ObjectiveTo investigate the therapeutic effects and potential mechanisms of Atractylodes chinensis volatile oil microemulsion in relieving depression， thus establishing a theoretical foundation and a new approach for developing it as a novel adjunctive antidepressant. MethodsSixty SD male rats were assigned into four groups： control， model （chronic unpredictable mild stress）， positive drug （flupentixol hydrochloride， 1.8 mg·kg^-1）， and low-， medium-， high-dose （16.2， 32.4， 64.8 mg·kg^-1） A. chinensis volatile oil microemulsion. The sucrose preference test， open field test， tail suspension test， and forced swimming test were conducted to measure the sucrose preference rate， total exercise distance， average speed， resting time， tail suspension time， and swimming immobility time before and after treatment. The morphology of the rat brain tissue was visualized by hematoxylin-eosin （HE） staining. The levels of 5-hydroxytryptamine （5-HT）， norepinephrine （NE）， and cortisol （CORT） in the hippocampal tissue were measured by enzyme-linked immunosorbent assay （ELISA）. Real-time PCR was used to detect mRNA level differences of cyclic adenosine monophosphate （cAMP）， protein kinase A （PKA）， cyclic adenosine monophosphate response element-binding protein （CREB）， brain-derived neurotrophic factor （BDNF）， and tyrosine kinase B （TrkB） in the hippocampus. Western blot was employed to assess protein level variations of cAMP， PKA， CREB， BDNF， and TrkB in the same tissue samples. ResultsCompared with that in the blank group， the body mass of rats in low-， medium-， high-dose A. chinensis volatile oil emulsion groups decreased （P<0.05）， indicating that the modeling was successful. Compared with the model group， medium-， high-dose A. chinensis volatile oil emulsion shortened the tail suspension time， swimming immobility time， and resting time （P<0.05， P<0.01）， while increasing the sucrose preference rate， total exercise distance， and average speed （P<0.01）. No significant changes were observed in the low-dose A. chinensis volatile oil emulsion group. ELISA results indicated that CORT concentrations in the hippocampal tissue of medium and high-dose A. chinensis volatile oil emulsion groups decreased （P<0.01）. In the high-dose group， 5-HT and NE concentrations increased （P<0.05， P<0.01）， while they had no significant changes in the low-dose group. Real-time PCR results revealed that the mRNA levels of cAMP， PKA， and CREB in the hippocampus of the medium-dose Beicangzhu volatile oil emulsion group increased （P<0.05， P<0.01）， and those of cAMP， PKA， CREB， BDNF， and TrkB were upregulated in the high-dose Beicangshu volatile oil microemulsion group （P<0.01）. Western blot and immunofluorescence results demonstrated that the protein levels of cAMP， PKA， and TrkB in the hippocampal tissue of the low-dose A. chinensis volatile oil microemulsion group were up-regulated （P<0.05）. The medium-dose Beicangzhu volatile oil emulsion group exhibited increases in protein levels of cAMP， PKA， BDNF， and TrkB （P<0.05， P<0.01）， while the high-dose group showed elevationsin protein levels of cAMP， PKA， CREB， BDNF， and TrkB （P<0.05， P<0.01）. ConclusionBeicangzhu volatile oil emulsion demonstrates certain antidepressant efficacy by inhibiting CORT expression， upregulating the expression of 5-HT， NE， cAMP， PKA， CREB， BDNF， and TrkB， activating the CREB/BDNF signaling pathway to improve the cerebral protection.

