1.Staged treatment of post-stroke depression based on "deficiency of heart qi leading to sadness"
Yilong SUN ; Yanbo SONG ; Fangbiao XU ; Yijun WU ; Yuhe HU ; Yongkang SUN ; Huan YU ; Yina WANG ; Xinzhi WANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(12):1646-1654
Post-stroke depression is a common complication after a stroke. Based on the theory of "deficiency of heart qi leading to sadness"recorded in Huangdi Neijing, our team proposes that deficiency of heart qi is the basic pathogenesis of post-stroke depression, with sadness being its main manifestation. Therefore, we advocate treating post-stroke depression from the perspective of the heart, and clinically, it can be divided into four stages: heart-liver stage, heart-lung stage, heart-spleen stage, and heart-kidney stage. Treating post-stroke depression with the principle of regulating qi and nourishing the heart, patients in the heart-liver and heart-lung stages are mainly middle-aged and young adults, with a pathological nature of qi stagnation and mild deficiency of heart qi, and therefore, the method of promoting the flow of meridians and regulating qi should be adopted. In contrast, patients in the heart-spleen and heart-kidney stages are mainly middle-aged and elderly, with a pathological nature of qi deficiency and severe deficiency of heart qi, and therefore, nourishment and tonification should be prioritized. In response to the above four stages, our team has achieved good clinical efficacy by administering Xiaoyao Powder, Baihe Dihuang Decoction, Ganmai Dazao Decoction and Jingui Shenqi Pill respectively. This study discusses the approach to treating post-stroke depression from the perspective of a "deficiency of heart qi leading to sadness" by examining three aspects: the theoretical basis of Chinese and Western medicine to treat post-stroke depression from the heart, the basic pathogenesis and staging of post-stroke depression, and the treatment principle of regulating qi and nourishing the heart. The study also briefly analyzes the clinical experience of the medications used for this condition to provide a reference for the treatment of post-stroke depression.
2.Overview of Key Technologies in Surgical Robots and Optimization Discussions
Xunjun MA ; Jun YU ; Haitao LIU ; Ya LI ; Hao WU ; Yanbo HUANG ; Bide XU ; Li LIN ; Jinwu WANG
Chinese Journal of Medical Instrumentation 2024;48(5):505-511
Surgical robot is the national strategic diagnostic and therapeutic equipment research focus,get a number of scientific research institutes,colleges and universities and enterprises pay extensive attention to the design and development of a variety of surgical robots,and registration declaration.This article explores the critical technologies of surgical robots and key areas for optimizing their performance,including kinematic positioning errors,pose errors,feedback model errors,image recognition positioning errors,path planning,and safety aspects.The findings not only provide a scientific basis for future standardization research on surgical robots but also offer significant theoretical and practical references for the research,manufacturing,and registration processes in the medical robotics industry.
3.Regulation of Alzheimer's Disease by Chinese Medicine Based on BDNF/TrkB Signaling Pathway: A Review
Liuping YUE ; Yongkang SUN ; Fangbiao XU ; Yanbo SONG ; Xinzhi WANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(20):274-282
Alzheimer's disease (AD) is a chronic neurodegenerative disorder characterized by the progressive loss of cognitive and memory functions. Its pathological features mainly include neurofibrillary tangles formed by the aggregation of hyperphosphorylated tau proteins and amyloid plaques formed by the accumulation of β-amyloid. The exact pathogenesis of AD has not been fully elucidated, and there are currently no effective specific drugs or radical treatments available in clinical practice. In recent years, the incidence of AD has been on the rise, severely affecting life and health, making the search for effective drugs and therapeutic components for AD treatment crucial. Modern medical research has found that the brain-derived neurotrophic factor (BDNF)/tropomyosin receptor kinase B (TrkB) signaling pathway is closely related to neurogenesis, apoptosis, neuroinflammation, synaptic plasticity, and oxidative stress, playing a vital role in the pathophysiological development of AD. Additionally, Chinese medicine has a long history of treating neurodegenerative diseases with few adverse reactions and features a multi-target, multi-link, and multi-pathway approach to treatment. Therefore, the author reviewed the latest research reports in China and abroad to elaborate on the role of the BDNF/TrkB signaling pathway in the onset and progression of AD, and summarized the research progress on the regulation of the BDNF/TrkB pathway by Chinese medicine compounds and monomers in AD intervention. This study is expected to provide references for the development of clinical drugs for the prevention and treatment of AD and to broaden the perspective on Chinese medicine treatment of AD.
