Berberine is a kind of isoquinoline alkaloid extracted from the roots and rhizomes of many medicinal plants,such as Coptis chinensis of Ranunculus family,Phellodendron chinensis of rutaceae family,and Berberine Sanacanthus family.In recent years,with the deepening of research,berberine has shown re-markable prevention and treatment effect in a variety of neuro-psychiatric disease models.This paper summarizes the research progress of berberine in neuropsychiatric diseases and provides theoretical support for further clinical prevention and treatment of neuropsychiatric diseases.

Berberine is a kind of isoquinoline alkaloid extracted from the roots and rhizomes of many medicinal plants,such as Coptis chinensis of Ranunculus family,Phellodendron chinensis of rutaceae family,and Berberine Sanacanthus family.In recent years,with the deepening of research,berberine has shown re-markable prevention and treatment effect in a variety of neuro-psychiatric disease models.This paper summarizes the research progress of berberine in neuropsychiatric diseases and provides theoretical support for further clinical prevention and treatment of neuropsychiatric diseases.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective To observe the effects of general anesthesia with remazolam on electrophysiological monitoring indicators and cerebral oxygen saturation(ScO2)in patients undergoing carotid endarterectomy(CEA).Methods Patients who underwent elective CEA from July 2022 to June 2024 in neurosurgery department of our hospital were randomly divided into the ramazolam group(R group)and the propofol group(P group).Patients in both groups were given propofol 1.5 to 2.0 mg/kg,cisatracurium 0.1 to 0.2 mg/kg,and sufentanil 0.3 to 0.4 μg/kg for anesthesia induction.Anesthesia maintenance:patients in the R group received intravenous infusion of remifentanil 0.5 to 1.0 mg·kg-1·h-1,while patients in the P group received intravenous infusion of propofol 5.0 to 7.0 mg·kg-1·h-1.Both groups received intravenous infusion of remifentanil 0.1 to 0.2 μg·kg-1·min-1 for anesthesia maintenance.The operation time,carotid artery occlusion time,intraoperative infusion volume,remifentanil and norepinephrine dosage,and awakening time of patients in the two groups were recorded.The hemodynamic and cerebral oxygen indicators,amplitude and latency of evoked potentials before anesthesia(T0),after anesthesia(T1),5 minutes before blockade(T2),5 minutes after blockade(T3),5 minutes after unblocking(T4)and at the end of surgery(T5)of patients in the two groups were observed and compared,and the total incidence of postoperative complications was followed up and calculated.Results Compared with the P group,the dosage of intraoperative norepinephrine of patients in the R group was reduced(P<0.05),and the awakening time was shortened(P<0.05).At T2,the average arterial pressure(MAP)of patients in the R group was higher than that in the P group(P<0.05).At T3,the ScO2 of patients in the R group was significantly higher than that in the P group,and the percentages of prolonged latency and decreased amplitude of motor evoked potentials(MEP)were significantly lower than those in the P group(P<0.05),the percentage of decreased amplitude of lower limb somatosensory evoked potentials(SSEP)was lower than that in the P group(P<0.05);At T5,the MEP amplitude of patients in the R group was significantly increased compared to that at T2,while the MEP amplitude of patients in the P group was significantly decreased compared to that at T2,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion As a general anesthesia maintenance drug,remazolam can achieve satisfactory anesthesia effects for CEA,with more stable intraoperative hemodynamics,and less impact on ScO2 and evoked potential monitoring during carotid artery occlusion compared to propofol,resulting in higher safety.

