1.Huanglian Jiedutang Improves Cognitive Impairment after Schemic Stroke by Regulating Neuron via NF-κB Signaling Pathway
Mengying SUN ; Lizhen WANG ; Tong LI ; Leilei WANG ; Shiyan JIA ; Tingting WANG ; Yanwen YANG ; Kaiqiang SI ; Youxiang CUI ; Zhilong LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):68-76
ObjectiveTo investigate the effects of Huanglian Jiedutang (HLJDT) on cognitive function in mice with ischemic stroke (IS) and to elucidate whether its neuroprotective effects are mediated by inhibition of the nuclear factor-κB (NF-κB) signaling pathway and subsequent suppression of NF-κB-regulated neuronal apoptosis. MethodsAn IS model was established using middle cerebral artery occlusion (MCAO). Sixty C57BL/6J mice were randomly assigned to five groups (n =12 per group), i.e., sham operation, model, HLJDT low-dose (3.9 g·kg-1·d-1), HLJDT high-dose (7.8 g·kg-1·d-1), and Ginkgo biloba extract (GBE, 31.2 mg·kg-1·d-1). Post-operatively, neurological deficit scores (Longa score), cerebral infarct volume assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and brain water content were evaluated. Learning and memory were assessed using new object recognition (NOR) and fear conditioning (FC) tests. Hippocampal pathology was examined via hematoxylin and eosin (HE) staining. Immunofluorescence detected expression of glial fibrillary acidic protein (GFAP, astrocyte marker), cellular oncogene Fos (c-Fos, neuronal activation marker), and glutamate decarboxylase 65 (GAD65). Western blot measured nuclear factor-κB inhibitor protein α (IκBα), phosphorylated IκBα (p-IκBα), NF-κB p65, phosphorylated NF-κB p65 (p-NF-κB p65), ionic calcium binding adapter molecule 1 (Iba-1), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and apoptosis-related proteins, such as cleaved cysteinyl aspartate-specific protease 3 (Caspase-3), B-cell lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax). Real-time quantitative PCR (Real-time PCR) was used to assess mRNA levels of Iba-1, TNF-α, IL-1β, NF-κB p65, cleaved Caspase-3, Bax, and Bcl-2. ResultsCompared with the sham group, the model group exhibited significantly increased neurological deficit scores, brain water content, and cerebral infarct volume (P<0.01). Hippocampal CA1 neurons were disorganized, showing nuclear pyknosis and karyolysis. NOR exploration time and FC freezing time were significantly reduced (P<0.01). GFAP and c-Fos expression were increased, while GAD65 expression was decreased (P<0.01). Cleaved Caspase-3 and Bax were upregulated, Bcl-2 was downregulated, and the Bax/Bcl-2 ratio was elevated (P<0.01). Expression levels of p-IκBα, p-NF-κB p65, IL-1β, TNF-α, and Iba-1 were significantly increased (P<0.01). Compared with the model group, HLJDT high-dose, low-dose, and GBE groups showed significant improvements in all parameters (P<0.01). Among them, the HLJDT high-dose group showed the most pronounced neuronal structural recovery and superior performance in NOR and FC tests (P<0.01). In this group, GFAP and c-Fos decreased, GAD65 increased (P<0.01), apoptosis-related protein expression was reversed, and NF-κB signaling and related inflammatory factor expression were suppressed (P<0.01). ConclusionHLJDT ameliorates cognitive dysfunction in mice after IS, potentially by inhibiting the NF-κB signaling pathway, thereby reducing neuroinflammation and hippocampal neuronal apoptosis.
