ObjectiveTo decipher the mechanism by which Zuoguiwan （ZGW） treat hyperthyroidism in rats with kidney-Yin deficiency based on the dopamine receptor D4 （DRD4）/nicotinamide adenine dinucleotide phosphate （NADPH） oxidase 4 （NOX4） signaling pathway. MethodsThe rat model of kidney-Yin deficiency was induced by unilateral intramuscular injection of dexamethasone （0.35 mg·kg^-1）. After successful modeling， the rats were randomized into model， methimazole （positive control， 5 mg·kg^-1）， low-， medium-， and high-dose （1.85， 3.70， 7.40 g·kg^-1， respectively） ZGW， and normal control groups. After 21 days of continuous gavage， the behavioral indexes and body weight changes of rats were evaluated. The pathological changes of the renal tissue were observed by hematoxylin-eosin staining. The serum levels of thyroid hormones ［triiodothyronine （T₃）， thyroxine （T₄）， thyroid-stimulating hormone （TSH）］， renal function indexes ［serum creatine （Scr） and blood urea nitrogen （BUN）］， energy metabolism markers ［cyclic adenosine monophosphate （cAMP） and cyclic guanosine monophosphate （cGMP）］， and oxidative stress-related factors ［superoxide dismutase （SOD）， malondialdehyde （MDA）， and NADPH）］ were measured by enzyme-linked immunosorbent assay （ELISA）. Western blot was employed to analyze the expression of DRD4， NOX4， mitochondrial respiratory chain complex proteins ［NADH：ubiquinone oxidoreductase subunit S4 （NDUFS4） and cytochrome C oxidase subunit 4 （COX4）］， and inflammation-related protein ［tumor necrosis factor-alpha （TNF-α）， interleukin-6 （IL-6）， p38 mitogen-activated protein kinase （MAPK）］ pathway in the renal tissue. ResultsCompared with the normal group， the model group showed mental malaise， body weight decreases （P<0.01）， inflammatory cell infiltration in the renal tissue， a few residual parotid glands in the thyroid， elevations in serum levels of T₃， T₄， Scr， BUN， cAMP， cAMP/cGMP， MDA， and NADPH （P<0.01）， down-regulation in protein levels of TSH， SOD， and DRD4 （P<0.05， P<0.01）， and up-regulation in expression of NOX4， p-p38 MAPK/p38 MAPK， and inflammatory factors （P<0.01）. Compared with the model group， ZGW increased the body weight （P<0.05， P<0.01）， reduced the infiltration of renal interstitial inflammatory cells， restored the thyroid structure and follicle size， lowered the serum levels of T₃， T₄， Scr， BUN， cAMP， cAMP/cGMP， MDA and NADPH （P<0.05， P<0.01）， up-regulated the expression of TSH， SOD and DRD4 （P<0.05， P<0.01）， and down-regulated the expression of NOX4， p-p38 MAPK/p38 MAPK， and inflammatory factors （P<0.05， P<0.01）. Moreover， high-dose ZGW outperformed methimazole （P<0.05）. ConclusionBy activating DRD4， ZGW can inhibit the expression of NOX4 mediated by the p38 MAPK pathway， reduce oxidative stress and inflammatory response， thereby ameliorating the pathological state of hyperthyroidism due to kidney-Yin deficiency. This study provides new molecular mechanism support for the clinical application of ZGW.

