Depression is a kind of complex mental illness， which is mainly treated by western medicine at present， but the effect of western antidepressant drugs is not good due to the combined influence of side effects and individual differences of patients. Depression is a "stagnation syndrome" in traditional Chinese medicine， and its treatment principle is to disperse stagnated liver Qi for relieving Qi stagnation. The classic traditional Chinese medicine formula Chaihu Shugansan （CHSGS） has a long history of treating depression and demonstrates significant therapeutic efficacy. Clinically， the addition and subtraction of CHSGS is flexible， but the properties of the active ingredients are vague， and the mechanism and function are unclear. In order to elucidate the pharmacodynamic basis and antidepressant mechanism of CHSGS， this article reviews the pharmacodynamic material basis of CHSGS， clinical research and antidepressant mechanism research progress. Clinically， CHSGS can treat various types of depression such as primary depression， post-stroke depression， and postpartum depression. This article summarizes 32 main ingredients of CHSGS， among which albiflorin， ferulic acid， naringin， hesperidin， saikosaponin a， glycyrrhetinic acid， tangeretin， meranzin hydrate， nobiletin and glycyrrhizic acid are the quality markers （Q-markers） for the antidepressant effect of CHSGS. The antidepressant mechanism of CHSGS is complex， including regulating monoamine neurotransmitters， hypothalamic-pituitary-adrenal （HPA） axis， neurotrophic factors， inflammatory response， cell damage-related pathways， oxidative stress， etc. This article helps to deeply understand the pharmacodynamic basis and mechanism of CHSGS in treating depression， and provides a theoretical basis for the clinical application of CHSGS in treating depression and the development of antidepressant drugs.

Objective:To evaluate the role of volume management guided by extravascular lung water index(EVLWI) in improving the clinical outcomes and cardiac function for patients with cardiogenic shock.Methods:This study was a single-center, prospective cohort study. Patients with cardiogenic shock admitted to the Department of Cardiovascular Medicine, Shanghai East Hospital from July 2022 to December 2023 were enrolled. Patients were matched 1∶1 by propensity score and divided into EVLWI group and control group. In the control group, the volume management strategy was determined by the attending physician based mainly on conventional factors, including clinical features, biochemical assessments, and certain blood pressure measurements. In EVLWI group, the volume management plan was formulated by integrating conventional factors with EVLWI derived from pulse index continuous cardiac output (PiCCO) monitoring. Baseline clinical data, in-hospital treatment, and hemodynamic data were collected. Major adverse cardiovascular events and cardiac function related parameters were compared at 30 d after treatment between the two groups. Baseline EVLWI levels were compared between the non-survivors and the survivors in the EVLWI group. The receiver operating characteristic curve was plotted to assess the accuracy of baseline EVLWI and central venous pressure in predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, and subgroup analysis was performed according to ischemic/non-ischemic etiology and with/without use of inotropic drugs. Kaplan-Meier curve was used for survival analysis, with log-rank tests comparing all-cause mortality, cardiac death, and readmission rate for heart failure at 30 d after treatment.Results:A total of 200 patients with cardiogenic shock were enrolled, aged (71.35±12.82) years, 144(72%) males, EVLWI group and control group 100 patients each. Compared with the control group, EVLWI group had lower all-cause mortality (16%(16/100) vs. 42%(42/100), log-rank P<0.01), cardiac death (14%(14/100) vs. 34%(34/100), log-rank P<0.01), and readmission rate for heart failure (4%(4/100) vs. 12%(12/100), log-rank P=0.03) at 30 d after treatment. Subgroup analysis showed that EVLWI-guided volume management was associated with lower all-cause mortality at 30 d after treatment in patients with cardiogenic shock of ischemic or non-ischemic etiology and with or without inotropic drugs (all P<0.05). In EVLWI group, baseline EVLWI levels were higher in non-survivors than those in survivors [(15.99±6.47) ml/kg vs.(9.75±2.55) ml/kg, P<0.01]. The baseline EVLWI could predicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock, with an area under the receiver operating characteristic curve of 0.84 (95% CI: 0.75-0.94, P<0.01), while the baseline central venous pressure had no predicting value ( AUC=0.54, 95% CI: 0.40-0.69, P=0.60). The optimal cutoff value of EVLWI in pridicting all-cause mortality at 30 d after treatment in patients with cardiogenic shock was >10.3 ml/kg. With the optimization of hemodynamic parameters, left ventricular ejection fraction was improved in EVLWI group, and serum levels of N-terminal pro-brain natriuretic peptide, creatinine, alanine aminotransferase and lactic acid were decreased (all P<0.05). Conclusion:EVLWI-guided volume management exerts a beneficial effect on therapeutic decision-making and improves clinical outcomes and cardiac function in patients with cardiogenic shock.