2.Exploring on Mechanism of Forsythiae Fructus-Lonicerae Japonicae Flos in Treatment of Acute Lung Injury Based on Serum Metabolomics
Wanshun CHANG ; Kang LI ; Zhaohua CHEN ; Yuqing HAN ; Yanwen CHEN ; Yanhui ZHU ; Zhenyu CHENG ; Haiying HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(24):117-125
ObjectiveTo investigate the mechanism of Forsythiae Fructus-Lonicerae Japonicae Flos(FF) in the treatment of acute lung injury(ALI) by investigating the effects of FF on serum metabolomics of rats with ALI. MethodsThirty male SD rats were acclimated for 1 week, and 6 rats were randomly selected as the blank group. The other 24 rats were injected with lipopolysaccharide(LPS) solution by tracheal drip to establish an ALI model. After successful model establishment, the rats were randomly divided into the model group, the FF low-dose group(3.0 g·kg-1), the FF high-dose group(6.0 g·kg-1), and the dexamethasone group(5 mg·kg-1), with six rats in each group. The FF low- and high-dose groups and the dexamethasone group were received daily oral administration of the corresponding drug solution, and the blank group and the model group were gavaged with an equal amount of saline, treatment was administered continuously for 3 d. The pathological conditions of rat lung tissues were evaluated by hematoxylin-eosin(HE) staining, wet/dry mass ratio(W/D) of the lung tissues, and protein concentration in rat bronchoalveolar lavage fluid(BALF). Metabolomic analysis of rat serum was performed by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS), combined with multivariate statistical analysis, the potential biomarkers of FF in treating ALI were screened by variable importance in the projection(VIP) value>1, P<0.05 from t-test, and log2fold change(FC)>1 or log2FC<-1. Kyoto Encyclopedia of Genes and Genomes(KEGG) database combined with MetaboAnalyst were used for pathway analysis of the screened differential metabolites. The protein expression levels of sphingosine-1-phosphate(S1P), phosphatidylinositol 3-kinase(PI3K), protein kinase B1(Akt1), and phosphorylated Akt1(p-Akt1) were examined by Western bolt. The expression levels of interleukin(IL)-6, IL-1β, and tumor necrosis factor(TNF)-α in BALF were detected by enzyme-linked immunosorbent assay(ELISA). ResultsCompared with the blank group, rats in the model group showed ALI pathological features such as alveolar lumen dilatation, interstitial hemorrhage and massive inflammatory cell infiltration, and the protein concentration in BALF and W/D of the lung tissues were significantly elevated(P<0.01). Compared with the model group, the low- and high-dose groups of FF as well as the dexamethasone group exhibited reduced pulmonary bronchial hemorrhage in rats, and the protein concentration in BALF and W/D were significantly decreased(P<0.05), and the lung injury was significantly alleviated. Analysis of rat serum metabolomics revealed that FF downregulated 38 biomarkers. Pathway enrichment analysis showed that FF primarily exerted therapeutic effects through 7 key metabolic pathways, including arginine biosynthesis, sphingomyelin metabolism, alanine, aspartate and glutamate metabolism, taurine and hypotaurine metabolism, α-linolenic acid metabolism, niacin and nicotinamide metabolism, and retinol metabolism. The results of Western bolt and ELISA showed that, compared with the blank group, the model group exhibited significantly elevated expression levels of S1P, PI3K, Akt1 and p-Akt1 proteins in the lung tissues, as well as increased expression levels of IL-6, IL-1β and TNF-α in BALF(P<0.01). Compared with the model group, the expression levels of the aforementioned indicators were significantly downregulated in the low- and high-dose FF groups as well as the dexamethasone group(P<0.05, P<0.01). ConclusionFF may play a role in ALI by regulating amino acid metabolism and lipid metabolism, and its mechanism may be related to the inhibition of S1P/PI3K/Akt1 signaling pathway to attenuate the inflammatory response caused by ALI.
3.Electrophysiological Abnormalities and Pharmacological Corrections of Pathogenic Missense Variants in KCNQ3.
