-subclavian distance,use of distal access catheter,anesthesia method(local anesthesia,general anesthesia),presence of isolated vertebral artery(opposite vertebral artery occlusion),whether the distal access catheter was shaped,position of the distal access catheter in the vertebral artery(vertebral artery V2 segment,V3 segment,V4 segment),endovascular treatment method(simple balloon dilation,balloon dilation+self-expanding stent,balloon dilation stent),intraoperative cerebral ischemia symptoms,severe intraoperative cerebral ischemia symptoms,and whether the surgical approach was changed.Gather clinical outcomes and follow-up status,including the surgery success rate(surgery completed via radial artery access with a residual stenosis rate of the target vessel less than 30％after endovascular treatment,and modified thrombectomy in cerebral infarction[mTICI]grade 3),neurological function impairment within 72hours after surgery,perioperative complications(disabling stroke,nondisabling stroke,puncture site complications),in-stent restenosis within six months post-surgery(≥50％narrowing reoccurring at the location or within 5 mm diameter of stent after previous stent placement or angioplasty)and stroke relapses(another stroke event after the first stroke).Base on whether the distal access catheter was shaped,the patients were divided into a shaping group and a non-shaping group.Compare the baseline and clinical data,as well as the vertebral-subclavian angle and distance between the groups.Results A total of 33 patients who underwent endovascular treatment for severe vertebral-basilar artery stenosis using the"bare stent"technique via the radial artery approach were included,comprising 29 males and 4 females,aged between 42 to 76 years,with an average age of(62±9)years.Among them,13 were in the shaping group,20 was in the non-shaping group.(1)No significant differences in clinical or baseline data were observed between the two groups(all P＞0.05).Compared with the non-shaping group,patients from the shaping group had significantly smaller vertebral-subclavian angle([62.80±21.57]° vs.[109.57±28.63]°,P＜0.01),and significantly longer vertebral-subclavian distance([13.58±7.35]mm vs.[6.13±4.31]mm,P=0.002).(2)Among the 33 cases,30(90.9％)were completed under local anesthesia,while 3 cases(9.1％)with isolated vertebral arteries experienced severe ischemic intolerance during surgery and were switched to general anesthesia.The success rate of endovascular treatment for severe vertebrobasilar artery stenosis via transradial artery approach was 93.9％(31/33),with only 2 cases switched to transfemoral approach due to difficulty in establishing the radial artery access also succeeded in completing the surgery.Neurological function impairment occurred in 5 cases(15.2％)within 72 hours postoperatively.The perioperative complication rate was 9.1％(3/33),including 1 case(3.0％)of disabling stroke and 2 cases(6.1％)of non-disabling stroke.No puncture site complications had occurred.During the 6-month follow-ups,in-stent restenosis occurred in 2 cases(6.1％),with no recurrence of stroke.Conclusions Endovascular treatment of severe vertebrobasilar artery stenosis using the"bare-support"technique via the radial artery under local anesthesia is safe and feasible.Larger prospective randomized controlled trials are needed to validate these findings.

Objective To investigate the clinical application value of wrist joint ulnar deviation supination 45° palmar oblique posi-tion in the diagnosis of scaphoid waist fracture and displacement.Methods The imaging and clinical data such as digital radiography(DR),CT of 93 wrist joint trauma patients were analyzed.The four position views including wrist joint anteroposterior+lateral view,scaphoid position,wrist joint ulnar deviation supination 45° palmar oblique position,scaphoid position+wrist joint ulnar devia-tion supination 45° palmar oblique position were analyzed by three readers.The consistency of the evaluation among different readers and the diagnostic efficiency of the diagnosis of scaphoid fracture and displacement were compared.Results The inter-observer agreement,sensitivity,specificity,accuracy,and other diagnostic efficiency of scaphoid waist fracture and displacement was evaluated,wrist joint ulnar deviation supination 45° palmar oblique position+scaphoid position and wrist joint ulnar deviation supination 45° palmar oblique position were better than those of scaphoid position and wrist joint anteroposterior+lateral view.The combination of wrist joint ulnar deviation supination 45° palmar oblique position+scaphoid position obtained the best diagnostic efficiency.Conclusion The wrist joint ulnar deviation supination 45° palmar oblique position shows the long axis of the scaphoid,which has a high diagnostic efficiency in the diagnosis of scaphoid waist fracture and displacement and would be used as a useful supplement to other scaphoid imaging.

Objective To investigate the optimal scanning parameters for cone beam computed tomography(CBCT)of the nasal bone,to achieve low-dose scanning of the nasal bone CBCT.Methods Utilizing Prangmerka CBCT 3D single-tooth sequence,nasal bone scans were performed on two human-equivalent phantoms using two dose protocols,five body types,and five resolutions,resul-ting in 50 scanning sequences.The dose area product(DAP)and volume CT dose index(CTDIvol)were recorded.Objective image quality assessment was conducted by calculating the contrast-to-noise ratio(CNR),signal-to-noise ratio(SNR),noise,and figure of merit(FOM)in region of interest(ROI)set on sagittal images.Subjective scoring was performed using a five-point Likert scale.Differences in radiation dose and image quality among various scanning parameters were compared and analyzed.Results(1)Signifi-cant differences in DAP were observed among different dose modes,body types,and resolutions(P＜0.05),with the lowest DAP values recorded for the XS body type.(2)Statistically significant differences in CNR,SNR,noise,and FOM were found among differ-ent dose modes and resolutions(P＜0.05).The XS body type exhibited the highest SNR and FOM values and the lowest noise.The 200 μm resolution demonstrated the higher CNR value and the highest SNR value,with moderate noise and FOM value.(3)Signifi-cant differences in image quality,contrast,sharpness,and noise were observed among different dose modes,body types,and resolu-tions(P＜0.05).Higher subjective scores were assigned to the 200 μm and 150 μm resolutions,indicating clear anatomical details.Conclusion The scanning parameters of 200 μm resolution combined with an ultra-low-dose protocol for the XS body type achieve a balance between low radiation dose and high image quality,making them suitable for low-dose nasal bone CBCT examinations.