4.A preliminary study on the effect and mechanism of PCOS in Morinda citrifolia
Baodan XU ; Yanbo FU ; Yunhua PENG
China Modern Doctor 2024;62(8):68-73
Objective To use the ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)to authenticate the chemical composition of Morinda citrifolia,and further experiments verify that Morinda citrifolia regulate miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in rats with polycystic ovary syndrome(PCOS).Methods Use UPLC-MS/MS analyze the chemical composition of Morinda citrifolia.SD female rats were randomly divided into three groups:normal control group(n=5),PCOS model group(n=5)and Morinda citrifolia gavage group(n=5).HE staining observe the morphology of ovarian histology,ELISA method detect the expression levels of testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),interleukin(IL)-1βand IL-18,RT-qPCR detect the mRNA expression of miR-223-3p and NLRP3,and Western blot detect the protein expression of NLRP3.Results UPLC-MS/MS identify 641 chemical composition of Morinda citrifolia,including luteolin,Apigenin,emodin and other composition.Compared with the normal control group,the number of cell layers of ovarian granule in the PCOS model group is reduced,and follicular cystic dilation,atresia follicles increased,T and LH levels increased(P<0.05),FSH levels decreased(P<0.05),IL-18 and IL-1β levels increased(P<0.05),and ovarian tissue miR-223-3p mRNA expression decreased(P<0.01),NLRP3 mRNA and protein expression increased(P<0.01)in PCOS model group.Compared with the PCOS model group,the proportion of follicles at all levels is normal,the number of granule cell layers increased,T and LH levels decreased(P<0.05),FSH levels increased(P<0.05),IL-18 and IL-1β levels decreased(P<0.05),miR-223-3p mRNA expression in ovarian tissue increased((P<0.05),NLRP3 mRNA and protein expression decreased(P<0.05)in Morinda citrifolia gavage group.Conclusion Morinda citrifolia can improve the ovary pathological state of PCOS rats,change the abnormal sex hormones and reduce the levels of inflammatory factors IL-18 and IL-1β.The mechanism maybe regulate the miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in PCOS rats.
5.Risk factors for early postoperative hypertension after transcatheter aortic valve implantation in patients with severe aortic stenosis: A retrospective cohort study in a single center
Jigao SHANG ; Peide ZHANG ; Xu WANG ; Xiang FENG ; Xuanshu LI ; Yanbo ZHANG ; Wei WANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(12):1813-1819
Objective To explore the risk factors and potential mechanisms of hypertension events on the same day after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. Methods Clinical data of patients who underwent TAVI for severe aortic stenosis at Department of Structural Heart Disease, Fuwai Hospital from December 2023 to February 2024 were retrospectively collected. According to the peak systolic blood pressure on the same day after surgery, patients were divided into a hypertension group (≥140 mm Hg) and a normal blood pressure group (<140 mm Hg). Logistic regression model was used to analyze the risk factors for hypertension on the same day after TAVI. Results A total of 54 patients after TAVI were included, with 41 patients in the hypertension group, including 18 males and 23 females, with an average age of (72.83±6.78) years; 13 patients in the normal blood pressure group, including 9 males and 4 females, with an average age of (70.00±7.57) years. Univariate analysis found that there were statistical differences in interventricular septal thickness [(13.71±1.98) mm vs. (12.23±1.59) mm, P=0.018], preoperative left ventricular ejection fraction (LVEF)>55% [33 (80.5%) vs. 6 (46.2%), P=0.040], and postoperative same-day LVEF>55% [33 (80.5%) vs. 4 (30.8%), P=0.003]. Multivariate logistic regression analysis found that postoperative same-day LVEF>55% [OR=10.173, 95%CI (1.044, 99.115), P=0.046] was an independent risk factor for hypertension on the same day after TAVI. Conclusion Myocardial contractility mainly participates in the occurrence of hypertension on the same day after TAVI. This study can not only improve our understanding of early hemodynamic changes after TAVI, but also provide a basis for the formulation of early hypertension treatment plans after TAVI to improve the short- and long-term prognosis of patients.
