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.

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.

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.

Objective To evaluate postoperative efficacy and safety of oral or nasal feeding Chinese patent medicine in the treatment of intracerebral haemorrhage(ICH)based on Bayesian network meta-analysis(BNMA).Methods The randomized controlled trial(RCT)study of Chinese patent medicine for intervening in post-operative patients of ICH was retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed,Embase,Cochrane Library,and Web of Science.The retrieval time is from the establishment of databases to August 25,2023.ROB 2.0 was used for risk of bias assessments.BNMA was performed by using R 4.2.2 loaded with the BUGSnet 1.1.0 package.Results A total of 28 RCTs were included,with a total sample size of 2 530 cases,including 9 kinds of Chinese patent medicines[Angong Niuhuang Pills(AGNH),Suhexiang Pills(SHX),Naoxueshu Oral Liquid(NXS),Naoxintong Capsules(NXT),Naoxuekang Tablets(NXK),Xiaoyukang Capsules(XYK),Yangxue Qingnao Granules(YXQN),Tongtian Oral Liquid(TT),Sanqi Tongshu Capsules(SQTS)].All patients underwent surgical treatment and postoperative treatment of conventional western medicine(CWMT),the experimental group was additionally given Chinese patent medicine orally or by nasal feeding.The BNMA results showed that AGNH+CWMT group ranked first in reducing short-term mortality,NIHSS score,and perihematomal edema,with P＜0.05 compared to CWMT group.SHX+CWMT group ranked first in improving total effective efficiency,with P＜0.05 compared to CWMT group.TT+CWMT group ranked first in increasing GCS scores,with P＜0.05 compared to CWMT group.YXQN+CWMT group ranked first in improving BI index,with P＜0.05 compared to CWMT group.NXS+CWMT group ranked first in promoting the absorption of cerebral hematoma,with P＞0.05 compared to CWMT group.NXT+CWMT group ranked first in shortening the average length of hospital stay,with P＞0.05 compared to CWMT group.Conclusion Compared with CWMT group,the combined use of Chinese patent medicine and CWMT is effective in improving the total effective rate,reducing mortality and NIHSS score,increasing GCS score and BI after operation in patients with ICH.There is no significant difference in promoting hematoma absorption and shortening the average length of hospital stay.AGNH has good effect,which may be the best Chinese patent medicine in the post-operative treatment of ICH patients.However,due to limitations in quality and methodology of included research,the conclusions obtained still need further validation.

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.

Objective:To investigate the value of multi-parametric analysis based on dual-layer detector spectral CT (DLCT) in predicting the initial recurrence risk for papillary thyroid carcinoma (PTC).Methods:From November 2021 to October 2022, 102 PTC patients confirmed by pathology were retrospectively collected at the First Affiliated Hospital of Nanjing Medical University in this cross-sectional study. There were 25 males and 77 females, with an age of (42±13) years old. The initial recurrence risk assessment for PTC patients was categorized into a low-risk group (75 cases) and an intermediate-high-risk group (27 cases). Clinical data, including age, gender, body mass index, history of nodular goiter, history of Hashimoto thyroiditis, and preoperative thyroid function, were collected. Tumor morphological features, including size, location, shape, aspect ratio, the degree of thyroid capsule contact, calcification, and cystic change, were evaluated. Quantitative DLCT parameters, including iodine concentration (IC), standardized iodine concentration (NIC), effective atomic number (Z eff), standardized effective atomic number (NZ eff), electronic density (ED), CT values under different energy levels (40-200 keV, 30 keV intervals) and slope of energy spectrum curve (λ HU) both in the arterial and venous phase were measured. The differences in clinical, morphological features, and spectral CT quantitative parameters between the two groups were compared using independent sample ttest, Mann-Whitney U test, or χ2 test. Multivariate logistic regression analyses were used to construct three models based on clinical and morphological features, quantitative DLCT parameters and their combination, respectively. The receiver operating characteristic curve was used to evaluate the predictive performance of these models for the initial recurrence risk of PTC patients, and the area under the curve (AUC) was compared using the DeLong test. Results:Significant differences were found in gender, lesion long diameter, lesion short diameter and calcification between the low-risk group and intermediate-high-risk groups ( P<0.05). The arterial phase IC, arterial phase Z eff, arterial phase λ HU, arterial phase CT 40 keV, venous phase NIC and venous phase NZ eff in intermediate-high-risk group were significantly lower than those in the low-risk group ( P<0.05). The logistic regression analysis revealed that the clinical model included gender ( OR=2.895, 95% CI 1.047-8.002, P=0.040) and lesion long diameter ( OR=1.142, 95% CI 1.042-1.251, P=0.004), with an AUC of 0.720, sensitivity of 63.0%, and specificity of 78.7% in predicting the initial recurrence risk of PTC patients. The DLCT quantitative parameter model included arterial phase IC ( OR=0.580, 95% CI 0.370-0.908, P=0.017), venous phase NIC ( OR=0.077, 95% CI 0.011-0.536, P=0.010), and venous phase NZ eff ( OR=0.002, 95% CI 0.001-0.103, P=0.009), with an AUC of 0.774, sensitivity of 71.9%, and specificity of 70.0%. The AUC of the combined model was 0.857, with a sensitivity of 74.1%, and specificity of 88.0%, outperforming the clinical model ( Z=2.92, P=0.004) and the DLCT quantitative parameter model ( Z=2.07, P=0.046). Conclusion:Multi-parametric analysis based on DLCT can help predict the initial recurrence risk for PTC, and combining it with clinical and morphological features, the predictive accuracy can be improved.