BackgroundSchizophrenia is a complex， chronic and severe mental disorder， and the pathogenesis of which has not been fully elucidated. The abnormalities in lipid metabolism and circulating metabolomes have already been implicated in the pathophysiology of schizophrenia. However， available studies have mainly focused on a few liposomes and circulating metabolites， failing to systematically reveal the mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia. ObjectiveTo uncover mediating role of circulating metabolomes in the causal relationship between liposomes and schizophrenia， thereby providing biomarkers and potential therapeutic targets for the prevention and treatment of schizophrenia. MethodsData from Genome-Wide Association Studies （GWAS） were analyzed， taking data on 179 liposomes as exposure variables， data on 123 circulating metabolites as intermediate variables， and data on schizophrenia as outcome variable. A two-step， two-sample Mendelian randomization analysis was conducted using the inverse-variance weighted （IVW）， MR- Egger， Weighted median， and Weighted mode methods to study the causal relationship of liposomes with schizophrenia and the mediating role of circulating metabolomes in the relationship. ResultsIVW model identified 8 lipids associated with schizophrenia without reverse causality. There were 5 circulating metabolomes strongly associated with schizophrenia. Acetate played a significant mediating role in the causal relationship between phosphatidylinositol （18：0_18：2） and schizophrenia （P=0.023， 95% CI： 0.036~0.532）， accounting for 28.4% of the causal relationship. ConclusionThis study demonstrates a causal relationship between liposomes and schizophrenia， with phosphatidylinositol being a risk factor in the progression of schizophrenia， and acetate playing a mediating role in this process. ［Fund by National Natural Science Foundation of China General Program （number， 82271546）； Shanxi Merit Funding for Overseas Students Sci-Tech Activities Project （number， 20240041）； Shanxi Province Science and Technology Innovation Leading Talent Team Project （number， 202304051001049）； Shanxi Scientific Research Foundation for the Returned Overseas Chinese Scholars （number， 2022-190）； "Six Measures for Health Care Prosperity" Specialized Research Program （number， Y2024008）］

Objective: To analyze the mediating effects of self-efficacy and self-management behaviors on the relationship between depression symptoms and glycemic control among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide references for optimizing health management of elderly T2DM patients. Methods: T2DM patients aged ≥60 years from 8 community health service centers in Nanjing City were selected using a convenience sampling method. Basic information such as gender and age was collected through questionnaires. Depressive symptoms, self-efficacy, and self-management behaviors were assessed using the Patient Health Questionnaire, the Diabetes Self-Efficacy Scale, and the Diabetes Self-Management Behavior Scale, respectively. Glycated hemoglobin (HbA1c) was measured to evaluate glycemic control. A mediating effect model was constructed to analyze the mediating effects of self-efficacy and self-management behaviors on the relationship between depressive symptoms and glycemic control. Results: A total of 567 elderly T2DM patients were included, with a median age of 70.00 (interquartile range, 7.50) years. There were 248 males (43.74%) and 319 females (56.26%). The median scores of self-efficacy, self-management behaviors, depressive symptoms, and HbA1c were 3.89 (interquartile range, 0.78), 4.45 (interquartile range, 1.55), 4.00 (interquartile range, 6.00), and 6.80% (interquartile range, 1.40%), respectively. The mediating effect analysis showed that depressive symptoms indirectly affected glycemic control among elderly T2DM patients through the independent mediating effects of self-efficacy (β=0.028, 95%CI: 0.016-0.043) and self-management behaviors (β=0.009, 95%CI: 0.003-0.016), as well as the chain mediating effect of both (β=0.025, 95%CI: 0.017-0.035). The mediating effects of self-efficacy and self-management behaviors accounted for 36.66% and 11.35% of the total effect, respectively, while the chain mediating effect accounted for 32.15% of the total effect. Conclusion Self-efficacy and self-management behaviors play mediating roles in the relationship between depressive symptoms and glycemic control among elderly T2DM patients.

Long non-coding RNA(lncRNA)is a class of endogenous non-coding RNA with a length of more than 200 nt.Due to lack of open reading frame(ORF),they lack the ability to directly encode proteins,but they play a crucial role in gene regulation.They are widely involved in epigenetics,transcription,translation,modification and degradation,thereby affecting the life activities of the body,and their expression imbalance is closely related to the occurrence and development of diseases.Therefore,analyzing the inherent characteristics of lncRNA and revealing its intrinsic role can not only deepen our understanding of human physiological and pathological processes,but also provide new ideas and potential solutions for the diagnosis,prevention and treatment of diseases.So as to provide references for the related research of lncRNAs.