Objective:To explore the influencing factors of post-percutaneous coronary intervention(PCI)positivity in young and middle-aged patients with acute myocardial infarction(AMI)and simultaneously assess its mediating effect in the relationship between illness-related shame and psychosocial adjustment.Methods:A total of 178 patients,who admit-ted in Cangzhou People's Hospital between October 2021 and December 2022 for AMI,underwent PCI,and were subse-quently defined as frailty after PCI,were selected.General demographic information survey forms,Patient Activation Measure(PAM),Social Impact Scale(SIS),and Psychosocial Adjustment to Illness Scale Self-Report(PAIS-SR)were applied to investigate the patients.Clinical data characteristics of the patients were analyzed.Pearson correlation analysis was conducted to investigate the association among PAM score,SIS score and PAIS-SR score.Multivariate linear stepwise regression analysis was employed to identify the influencing factors of positivity.The Bootstrap procedure in the Process plugin was used to validate the mediating effect of positivity between illness-related shame and psychosocial adjustment.Results:In this study,PAM score was(57.87±7.02)points,SIS score was(52.07±12.66)points,and PAIS-SR score was(61.07±10.58)points.Pearson correlation analysis indicated that PAM score was significant negatively correlated with SIS score and PAIS-SR score(r=-0.439,-0.504,P＜0.001 all),and SIS score was significant positively corre-lated with PAIS-SR score(r=0.722,P＜0.001).Multivariate linear stepwise regression analysis indicated that male(B=2.226,P=0.020),educational level(B=2.194,P=0.005)and stigma associated with illness(B=-0.210,P＜0.001)can influence the postoperative positivity of patients.Mediation effect analysis indicated that illness-related shame had a direct effect on psychosocial adjustment,accounting for 85.92％of the total effect,while positivity partially media-ted the relationship between illness-related shame and psychosocial adjustment with an effect size of 14.08％.Conclusion:Illness-related shame not only directly affects the psychosocial adjustment in frailty AMI patients after PCI,but also exerts an indirect influence on it through positivity.Medical staff should implement targeted strategies to enhance patients'positiv-ity,thereby reducing the negative impact of illness-related shame on psychosocial adjustment.

Objective:Using ecological niche width and situation model,the operation and management of public Traditional Chinese Medicine(TCM)hospitals in 16 cities in Shandong Province were evaluated to put forward countermeasures.Methods:The relevant index data of public TCM hospitals in 16 cities in Shandong Province from 2019 to 2022 were collected to analyze the development status.The ecological niche width model and niche situation model were applied to evaluate the operation and management of public TCM hospitals in 16 cities in Shandong.Results:The top three public TCM hospitals in terms of average ecological niche width were City G,City P and City F.The ecological niche situation value of public TCM hospitals in City K,City A and City J ranked the top three.Conclusion:The dimensions of operation management structure of public TCM hospitals in Shandong need to be enhanced and the development of operation management space needs to be balanced.It is feasible to evaluate operation management by using ecological niche width and situation model.It is suggested to improve the allocation efficiency of health personnel,facilities,funds and other resources;promote the spatial balanced development of operation management;promote the application of ecological niche width and situation model in the field of medicine and health management.

Objective To develop a toolkit suitable for assisting community health institutions in the early identification and inter-vention of mild cognitive impairment(MCI)among older adults.Methods A literature review was conducted to construct a draft of the identification and intervention toolkit.Tools with an expert approval rate above 70%were included after expert consultation.The final version of the toolkit was developed by integrating these tools with officially recommended tools in China.Results The expert consultation yielded an authority coefficient of 0.84.The finalized toolkit included the assessment tools of Mini-Mental State Examination,Montreal Cognitive Assessment,General Practitioner Assessment of Cognition,Cognitive Abilities Screening Instrument and Clock Drawing Test,and 18 intervention measures in-cluding pharmacological treatment,cognitive training and psychological interventions,etc.Conclusion The MCI Identification-Intervention Toolkit may serve as a reference for guiding the identification and inter-vention of MCI among older adults for community health institutions.

Objective:To explore the influencing factors of post-percutaneous coronary intervention(PCI)positivity in young and middle-aged patients with acute myocardial infarction(AMI)and simultaneously assess its mediating effect in the relationship between illness-related shame and psychosocial adjustment.Methods:A total of 178 patients,who admit-ted in Cangzhou People's Hospital between October 2021 and December 2022 for AMI,underwent PCI,and were subse-quently defined as frailty after PCI,were selected.General demographic information survey forms,Patient Activation Measure(PAM),Social Impact Scale(SIS),and Psychosocial Adjustment to Illness Scale Self-Report(PAIS-SR)were applied to investigate the patients.Clinical data characteristics of the patients were analyzed.Pearson correlation analysis was conducted to investigate the association among PAM score,SIS score and PAIS-SR score.Multivariate linear stepwise regression analysis was employed to identify the influencing factors of positivity.The Bootstrap procedure in the Process plugin was used to validate the mediating effect of positivity between illness-related shame and psychosocial adjustment.Results:In this study,PAM score was(57.87±7.02)points,SIS score was(52.07±12.66)points,and PAIS-SR score was(61.07±10.58)points.Pearson correlation analysis indicated that PAM score was significant negatively correlated with SIS score and PAIS-SR score(r=-0.439,-0.504,P＜0.001 all),and SIS score was significant positively corre-lated with PAIS-SR score(r=0.722,P＜0.001).Multivariate linear stepwise regression analysis indicated that male(B=2.226,P=0.020),educational level(B=2.194,P=0.005)and stigma associated with illness(B=-0.210,P＜0.001)can influence the postoperative positivity of patients.Mediation effect analysis indicated that illness-related shame had a direct effect on psychosocial adjustment,accounting for 85.92％of the total effect,while positivity partially media-ted the relationship between illness-related shame and psychosocial adjustment with an effect size of 14.08％.Conclusion:Illness-related shame not only directly affects the psychosocial adjustment in frailty AMI patients after PCI,but also exerts an indirect influence on it through positivity.Medical staff should implement targeted strategies to enhance patients'positiv-ity,thereby reducing the negative impact of illness-related shame on psychosocial adjustment.