Xiaorong WU ; Jili GONG ; Li QIU ; Guimei YANG ; Hui YUAN ; Xiangchun SHEN ; Yanwen SHEN ; Fuyun TIAN ; Zhaobing GAO
Neuroscience Bulletin 2025;41(9):1511-1521
The KCNQ potassium channels play a crucial role in modulating neural excitability, and their dysfunction is closely associated with epileptic disorders. While variants in KCNQ2 have been extensively studied, KCNQ3-related disorders have rarely been reported. With advances in next-generation sequencing technologies, an increasing number of cases of KCNQ3-related disorders have been identified. However, the correlation between genotype and phenotype remains poorly understood. In this study, we established a variant library consisting of 24 missense mutations in KCNQ3 and introduced these mutations into three different template types: KCNQ3, KCNQ3-A315T (Q3*), and KCNQ3-KCNQ2 tandem (Q3-Q2). We then analyzed the effects of these mutations on the KCNQ3 channel function using patch-clamp recording. The most informative parameter across all three backgrounds was the current density of the mutant channels. The current density patterns in the Q3* and Q3-Q2 backgrounds were similar, with most mutations resulting in an almost complete loss of function (LOF), they were concentrated in the pore-forming domain of KCNQ3. In contrast, mutations in the voltage-sensing domain or C-terminus did not show significant differences from the wild-type channel. Interestingly, these LOF mutations were typically associated with self-limited familial neonatal epilepsy, while neurodevelopmental disorders (NDD) were more closely associated with mutations that did not significantly differ from the wild-type. V1/2, another important parameter of the electrophysiological properties, could not be accurately determined in the majority of KCNQ3 mutations due to its nearly complete LOF in the Q3* and Q3-Q2 backgrounds. Intriguingly, the V1/2 of functional mutations were primarily leftward shifted, indicating a gain-of-function (GOF) effect, which was typically associated with NDD. In addition to previously reported mutations, we identified G553R as a novel GOF mutation. In the co-transfection background, parameters such as V1/2 could be determined, but the dysfunctional effects of these mutations were mitigated by the co-expression of wild-type KCNQ3 and KCNQ2 subunits, resulting in no significant differences between most mutations and the wild-type channel. Furthermore, we applied KCNQ modulators to reverse the electrophysiological abnormalities caused by KCNQ3 variants. The LOF mutations were reversed by the application of Pynegabine (HN37), a KCNQ opener, while the GOF mutation responded well to Amitriptyline (AMI), a KCNQ inhibitor. These findings provide essential insights into the pathogenic mechanisms underlying KCNQ3-related disorders and may inform clinical decision-making.
KCNQ3 Potassium Channel/genetics*
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Humans
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Mutation, Missense/genetics*
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KCNQ2 Potassium Channel/genetics*
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Patch-Clamp Techniques
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HEK293 Cells
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Animals
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Phenylenediamines/pharmacology*
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Carbamates
4.Methods and Strategies Employed in Compatibility and Formulation of New Chinese Medicinal Material Resources
Wenhua MING ; Qingqing LI ; Caifeng LI ; Yeran WANG ; Lan WANG ; Yanwen LI ; Zhiyong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):248-256
Chinese medicinal materials serve as the material foundation of traditional Chinese medicine (TCM) culture. The sustainable development of Chinese medicinal material resources is a focal point in the modernization of TCM. With the increasing scarcity of Chinese medicinal material resources, the expansion of new Chinese medicinal material resources has become a crucial means for the sustainable utilization of these resources. New Chinese medicinal material resources refer to natural resources that have been newly discovered or developed, possessing potential medicinal value or healthcare functions, which fall outside the traditional application scope of herbal medicines. These resources have not yet been widely recognized or applied within the framework of traditional TCM theory. They specifically include artificial substitutes for endangered medicinal materials, new medicinal parts of medicinal plants, medicinal materials with expanded clinical applications, and foreign medicinal resources. The rational compatability and formulation of new Chinese medicinal material resources are essential pathways for integrating them into the TCM system. Due to the weak foundational research on new Chinese medicinal material resources in China, the characteristics of these resources that align with the TCM theory are not yet fully understood, posing numerous constraints on formulating prescriptions based on the traditional compatibility principles of TCM. This paper integrates the traditional formulation theory of TCM with modern data integration methods, proposing four formulation models for new TCM resources: synergistic compatibility, substitutive compatibility, symptom-based compatibility, and efficacy semantic compatibility. These models provide new insights for the application of new Chinese medicinal material resources, not only facilitating their rational use in clinical practice but also offering theoretical support for the development and compatibility research of these resources.
5.Methods and Strategies Employed in Compatibility and Formulation of New Chinese Medicinal Material Resources
Wenhua MING ; Qingqing LI ; Caifeng LI ; Yeran WANG ; Lan WANG ; Yanwen LI ; Zhiyong LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):248-256
Chinese medicinal materials serve as the material foundation of traditional Chinese medicine (TCM) culture. The sustainable development of Chinese medicinal material resources is a focal point in the modernization of TCM. With the increasing scarcity of Chinese medicinal material resources, the expansion of new Chinese medicinal material resources has become a crucial means for the sustainable utilization of these resources. New Chinese medicinal material resources refer to natural resources that have been newly discovered or developed, possessing potential medicinal value or healthcare functions, which fall outside the traditional application scope of herbal medicines. These resources have not yet been widely recognized or applied within the framework of traditional TCM theory. They specifically include artificial substitutes for endangered medicinal materials, new medicinal parts of medicinal plants, medicinal materials with expanded clinical applications, and foreign medicinal resources. The rational compatability and formulation of new Chinese medicinal material resources are essential pathways for integrating them into the TCM system. Due to the weak foundational research on new Chinese medicinal material resources in China, the characteristics of these resources that align with the TCM theory are not yet fully understood, posing numerous constraints on formulating prescriptions based on the traditional compatibility principles of TCM. This paper integrates the traditional formulation theory of TCM with modern data integration methods, proposing four formulation models for new TCM resources: synergistic compatibility, substitutive compatibility, symptom-based compatibility, and efficacy semantic compatibility. These models provide new insights for the application of new Chinese medicinal material resources, not only facilitating their rational use in clinical practice but also offering theoretical support for the development and compatibility research of these resources.