Objective To investigate the effect of 5-Aza-CdR on Notch1 pathway and neural regeneration and to explore the effects of 5-Aza-CdR on learning memory ability in mice by exploring active avoidance behavior.Methods Sixty 6～8-week-old SPF-grade ICR male mice were divided into two groups.5-Aza-CdR was administered to one group of mice via lateral ventricular injection,while the control group was injected with bovine serum albumin.Notch1 and HES1 mRNA and protein expression levels were detected by Real-time PCR and Western blot 24 hours after injection;5-bromo-2'-deoxyuridine-positive cells were observed by laser confocal microscopy,and Notch1 expression in hippocampal dentate gyrus was viewed with laser confocal microscopy.Notch1 methylation changes were detected by ethylation-specific PCR,and learning and memory behaviors of mice were assessed by passive avoidance tests and shuttle avoidance assays.Results Injection of 5-Aza-CdR increased hippocampal Notch1 pathway activity,promoted neuronal regeneration in the DG region,decreased methylation levels in the Notch1 promoter region,and enhanced the ability of mice to perform active avoidance behavior.Conclusions The effect of 5-Aza-CdR on active avoidance behavior may be related to the influence of hippocampal neural regeneration through the Notch 1 pathway.

Objective Explore changes in polysaccharides in Jiangxiangru before and after ginger juice preparation,and evaluate polysaccharide anti-inflammatory and antioxidant activities before and after processing.Methods The contents of Jiangxiangru polysaccharide(JXRPs)and Ginger juice processed of Jiangxiangru polysaccharide(JZJXRPs)before and after processing were determined by phenol-sulfuric acid method.We used the swelling model in rats and endotoxin(LPS)to establish the RAW264.7 mouse macrophage inflammation model.The optimal administration concentration was determined using a cell proliferation(MTT)assay.Enzyme-linked immunosorbent assay(ELISA)were used to measure Interleukin-6(IL-6),Interleukin-12(IL-12),Nitric oxide(NO),Interleukin-4(IL-4),and Interleukin-10(IL-10).Bleeding time of mice by tail cutting was observed to evaluate the hemostatic effect.The ability to remove 1,1-diphenyl-2-picryl-hydrazyl radical(DPPH)and 2,2'-Azinobis-(3-ethylbenzthiazoline-6-sulphonate)(ABTS)was used to evaluate in vitro antioxidant activity.Results The contents of JXRPs and JZJXRPs were 13％and 22％,respectively.In swollen rats at 4 h after injection,compared with the model group,200 mg/kg JXRPs and 100 mg/kg JZJXRPs significantly reduced rat swelling(P＜0.05).In vitro anti-inflammation assessment showed that the polysaccharides before and after processing significantly inhibited secretion of IL-6,IL-12,and NO(P＜0.01)and promoted secretion of IL-4 and IL-10(P＜0.01),and also that processing post-effects were stronger.The hemostatic experiment show that,compared with the control group,JXRPs increased hemostasis,but without a significant difference,and no significant difference was found using JZJXRPs,although high doses showed a trend to increase hemostasis.In vitro antioxidant activity showed that JXRPs and JZJXRPs had different scavenging abilities for DPPH and ABTS with IC50 values of JXRPs of 0.2215 and 0.2110 mg/ml,respectively,and IC50 values of JZJXRPs of 0.1651 and 0.1884 mg/mL,respectively.Conclusions After Jiangxiangru is produced in ginger juice,it promotes dissolution of polysaccharides and increases polysaccharide content.Anti-inflammatory,hemostasis,and antioxidant capacities are stronger in JZJXRPS than JXRPS,which lays the foundation for follow-up research and clinical applications of JXRPS.

