BackgroundThe functional changes of the default mode network （DMN） are closely related to the onset of major depressive disorders. However， the relationship between the DMN subsystem （core subsystem， dorsomedial prefrontal cortex subsystem， medial temporal lobe subsystem） and symptoms of first-episode major depressive disorder remains unclear. ObjectiveTo investigate abnormal functional connectivity between DMN subsystems and the whole brain in first-episode major depressive disorder patients during the resting-state， and to analyse the correlations between these functional connectivity patterns and clinical symptoms， so as to reveal the potential neural mechanisms from the perspective of DMN subsystem. MethodsFrom September 2020 to September 2023， a total of 64 first-episode outpatients and inpatients meeting the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fourth edition （DSM-IV） were enrolled at the Inner Mongolia Autonomous Region Mental Health Center as the study group. During the same period， 54 healthy volunteers matched for age， gender， and years of education were recruited from the community as the control group. Both groups were assessed using the Hamilton Depression Scale-24 item （HAMD-24）. Resting-state functional magnetic resonance images （rs-fMRI） of the two groups were acquired using a Siemens 3.0 T scanner， and differences in functional connectivity between DMN subsystems （core subsystem， dorsomedial prefrontal cortex subsystem， medial temporal lobe subsystem） and the whole brain were compared. The functional connectivity values of brain regions with statistically significant differences between the two groups were extracted. Spearman's rank correlation coefficient analysis was used to investigate the correlation between these functional connectivity values and HAMD-24 scores of the study group. ResultsUltimately， 46 patients and 43 controls completed the study. Compared with the control group， the study group exhibited significantly stronger functional connectivity in the following pathways： between the right superior parietal lobule （core subsystem） and right cerebellar lobule VIII （t=3.954， P<0.05， GRF-corrected）， between the right lateral temporal cortex （dorsomedial prefrontal cortex subsystem） and right cerebellar lobule VIII， right and left hippocampi， right medial， and paracingulate gyrus （t=4.595， 4.208， 5.200， 4.038， P<0.05， GRF-corrected）， and between the temporoparietal junction （dorsomedial prefrontal cortex subsystem） and left lingual gyrus and right cerebellar lobule VIII （t=3.557， 4.274， P<0.05， GRF-corrected）. Conversely， weaker functional connectivity was observed between the right inferior frontal gyrus and left gyrus rectus （t=-3.824， P<0.05， GRF-corrected）. Furthermore， within the study group， the functional connectivity values between the right lateral temporal cortex and right hippocampus， as well as between the temporoparietal junction and right cerebellar lobule VIII， were both negatively correlated with the HAMD-24 cognitive impairment factor score （r=-0.306， -0.318， P<0.05）. ConclusionIncreased functional connectivity between the DMN （specifically its core and dorsomedial prefrontal cortex subsystems） and cerebellum， partial limbic system， and lingual gyrus may be associated with the neuropathology of first-episode major depressive disorder. Furthermore， alterations in functional connectivity between the dorsomedial prefrontal cortex subsystem and both the cerebellum and hippocampus in these patients may be related to cognitive function. ［Funded by 2019 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project （number， 2019MS03038）； 2023 Annual Inner Mongolia Autonomous Region Natural Science Foundation Project （number， 2023MS08028）］

Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective To explore the effects of inhospital emergency process ~engineering for patients with acute poisoning.Methods Emergency Department of the Affiliated Hospital of Hangzhou Normal University implemented inhospital poisoning emergency process reengineering in March 2016.This implementation optimized original emergency process and applied it in patients with acute poisoning beginning with 6 aspects including refining precheck patients,assessment of poisoning emergency response group,fast gastrolavage,transportation,gastrolavage combined with blood purification group rapid preparation,emergency intensive care unit preparation.We compared the rescue efficiency of patients with acute poisoning before (from March 2015 to February 2016) and after (from March 2016 to February 2017) process reengineering.Results After process reengineering,the time from being admitted to hospital to beginning gastrolavage and the duration of gastrolavage was (8.91 ± 5.29)min and (31.86 ± 8.42)min respectively shorter than those before process reengineering with significant differences (t=3.397,4.028;P ＜ 0.01).After process reengineering,the time from being admitted to hospital to opening blood purification tubes (176.59 ± 88.73)min and from being admitted to hospital to starting blood perfusion (229.35 ± 108.79)min were significantly sooner than those before process reengineering (t=3.600,3.550;P ＜ 0.01).Conclusions The inhospital emergency process reengineering is scientific and convenient.It is propitious to improve rescue efficiency of patients with acute poisoning.

Objective To observe the age-related changes of brain-derived neurotrophic factor(BDNF) and investigate the effects of ginsenosides(GS) on BDNF in nucleus basalis of Meynert(NBM) and cerebral cortex of aged rats. Methods Twenty-four female Wistar rats were randomly divided into 3 groups: young group(3-5 months),aged groups(27 months) and GS group(27 months).GS group was fed with GS from 18 to 27 months.Immunohistochemistry and Imaging analysis were used to show the expression and distribution of BDNF in NBM and cerebral cortex of each group. Results BDNF level of aged group was much lower than that of young group in these two brain areas(P