Objective:To explore the efficacy and adverse reactions of CAG regimen combined with venetoclax,chidamide,and azacitidine in the treatment of elderly patients with acute myeloid leukemia(AML).Methods:15 elderly AML patients aged ≥ 60 years old who were admitted to the Hematology Department of our hospital from May 2022 to October 2023 were treated with the CAG regimen combined with venetoclax,chidamide and azacitidine,and the efficacy,treatment-related adverse events,overall survival(OS)and event-free survival(EFS)were analyzed.Results:After one course of treatment,11 out of 15 patients achieved complete response(CR),3 patients achieved CR with incomplete hematologic recovery(CRi),and 1 patient died due to prior infection before efficacy evaluation,and the overall response rate(ORR)was 93.3％(14/15).The median follow-up time was 131(19-275)days,with median OS and EFS both remaining unreached.Next-generation sequencing(NGS)analysis showed that among the 15 patients,13 were detected with gene mutations,and there were 7 genes with mutation frequencies of more than 10％,including ASXL1(4 cases),RUNX1(4 cases),BCOR(3 cases),DNMT3A(3 cases),STAG2(2 cases),IDH1/2(2 cases),and TET(2 cases).Among the 13 patients with detectable mutations,12 patients achieved composite response(CR+CRi).The average recovery time of white blood cell count was 14.6 days after chemotherapy,and the average recovery time of platelets was 7.7 days after chemotherapy.The main adverse event was myelosuppression,with 10 patients accompanied by infection.Except for 1 patient who died due to septic shock during chemotherapy,no patients experienced serious complications such as heart,liver,or kidney damage during the treatment process.Conclusion:The CACAG+V regimen,which combines the CAG regimen with venetoclax,chidamide,and azacitidine,can be applied in the treatment of elderly AML patients,demonstrating good safety and induction remission rate.

Objective:To develop an artificial intelligence (AI)-based platelet review strategy to identify abnormal platelet histograms with no significant difference between initial impedance platelet count (PLT-I) and PLT-F results.Methods:This study included 5 119 routine blood analysis in Nanfang Hospital of Southern Medical University and its Ganzhou branch from July 2023 and March 2024. Specimens exhibiting abnormal platelet histograms and an initial platelet count >40×10?/L underwent review using the fluorescent platelet count (PLT-F) channel. Consistency of the results was defined as a difference between impedance platelet count (PLT-I) and PLT-F less than ±20% of the PLT-F results. A deep learning model was developed using platelet and red blood cell histogram data from a training set of 3 807 specimens. The model′s diagnostic performance was evaluated on an independent external validation set ( n=805) using receiver operating characteristic (ROC) curve analysis. Changes in the number of reviewed samples and sample turnaround time were analyzed to assess its clinical utility. Results:The deep learning model based on platelet and red blood cell histograms achieved an area under the ROC curve (AUC) of 0.854 in the training set. At a cutoff value of 0.1, the sensitivity was 0.954 and specificity was 0.358. The model could reduce review by 16.80% (190/1 131). In the validation set, the AUC was 0.805, with a sensitivity of 0.955 and specificity of 0.307, corresponding to a reduction of 17.41% (47/270) in reviewed specimens.Conclusion:The platelet review prediction model developed based on deep learning technology can efficiently identify samples with consistent results before and after review, reducing unnecessary reviews and shortening specimen testing time, thereby improving the efficiency of platelet test.