6.Understanding the excellent use of Chaihu Guizhi Decoction from xiang thinking
Yilong SUN ; Fangbiao XU ; Yanbo SONG ; Yuhe HU ; Yongkang SUN ; Wenbo LIU ; Liuping YUE ; Xinzhi WANG
Journal of Beijing University of Traditional Chinese Medicine 2024;47(11):1512-1519
Chaihu Guizhi Decoction is an excellent prescription of ZHANG Zhongjing;however,nowadays the application of Chaihu Guizhi Decoction is primarily derived from the text.The xiang thinking is the source of traditional Chinese medicine thinking.Understanding Chaihu Guizhi Decoction from the xiang thinking,it is easy to perceive the true meaning of ZHANG Zhongjing,and grasp the location of the disease and the patient's overall qi,so as to make better use of this formula.This article discusses the understanding of Chaihu Guizhi Decoction from five perspectives:firstly,it gives an overview of the xiang thinking,pointing out the source and essential value of the xiang thinking;secondly,it analyses the disease position and the patient's qi of Chaihu Guizhi Decoction under the perspective of the xiang thinking as a whole;thirdly,it discusses the disease position and the patient's qi of the original text of Chaihu Guizhi Decoction from the xiang thinking;fourthly,it discusses how to understand the principle of formula formation and the main and minor parts of Chaihu Guizhi Decoction by xiang thinking;finally,it analyses the primary medicines in Chaihu Guizhi Decoction by using xiang thinking based on the records of Shennong Bencao Jing.Based on these five points,we hope to reveal the traditional Chinese medicine thinking behind Chaihu Guizhi Decoction,and provide new ideas for the clinical application of Chaihu Guizhi Decoction.
7.Treating Emotional Disorders from the Classification of Gallbladder
Yijun WU ; Yongkang SUN ; Fangbiao XU ; Yanbo SONG ; Wenbo LIU ; Shuang JIANG ; Haohao LIAO ; Xinzhi WANG
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(3):309-314
This article summarizes the unique viewpoints and experience application of the famous and veteran Chinese medicine practitioner,Professor Wang Xinzhi,in treating emotional diseases from the perspective of gallbladder theory.Based on the physiologi-cal functions and characteristics of the gallbladder in Chinese medicine,it is proposed that the"heart mind-gallbladder-viscera"axis dominates the generation and changes of emotions,and it is believed that gallbladder failure is the key pathogenesis of emotional disor-ders.The treatment of clinical syndromes should be based on the type of gallbladder,and emotional diseases can be divided into types of insufficient gallbladder qi,unfavorable Shaoyang,gallbladder and heat excess,timidity-deficiency,and heart-gallbladder indeci-sion,according to clinical manifestations;based on the basic principle of adjusting the functions of the heart,spleen,liver,gallblad-der,kidney and other organs,treatment methods such as tonifying the spleen and kidneys,increasing gallbladder qi,resolving Shaoy-ang,clearing gallbladder heat,warming yang and replenishing qi,calming the mind,resolving phlegm and removing blood stasis should be used,highlighting the joint treatment of the heart and the gallbladder,and the simultaneous regulation of the liver and gall-bladder,so that the mind can be at ease,the gallbladder can be decisive,and the emotions can be harmonious.
8.Relationship between IL-10 gene polymorphisms and acute kidney injury and its related mechanisms
Qing XU ; Hunian LI ; Yanbo ZHAO ; Bojun LI
Journal of China Medical University 2024;53(9):809-814
Objective To investigate the relationship between interlukin-10(IL-10)gene polymorphisms and acute kidney injury(AKI)and its related mechanisms.Methods A prospective study was conducted on 100 patients with AKI admitted to our hospital from March 2021 to March 2023,who were selected as the study group.Following the 1∶1 pairing principle,100 healthy individuals who underwent physical examinations during the same period were included as the control group.General data,IL-10 genotypes,and gene frequency distributions of the two groups were compared.The factors influencing AKI were assessed using a logistic regression analysis,and the interaction between IL-10gene polymorphisms and conventional risk factors was analyzed using multifactor dimension reduction(MDR).Results The quantitative values of serum creatinine(sCr),blood urea nitrogen(BUN),and urine protein in the study group were higher than those in the control group.The proportion of the GG genotype at IL-10-1082 was lower than that in the control group,and the proportions of the AA genotype and A allele were higher than those in the control group(P<0.05).Logistic regression analysis showed that BUN(OR=4.487),urinary protein quantitation(OR=5.905),sCr(OR=3.573),AA genotype at position 1082(OR=4.823),and the A allele(OR=4.479)were risk factors for AKI(P<0.05).Interaction display,IL-10-1082 polymorphism×sCr,IL-10-1082 polymor-phism×BUN,IL-10-1082 polymorphism×urinary protein quantification,and IL-10-1082 polymorphism×sCr×BUN×urinary protein quantification models exhibited good accuracy and cross-consistency(P<0.05).Conclusion IL-10gene polymorphisms are strongly associated with the development of AKI.