Objective:To explore the efficacy of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer (NSCLC) .Methods:A total of 80 patients with advanced NSCLC treated in the Baoding No.2 Central Hospital from September 2019 to September 2023 after second-line treatment were selected as research subjects. Patients who received only anlotinib treatment were included in the monotherapy group ( n=40), while patients who received atezolizumab combined with anlotinib treatment were included in the combination group ( n=40). The clinical efficacy and serum levels of carcinoembryonic antigen (CEA) and vascular endothelial growth factor (VEGF) of the two groups were compared. Kaplan-Meier survival curve was used to analyze the survival of the two groups. The functional assessment of cancer therapy-lung cancer (FACT-L) was used to assess the quality of life of patients in both groups before and after treatment. The incidence of adverse reactions was compared between the two groups. Results:After four cycles of treatment, the objective response rate (ORR) of the combination group was 37.50% (15/40), which was higher than that of the monotherapy group [17.50% (7/40) ], with a statistically significant difference ( χ2=4.01, P=0.045). The disease control rates (DCRs) of the two groups were 85.00% (34/40) and 75.00% (30/40), respectively, with no statistically significant difference ( χ2=1.25, P=0.264). Before treatment, the CEA levels in combination group and monotherapy group were (10.18±2.15) and (10.14±2.02) μg/L, and the VEGF levels were (804.04±46.58) and (809.10±43.63) ng/L, respectively, with no statistically significant difference (both P>0.05). After treatment, the serum CEA levels of patients in combination group and monotherapy group were (4.35±1.05) and (6.63±1.37) μg/L, and the VEGF levels were (431.26±50.19) and (549.92±55.27) ng/L, respectively, with statistically significant differences ( t=8.35, P<0.001; t=10.05, P<0.001), and the levels of serum CEA and VEGF in the two groups after treatment were lower than before treatment ( t=32.47, P<0.001; t=21.73, P<0.001; t=88.65, P<0.001; t=58.27, P<0.001). Survival analysis showed that the median progression-free survival (PFS) of the monotherapy group and the combination group were 4.12 and 6.06 months, respectively, with a statistically significant difference ( χ2=17.70, P<0.001), the median overall survival (OS) were 11.8 and 12.7 months, respectively, with no statistically significant difference ( χ2=3.09, P=0.079). Before treatment, the FACT-L scores of patients in combination group and monotherapy group were 61.20±6.98 and 60.52±7.14, respectively, with no statistically significant difference ( t=0.43, P=0.668). After treatment, the FACT-L scores of the two groups were 83.24±9.38 and 74.58±7.86, respectively, with a statistically significant difference ( t=4.48, P<0.001), and the FACT-L scores of the two groups after treatment were all higher than before treatment ( t=29.36, P<0.001; t=21.51, P<0.001). During treatment, the total incidence of drug-related adverse reactions in two groups was 42.50% (17/40) and 55.00% (22/40), respectively, with no statistically significant difference ( χ2=1.25, P=0.263) . Conclusions:Atezolizumab combined with anlotinib in the treatment of advanced NSCLC can enhance the short-term efficacy, prolong the PFS of patients, improve the quality of life, and the related adverse reactions are tolerable.

Nursery services are a vital component of childcare for infants and toddlers.The quality and management of nursery services significantly impact the holistic development of infants and toddlers in terms of their physical,psychological,and social skills and capabilities.The first 1000 days in the life of an infant or toddler are a critical period that shapes their health status for their whole life,which highlights the need to prioritize health in childcare for infants and toddlers and to approach daily childcare services from a medical perspective.Based on the approach of integrating medical care and education,we innovatively explored and constructed a multidisciplinary patrol supervision model for childcare services,focusing on the PDCA cycle(Plan-Do-Check-Act cycle).We aim at establishing a multidisciplinary team of medical and nursing experts who provide evaluation and guidance for the institutional management,health management for infants and toddlers,disease prevention,and risk identification and screening of childcare services for infants and toddlers.This approach addresses the issue of the simplistic nature of the traditional patrol supervision involving only childcare physicians,improves service quality with high efficiency,meets the expectations of both childcare service providers and the families of infants and toddlers-the users of childcare services,enhances the effective implementation of childcare for infants and toddlers based on the integration of medical care and education,and improves the quality of a health-centered approach to childcare for infants and toddlers.