Objective:To explore the effects of game addiction disorders on brain cognitive control functions based on near-infrared spectroscopy.Methods:Thirteen subjects were screened according to the Online Game Addiction (OGA) Scale. The experimental paradigm was the stop-signal task. The relative concentration levels of oxyhemoglobin (HbO 2) and deoxyhemoglobin (Hb) in the prefrontal region of the brain during cognitive activity were collected using near-infrared spectroscopy to assess the cognitive control function of the subjects. Results:The game-addicted patients had lower keystroke accuracy in the stop-signal task than healthy subjects, and the difference was statistically significant ( P<0.05). Compared to healthy subjects, game-addicted patients had less activation in prefrontal areas and showed uncontrolled behavior and brain activity. Conclusions:Game addiction disorders impair brain cognitive control, which in turn triggers a weakening of cognitive control. The results of this study provide a reference for the prevention and treatment of game addiction.

Objective:To investigate the effect of visceral obesity on the short-term curative effect of Da Vinci robotic-assisted radical resec-tion for rectal cancers.Methods:Clinical and pathological data of patients with rectal cancer undergoing Da Vinci robotic-assisted surgery,admitted to People's Hospital of Zhengzhou University and Cancer Hospital of Zhengzhou University from November 2019 to June 2022 were retrospectively analyzed.Visceral fat area(VFA)≥100 cm2 was used as the standard to define visceral obesity.Patients were categorized in-to visceral and non-visceral obesity groups.The short-term efficacy of the two groups was evaluated,and the influencing factors of post-operative complications were analyzed using univariate and multivariate Logistic regression.Results:Among a total of 169 patients,93 were included in the visceral obesity group and 76 in the non-visceral obesity group.There was no significant difference in the baseline data between the two groups(P>0.05).There was no conversion to laparotomy in the non-visceral obesity group,and the conversion rate was 1.1%(1/93)in the visceral obesity group.The second operation rate was 2.2%(2/93)in the visceral obesity group and 1.3%(1/76)in the non-visceral obesity group with no statistical difference between the two groups.There were no significant differences in the operation dur-ation,intraoperative blood loss,number of lymph node dissections,and total postoperative complication rate between the two groups(P>0.05).Multivariate Logistic regression analysis revealed that an NRS≥3 independently contributed as a risk factor for postoperative com-plications(OR=3.190,95%CI:1.240-8.210,P=0.016).Conclusions:An NRS≥3 is an independent risk factor for complications post-robotic rad-ical rectal cancer surgery.The robotic surgical platform can overcome obesity-related limitations and is equally safe and effective for pa-tients with visceral obesity presenting with rectal cancer.