6.Study on the"Properties-efficacy"of Foreign Medicinal Resource Moringa oleifera Leaves Based on Different"Xiang"
Yanwen LI ; Caifeng LI ; Qingqing LI ; Fengrong ZHANG ; Luming QIU ; Zhiyong LI
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(8):122-130
Objective To predict and analyze the"properties-efficacy"of foreign medicinal resource Moringa oleifera leaves by taking"Xiang"based on plant phylogenetic relationships and component structural characteristics.Methods The properties of Moringa oleifera were determined by screening plants with its genetic relationship.Network pharmacology was used to study the biological network characteristics of Moringa oleifera leaves and related Chinese materia medica,and the"properties-efficacy"of Moringa oleifera leaves was studied based on the"xiang"of medicinal plants.Using"the relationship chart between the efficacy of Chinese materia medica and 12 types of chemical components",the possible efficacy and distribution of medicinal properties of Moringa oleifera leaves were predicted,and a study on the"properties-efficacy"characteristics of Moringa oleifera leaves was conducted based on the structural features of the components.Results Moringaceae and Caricaceae had a genetic relationship in plant classification;Moringa oleifera leaves,Carica papaya and Carica papaya leaves had a relatively high number of common targets,common clinical phenotypes and signaling pathways.The large proportion of coincidence showed that Moringa oleifera leaves might have similar functional performance and mechanism to Carica papaya and Carica papaya leaves;Moringa oleifera leaves contain flavonoids,tannins,monophenols,which were related to the efficacy of Chinese materia medica on tonifying qi,dispersing wind heat,cooling blood and regulating qi.Clustering analysis method was used to get the corresponding"properties-efficacy"relationship,and the results indicated that Moringa oleifera leaves were cool in property and sweet in taste,which belonged to lung meridian and had the efficacy of dispersing wind heat.Conclusion It is feasible to predict and analyze the"properties-efficacy"of foreign medicinal resources by taking"xiang".
7.Effect of arctigenin on cognitive dysfunction induced by sevoflurane anesthesia in aged rats and the role of autophagy-mediated pyroptosis
Pengcheng WANG ; Zhen WANG ; Guoqing ZHANG ; Yanwen DAI ; Tiezhu HOU ; Zhisong LI
Chinese Journal of Anesthesiology 2025;45(2):163-169
Objective:To evaluate the effect of arctigenin (ARG) on cognitive dysfunction induced by sevoflurane anesthesia in aged rats and the role of autophagy-mediated pyroptosis.Methods:Fifty SPF male Sprague-Dawley rats, aged 18-20 months, weighing 550-600 g, were divided into 5 groups ( n=10 each) using a random number table method: control group (C group), sevoflurane anesthesia group (Sev group), sevoflurane anesthesia+ ARG group (Sev+ ARG group), sevoflurane anesthesia+ autophagy inducer rapamycin group (Sev+ RAPA group), and sevoflurane anesthesia+ ARG+ autophagy inhibitor 3-methyladenine (3-MA) group (Sev+ ARG+ 3-MA group). Except for group C, the rats in the other groups inhaled 6% sevoflurane for 3 h to establish the cognitive impairment model. At 30 min before anesthesia, ARG 20 mg/kg was intraperitoneally injected in Sev+ ARG group, rapamycin 7.5 mg/kg was intraperitoneally injected in Sev+ RAPA group, and ARG 20 mg/kg (dissolved in dimethyl sulfoxide) was intraperitoneally injected, followed by immediate intraperitoneal injection of 3-MA 1.5 mg/kg in Sev+ ARG+ 3-MA group. The equal volume of dimethyl sulfoxide was intraperitoneally injected in C group and Sev group. The Morris water maze test was conducted to assess the cognitive function at 48 h after the end of administration. After completion of the Morris water maze test, the hippocampal tissue was taken under deep anesthesia for observation of the pathological changes (after HE staining) which were scored and for determination of neuronal pyroptosis (after propidium iodide staining) and expression of neuronal autophagy-related proteins (microtubule-associated protein 1 light chain 3 [LC3], Beclin-1, p62), pyroptosis-related proteins (NOD-like receptor protein 3 [NLRP3], apoptosis-associated speck-like protein containing a CARD [ASC], pro-cysteine aspartate-specific protease 1 [pro-caspase-1], cleaved-caspase-1, gasdermin D [GSDMD], and N-terminal fragment of gasdermin D [GSDMD-N], interleukin-1β [IL-1β] and IL-18). Results:Compared with C group, the escape latency was significantly prolonged, the time of staying at the original platform quadrant was shortened, the number of crossing the original platform was reduced, the hippocampal injury score and neuronal pyroptosis rate were increased, LC3Ⅱ/LC3Ⅰ ratio was decreased, the expression of Beclin-1 was down-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was up-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were increased in Sev group ( P<0.05). Compared with Sev group, the escape latency was significantly shortened, the time of staying at the original platform quadrant was prolonged, the number of crossing the original platform was increased, the hippocampal injury score and neuronal pyroptosis rate were decreased, LC3Ⅱ/LC3Ⅰ ratio was increased, the expression of Beclin-1 was up-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was down-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were decreased in Sev+ ARG group and Sev+ RAPA group ( P<0.05). Compared with Sev+ ARG group, the escape latency was significantly prolonged, the time of staying at the original platform quadrant was shortened, the number of crossing the original platform was reduced, the hippocampal injury score and neuronal pyroptosis rate were increased, LC3Ⅱ/LC3Ⅰ ratio was decreased, the expression of Beclin-1 was down-regulated, the expression of p62, NLRP3, ASC, IL-1β and IL-18 was up-regulated, and the cleaved-caspase-1/pro-caspase-1 ratio and GSDMD-N/GSDMD ratio were increased in Sev+ ARG+ 3-MA group ( P<0.05). Conclusions:AGR can alleviate sevoflurane anesthesia-induced cognitive dysfunction in aged rats, and the mechanism is related to reduction of autophagy-mediated cell pyroptosis.
8.Statistics and Analysis on the Ethnic Patent Medicine in the Chinese Pharmacopeia,National Essential Medicine List,and National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance Medicine List of China
Yuyan WANG ; Qingqing LI ; Zhihao WANG ; Wenhua MING ; Yingfei LI ; Yanwen LI ; Zhiyong LI
Herald of Medicine 2025;44(5):743-752
Objective In this paper,the ethnic patent medicines(EPMs)in the Chinese Pharmacopeia,National Basic Medical Insurance,Employment Injury Insurance and Maternity Insurance Medicine List,and National Essential Medicine List(re-ferred to as"one pharmacopeia and two lists")were counted and analyzed.Methods The EPMs in"one pharmacopeia and two lists"were summarized,and the information of manufacturers,medicinal materials used in EPMs,and their current quality standards were collated,and their indicative function,adverse reactions,contraindications,and precautions were analyzed.The modern research level of the above EPMs was analyzed by searching relevant literature on CNKI and PubMed.Results A total of 142 EPMs in"one pharmacopeia and two lists"were included,and 68 of the EPMs had exclusive manufacturers and 98.75%of the medicinal materials had provincial-level or higher quality standards.There were issues such as the expression of indicative function in the instruction being mixed between medical terms,91.55% of the EPMs lacking sufficient information on adverse re-actions,contraindications,and precautions,and modern basic research was weak.Conclusions In the development of EPMs,it is important to improve information on adverse reactions,contraindications,and precautions in the instructions.In expressing indic-ative function,it is necessary to avoid mixing medical terms,which is more conducive to the clinical promotion of EPMs.