Objective To investigate the removal of metal artifacts caused by different metal implants in different parts of the human body using dual-energy CT and to select the best method for metal artifacts reduction.Methods Forty-three patients with metal implants underwent dual-energy CT scans.Reconstructed images were obtained to produce eight sets of imaging data:conventional image(CI),120 keV,140 keV,160 keV,180 keV,200 keV,Orthopedic metal artifact reduction algorithm(O-MAR),200 keV+O-MAR.The optimal spectral monoenergetic images was selected based on the trend of changes in artifact index(AI)values with different keV monoenergetic images and subjective evaluation.One-way ANOVA was used to analyze and compare objective image evaluation indi-cators and subjective evaluations of image quality among different groups.The intraclass correlation coefficient(ICC)was used to evaluate the consistency and reliability of subjective evaluations of image quality among different observers.Results The AI values of differ-ent keV monoenergetic images showed a decreasing trend with increasing keV,and the virtual monoenergetic images at the 200 keV level had the smallest AI value.There were statistically significant differences in objective indicators for the removal of high-density artifacts and low-density artifacts among the groups(P＜0.05).Pairwise comparison showed statistical differences between CI and O-MAR,CI and O-MAR+200 keV,200 keV and O-MAR,200 keV and O-MAR+200 keV(P＜0.05),with O-MAR+200 keV demon-strating the best objective indicators.The ICC for subjective evaluation among different observers was 0.97％,and the ICC within observers was 0.91％.There were statistically significant differences in subjective image scores among the groups(P＜0.05),with the CI had the lowest score[(1.04±0.24)points]and the O-MAR+200 keV combination had the highest score[(4.57±0.78)points].Conclusion Dual-energy CT virtual monoenergetic 200 keV spectroscopy combined with O-MAR technique can be used as the best technique for removing metal implant artifacts and achieving better contrast in the surrounding soft tissue of prostheses.

Ma-huang Lian-yao Chi-xiao-dou Tang is one of the three formulas for typhoid jaundice.But it has not received much attention,and the source of Lian-yao in the formula is unknown and the status and role are difficult to identify.In this paper,we first analyzed the functions of Ephedra and the symptoms of the whole formula.The formula was mainly used to"clear damp-heat"in order to remove jaundice.On this basis,it is proved that Lian-yao is the root of Forsythia,not"Qiao-gen".Today,the use of Forsythia instead of Lian-yao has the same effect.Then,the indispensable and important position of Forsythia in the formula was analyzed.It also pointed out some valuable directions for the medicinal use and research and development of Forsythia based on its wide range of effects but the lack of main symptoms.This paper provides insights for in-depth theoretical and practical research on Forsythiae Fructus.

Objective:To learn about the application of medical ethics review in scientific research and prevention of endemic diseases.Methods:The method of retrospective analysis was used, original articles on field epidemiological investigation and clinical medicines published by Chinese Journal of Epidemiology from 2017 to 2020 were collected. Examination of medical ethics in national, provincial and municipal fund programs and nonfund projects was carried out. Statistical analysis was performed using Cochran-Armitage trend test and Cochran-Mantel-Haenszel (CMH) test.Results:A total of 638 articles were collected from 2017 - 2020, with 36 excluded and 602 remaining. The proportion of papers published after medical ethics review over the past four years was 56.85% (83/146), 62.50% (105/168), 59.87% (94/157), and 60.31% (79/131), respectively. There was no statistically significant difference in trend testing ( Z = 0.41, P > 0.05). There was no statistically significant difference in the proportion of papers produced by academic works, on-site investigations, and clinical medicine programs among different years (χ 2 = 0.01, 1.31, 1.92, P > 0.05). The proportion of papers published that supported by various fund programs that had undergone medical ethics review over the past four years was 60.55% (66/109), 62.28%(71/114), 62.38% (63/101), and 60.22% (56/93), respectively. The trend test showed no statistically significant difference( Z = - 0.03, P > 0.05). There was no statistically significant difference in the proportion of papers published that supported by national level projects, provincial and ministerial level projects, and municipal level projects among different years (χ 2 = 0.06, 0.02, 0.19, P > 0.05). The difference in the trend test of the output papers of research projects approved by the higher-level ethics committee and marked with approval numbers over the past 4 years was statistically significant ( Z = 2.85, P < 0.01); the difference was statistically significant when compared across years (χ 2 = 8.13, P < 0.01); the proportion of papers increased from 8.22% (12/146) in 2017 to 18.08% (25/131) in 2020 (χ 2 = 7.04, P = 0.008). There was no statistically significant difference ( Z = - 0.53, P > 0.05) in the proportion of papers that expressed their consent in terms of informed consent over the past 4 years; There was no statistically significant difference in comparison between different years (χ 2 = 0.28, P > 0.05). Conclusions:Medical ethics review has been taken seriously by the majority of researchers and is widely used in endemic scientific research and prevention projects.