Biodegradation of pyridine pollutant by microorganisms is one of the economical and effective methods to solve the environmental pollution of pyridine under high salinity conditions. To this end, screening of microorganisms with pyridine degradation capability and high salinity tolerance is an important prerequisite. In this paper, a salt-resistant pyridine degradation bacterium was isolated from the activated sludge of Shanxi coking wastewater treatment plant, and identified as a bacterium belonging to Rhodococcus on the basis of colony morphology and 16S rDNA gene phylogenetic analysis. Salt tolerance experiment showed that strain LV4 could grow and degrade pyridine with the initial concentration of 500 mg/L completely in 0%-6% saline environment. However, when the salinity was higher than 4%, strain LV4 grew slowly and the degradation time of pyridine by strain LV4 was significantly prolonged. Scanning electron microscopy showed that the cell division of strain LV4 became slower, and more granular extracellular polymeric substance (EPS) was induced to secrete in high salinity environment. When the salinity was not higher than 4%, strain LV4 responded to the high salinity environment mainly through increasing the protein content in EPS. The optimum conditions for pyridine degradation by strain LV4 at 4% salinity were 30 ℃, pH 7.0 and 120 r/min (DO 10.30 mg/L). Under these optimal conditions, strain LV4 could completely degrade pyridine with an initial concentration of 500 mg/L at a maximum rate of (29.10±0.18) mg/(L·h) after 12 h adaptation period, and the total organic carbon (TOC) removal efficiency reached 88.36%, indicating that stain LV4 has a good mineralization effect on pyridine. By analyzing the intermediate products in pyridine degradation process, it was speculated that strain LV4 achieved pyridine ring opening and degradation mainly through two metabolic pathways: pyridine-ring hydroxylation and pyridine-ring hydrogenation. The rapid degradation of pyridine by strain LV4 in high salinity environment indicates its application potential in the pollution control of high salinity pyridine environment.
Rhodococcus/genetics* ; Phylogeny ; Extracellular Polymeric Substance Matrix/metabolism* ; Sewage ; Biodegradation, Environmental ; Pyridines/metabolism*

Objective: To investigate the expression and clinical significance of lysophosphatidic acid receptor 5 (LPA5) protein in breast cancer tissues. Methods: The specimens of breast cancer tissues and adjacent tissues of 80 breast cancer patients from January 2015 to December 2016 in the First People's Hospital of Yongkang were selected in the study.The expression of LPA5 in breast cancer tissues and adjacent tissues was determined by immunohistochemistry.The clinical case characteristics of patients were collected. Results: The positive expression rate of LPA5 in breast cancer tissues(72.5%) was higher than that in adjacent tissues(8.75%)(χ²=67.394, P<0.05). The positive rate of LPA5 in clinical stage Ⅲ-Ⅳ(91.3%) was higher than that in stage Ⅰ-Ⅱ(64.9%)(χ²=5.725, P<0.05). The positive rate of LPA5 in patients with lymph node metastasis(94.7%) was higher than that in patients without lymph node metastasis(52.4%)(χ²=17.951, P<0.05). The positive rate of LPA5 in patients with intravascular tumor thrombus(92.3%) was higher than that in patients without intravascular tumor thrombus (63.3%)(χ²=7.580, P<0.05). The expression of LPA5 in breast cancer tissues was not related to age and tumor diameter (P>0.05). There were no significant differences in the positive expression rates of LPA5 in the breast cancer tissues among luminal type, human epidermal growth factor receptor 2 (Her2) overexpressing type and triple negative type (P>0.05). The disease-free survival rate(86.3%) and overall survival rate(87.5%) of patients with negative expression of LPA5 in breast cancer tissues were higher than those in breast cancer tissues with positive expression (65.0%, 66.3%)(χ²=4.517, 4.328, all P<0.05). Conclusion LPA5 expression is up-regulated in breast cancer tissues, and LPA5 may be involved in the development and progression of breast cancer, which is closely related to the prognosis of breast cancer.