9.Effect of hydrogen sulfide on calcification during macrophage phagocytosis of lipids and its mechanisms
Yanwen LIU ; Qian XU ; Kun ZHOU ; Ziyi LI ; Shuiqing LIU ; Jun ZHANG ; Zhong REN ; Zhisheng JIANG
Chinese Journal of Arteriosclerosis 2025;33(4):317-325
Aim To investigate the effect of hydrogen sulfide on macrophage calcification and its underlying mo-lecular mechanisms.Methods Oil red O staining was used to observe intracellular lipid accumulation,and von Kossa staining and atomic absorption spectroscopy were used for morphological and quantitative analysis of calcium deposition and intracellular calcium content in a mononuclear macrophage calcification model.Western blot and RT-PCR were used to detect the mRNA and protein expression of osteopontin(OPN)at different doses and treatment times of hydrogen sulfide.At the same time,Western blot was used to detect the expression changes of early growth response factor 1(EGR1),endo-plasmic reticulum stress-related markers C/EBP homologous protein(CHOP)and glucose-regulated protein 78(GRP78).Reactive oxygen species levels were evaluated by fluorescence probe staining,and the effect of hydrogen sulfide on macro-phage calcification was evaluated by combining von Kossa staining and calcium ion fluorescence probe staining.The mo-lecular mechanisms of hydrogen sulfide affecting macrophage calcification were explored by interfering with EGR1 expression and using endoplasmic reticulum stress inhibitor 4-phenylbutyric acid(4-PBA).Results Compared with oxidized low density lipoprotein(ox-LDL)group,β-glycerophosphate(β-GP)+40 g/L ox-LDL group showed a significant increase in intracellular lipid accumulation,while hydrogen sulfide significantly inhibited macrophage calcification in a con-centration-and time-dependent manner.Compared with the β-GP+ox LDL group,the most significant effect was observed after incubation with 100 μmol/L NaHS for 4 days.The hydrogen sulfide group showed a 66%decrease in intracellular calcium content(P<0.01),a 71%decrease in intercellular calcium deposition(P<0.01),and a 50%and 48%decrease in OPN mRNA and protein expression,respectively(P<0.05).Hydrogen sulfide treatment upregulated the ex-pression of EGR1 by 21%,while downregulating the expression of CHOP and GRP78 by 58%and 59%,respectively(P<0.01).The endoplasmic reticulum stress inhibitor 4-PBA could downregulate OPN expression by 73%(P<0.01),while interfering with EGR1 expression completely counteracts the inhibitory effect of hydrogen sulfide on OPN expression and calcium deposition(P<0.01).Conclusion Hydrogen sulfide significantly inhibits macrophage calcification by upregulating EGR1 expression and suppressing endoplasmic reticulum stress.
10.Mediating effect of coping styles on early postoperative cognitive appraisal of health and stigma in patients with radical prostatectomy
Li'e LIN ; Li LAN ; Yanwen GONG ; Ke LIU
Modern Clinical Nursing 2025;24(5):25-32
Objective To explore the mediating effect of coping styles on the early postoperative cognitive appraisal of health and stigma in patients with radical prostatectomy,so as to provide a reference for an early intervention in postoperative stigma.Methods Convenience sampling was used to select 223 patients who received radical prostatectomy at 5 Tier-ⅢA hospitals in Guangzhou from November 2022 to December 2023.Data were collected using the demographic data questionnaire,social impact scale,brief health cognition appraisal scale and medical coping style scale.Pearson correlation analysis was performed to examine the correlations between the stigma,health cognition appraisal and coping styles.Structural equation modelling was employed to analyse the mediating effect of coping styles on the health cognition appraisals and stigma.Results A total of 210 patients completed the study.The score of stigma for the patients after the radical prostatectomy was(49.46±13.56).Stigma exhibited positive correlations with negative cognitive appraisals(threat and harm)and negative coping styles(avoidance and submission)(both P<0.01).There were negative correlations between stigma and challenging cognitive appraisal and confrontation coping style(both P<0.01).Submission coping style played a mediating role between the cognitive appraisal of health(harm,threat and challenge)and stigma(β=0.072,0.075,-0.121,all P<0.01),accounting for 14.06%,23.15%and 100.00%,respectively,of the total effect.Conclusion Submission coping style is the mediator between the early postoperative cognitive appraisals and stigma in patients with radical prostatectomy.Negative cognitive appraisal positively predicts stigma through the submission coping style,while challenging cognitive appraisal negatively predicts stigma through the submission coping style.Caregivers should assess the early coping styles of patients after surgery,guide patients to correctly cope with the disease,and help them to avoid submissive responses to the postoperative stress hence to reduce the sense of stigma.

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