Objective To explore and analyze the feasibility of using indocyanine green(ICG)near-infrared fluores-cence(NIF)imaging technology for the early diagnosis of oral potential malignant disorders and oral squamous cell car-cinoma.Methods 7,12-Dimethylbenz[a]anthracene in acetone solution was used to induce various pathological models of buccal mucosal lesions(mild/moderate dysplasia,severe dysplasia,squamous cell carcinoma)in golden hamster.ICG-NIF was conducted for the quantitative analysis of the fluorescence signal of lesion tissue,and evaluation of the diagnos-tic and discriminative capabilities of the ICG-NIF technology for mucosal lesions in various pathological states.Immuno-histochemical staining was perform to examine the mi-crovessel density(MVD)and microlymphatic vessel den-sity(MLVD)of mucosa in various pathological states and explore the histological reasons underlying the differ-ences in fluorescence signals.Results The results of ICG-NIF fluorescence quantitative analysis reveal the higher fluorescence intensity of mucosal lesions in the experimental group compared with that of the normal mucosa on the control side,with statistical differences(P＜0.05).Moreover,the more severe the malignancy of mucosal lesions in the experimental group,the higher the fluorescence intensity.According to histopathological analysis,the malignant pro-gression of mucosal lesions in golden hamsters was accompanied with an increase in MVD(P＜0.05)and a decrease in MLVD(P＜0.05).Conclusion The abnormal proliferation of mucosal lesions in golden hamsters exhibits a difference in ICG-NIF fluorescence signal compared with normal mucosal tissue.Fluorescence quantitative analysis methods can provide assistance in differentiation and show potential for clinical applications.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objective To observe the effect of coronary reperfusion therapy on the differential ex-pression of plasma exosomal miRNAs in patients with acute myocardial infarction(AMI).Meth-ods Three elderly male AMI patients undergoing coronary reperfusion therapy in our hospital from October to November 2022 were recruited in this study.The venous blood samples were col-lected at admission and 2 and 24 h after recanalization.MiRNA-sequencing was used to screen the differentially expressed miRNAs which were commonly expressed in the plasma exosomes of the 3 patients.Bioinformatics analysis was performed on the target genes,and then the differentially expressed miR-499a-5p was verified by qPCR.Results Compared with the plasma exosomal miRNAs at admission,there were 418 up-regulated and 406 down-regulated miRNAs at 2 h after operation,and 320 up-regulated and 225 down-regulated miRNAs at 24 h after operation(P＜0.05);Compared with the miRNAs at 2 h after operation,there were 344 up-regulated and 350 down-regulated ones at 24 h after operation(P＜0.05).Kyoto Encyclopedia of Genes and Ge-nomes enrichment analysis showed that the differentially expressed miRNAs were enriched in phosphatidylinositol-3-kinase-protein kinase B,hypoxia-inducible factor 1,and vascular smooth muscle contraction pathways.Gene Ontology analysis indicated that the molecular functions of dif-ferentially expressed miRNA target genes were mainly enriched in protein binding and DNA bind-ing;cellular components were mainly enriched in cell membrane and cytoplasm;and biological processes were mainly enriched in signaling and transcription of DNA templates.The miR-499a-5p level was significantly lower at 2 h postoperatively than at admission[(0.577±0.020)vs(1.000± 0.023),P＜0.05],and at 24 h postoperatively than at 2 h postoperatively[(0.068±0.006)vs(0.577±0.020),P＜0.05].Conclusion Plasma exosomal miRNAs can be used as a biomarker for early diagnosis of elderly AMI patients and for predicting the efficacy of reperfusion therapy.

Objective:To compare the clinical characteristics and magnetic resonance imaging(MRI)features of isolated infarction of the splenium of the corpus callosum and reversible splenial lesion syndrome(RESLES).Methods:Clinical and imaging findings of 12 patients with a clinical diagnosis of isolated infarction of splenium of the corpus callosum and 13 patients with RESLES from Deportment of Neurology in Beijing Geriatric Hospital between December 2018 and November 2022 and follow-up results were retrospectively analyzed.Results:The patients with isolated infarction of SCC were older than the patients with RESLES(age of patients with isolated infarction of SCC: 67.6±9.2, age of patients with RESLES: 23.2±17.8).All patients with infarction had one to three risk factors for cerebrovascular diseases.Both two groups showed hyperintense lesions on T2WI, fluid-attenuated inversion recovery(FLAIR)and diffusion-weighted imaging(DWI), and hyperintense lesions on T1WI and a low apparent diffusion coefficient(ADC).Most SCC infarctions occurred unilaterally(one case with bilateral lesions and 12 cases with unilateral lesions), with irregular dot-like or patchy lesions.Nine patients in the infarction group completed the follow-up, during which the lesions did not disappear on the T1WI, T2WI, FLAIR and ADC sequence.One patient in this group had a recurrent stroke.In the RESLES group, all lesions were located on the midline of SCC, with round, oval or boomerang-shaped lesions.All patients in the RESLES group completed the follow-up, during which lesions either shrank or disappeared.Conclusions:Infarction and RESLES can both result in SCC lesions.The existence of risk factors and imaging features about the locations of lesions, the morphology, and lesion changes during follow-up are helpful in the differential diagnosis.