9.Application of fluoroscopic stereophotogrammetric analysis in the detection of aseptic loosening of prostheses
Han YANG ; Hao LEI ; Bide XU ; Hao WU ; Xunjun MA ; Yanbo HUANG ; Yuanqing MAO ; Jingwei ZHANG ; Jinwu WANG
Journal of Shanghai Jiaotong University(Medical Science) 2024;44(9):1061-1068
Objective·To verify the accuracy and clinical feasibility of fluoroscopic stereophotogrammetric analysis(FSA)technology based on two dimension(2D)-three dimension(3D)registration for early migration detection of aseptic loosening of joint prostheses.Methods·2D-3D registration algorithms centering on the light source and projected object respectively in FSA technology were verified under various working conditions through image synthesis experiments,and the feasibility of clinical application was verified through real model experiments.The image synthesis experiment established a perspective projection environment with the same parameters as the real environment in a virtual environment,the 2D perspective images of the 3D model(bone or prosthesis)during the six degrees of freedom transformation were recorded,and the six degrees of freedom transformation of the 3D model was restored by using different 2D-3D registration algorithms.The error of each registration algorithm was calculated.For real model validation,the migration between bone and prosthesis after joint replacement surgery was simulated with a high precision bone prosthesis migration simulator.The 3D model of the bone or prosthesis was reconstructed by using computed tomograph(CT)images and optical scanning,and the 2D perspective images before and after prosthesis migration were captured by using a fluoroscopy device.The migration of the prosthesis was restored by using FSA technology based on 2D-3D registration,and the error of FSA technology was calculated.Results·The accuracy of the 2D-3D registration algorithm centering on the light source was higher than that of the algorithm centering on the projected object under different working conditions.When the initial registration conditions were favorable,the algorithm centering on the light source reduced the rotation error compared to the algorithm centering on the projected object,with a statistical difference(P=0.021),and the displacement error decreases,with a significant statistical difference(P=0.000).Moreover,algorithms centering on the light sources required lower similarity and fewer registration times to meet clinical application requirements.Conclusion·The accuracy of FSA technology based on 2D-3D registration in early migration detection of artificial joint prostheses meets clinical application requirements.This technology can warn of late aseptic loosening of prostheses by detecting early migration of prostheses after joint replacement surgery,and is expected to be applied to clinical practice through further research.
10.Newborn screening, clinical features and genetic analysis for Citrin deficiency in Henan province
Xinyun ZHU ; Yizhuo XU ; Jie ZHANG ; Xiaole LI ; Jingwen HE ; Chenlu JIA ; Shubo LYU ; Suna LIU ; Yanbo GAO ; Kun MA ; Yunjia OUYANG ; Yihui REN ; Dehua ZHAO
Chinese Journal of Medical Genetics 2024;41(4):461-466
Objective:To explore the prevalence, clinical features, genetic characteristics and prognosis of Citrin deficiency in Henan province of China.Methods:A total of 986 565 neonates screened by tandem mass spectrometry at the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2021 were retrospectively analyzed. Analysis of SLC25A13 gene variants and parental verification were carried out for neonates suspected for Citrin deficiency by next-generation sequencing. The clinical, biochemical and genetic characteristics of Citrin deficiency patients were integrated to guide the diet treatment and follow up the growth and development. Paired- t test was used to compare the amino acid levels in the peripheral blood samples before and after the treatment. Results:Nine cases of Citrin deficiency were diagnosed among the 986 565 neonates. Specific elevation of citrulline was observed in all of the 9 cases. Six variants were detected by genetic sequencing, among which c. 852_855delTATG, c. 615+ 5G>A, c. 550C>T and IVS16ins3kb were known pathogenic variants, whilst c. 1111_1112delAT and c. 837T>A were unreported previously. The detection rate for c. 852_855delTATG was the highest (61.6%, 11/18), followed by IVS16ins3kb (16.7%, 3/18). The clinical symptoms of all patients were relieved after the treatment, and the blood amino acid profile and biochemical parameters were significantly improved by gradually falling within the normal range. By June 2022, all patients had shown a good prognosis.Conclusion:The prevalence of Citrin deficiency among neonates from Henan Province by tandem mass spectrometry is 1/109 618, and the carrier rate for the pathogenic variants of the SLC25A13 gene was 1/166. The c. 852_855delTATG may be a hot spot variant among the patients. Discovery of the novel variants has enriched the mutational spectrum of the SLC25A13 gene. Above results have provided a basis for the early diagnosis, treatment, prognosis and genetic counseling for the affected families.


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