Objective:To analyze TCM tongue diagnosis related research on coronary heart disease (CHD) at home and abroad using the method of bibliometrics; To provide reference for further research on clinical diagnosis and treatment of CHD.Methods:Research literature about TCM tongue diagnosis for CHD was retrieved from CNKI, VIP, CBM, Wanfang Data, PubMed, Embase, Cochrane Library and Web of Science from the establishment of the databases to December 31st, 2022. The key features of literature related to tongue diagnosis from CHD, including publication volume, region, institution, authors, and research hotspots, were analyzed using BICOMBS2.0, CiteSpace 6.1.R6, and Excel 2019 software.Results:Totally 364 Chinese articles and 5 English articles were included. Liaoning University of Traditional Chinese Medicine was the institution that published the most relevant research in Chinese, and Shanghai University of Traditional Chinese Medicine was the institution that published the most relevant research in English. Professor Wang Yiqin of Shanghai University of Traditional Chinese Medicine was the author with the largest number of publications in both Chinese and English, and the authors with the largest number of publications on Chinese research worked closely cooperate with each other. Chinese research focused on syndrome characteristics of CHD, objectification of tongue diagnosis and data mining based on the clinical experience of renowned TCM practitioners; the English research topic included modern data collection and analysis and expert consensus.Conclusions:The research team of tongue diagnosis for CHD in China has begun to take shape. There are few English articles on tongue diagnosis for CHD, and the development level is relatively lagging behind. In the future, different institutions and researchers need to strengthen international cooperation to enhance the international influence of TCM diagnostics.

Objective To establish an allogeneic rat model of endometriosis and to evaluate the effects of gonadotropin-releasing hormone (GnRH) agonist GenSci006 on experimental rat endometriosis. Methods Endometrium from SPF grade donor female SD rats were transplanted onto the abdominal wall of recipient female rats to construct an allogeneic endometriosis model. The rats undergoing sham surgery were divided into the sham group. Three weeks later, the length, width and height of the ectopic endometrium were measured, and the volume of the endometrium (V₁) was calculated before drug administration. The modeling rats were randomly divided into four groups: model group, triptorelin group (0.25 mg/kg), GenSci006-1 group (0.125 mg/kg) and GenSci006-2 group (0.25 mg/kg). Each group had 16 rats and received a single dose of the corresponding drug. The sham group and model group were administered an equal volume of solvent. Three weeks after administration, ectopic endometrium was measured to calculate the volume V₂ and inhibition rate. The effect of GenSci006 on rat uterus and ovarian tissues was assessed by comparing organ coefficients and changes in pathological sections. Enzyme-linked immunosorbent assay (ELISA) was used to measure the levels of serum estradiol (E₂), progesterone (P₄), follicle stimulating hormone (FSH), and luteinizing hormone (LH). Real-time fluorescent quantitative PCR was used to detect the expression of GnRH receptor (GnRHR) mRNA in the hypothalamus and pituitary. Western blot was used to detect the expression of estradiol receptor alpha (ERα), beta (ERβ) and progesterone receptor (PR) in ectopic endometrium. Results Three weeks after administration, compared with the model group, the body weight of rats in the triptorelin and GenSci006-2 groups significantly increased (P < 0.05), while the volume of ectopic endometrium significantly decreased (P < 0.05). Compared with the sham group, the model group showed no significant changes in uterine and ovarian organ coefficients or endometrial thickness (P > 0.05). Compared with the model group, the uterine organ coefficients and endometrial thickness were significantly reduced in the triptorelin and GenSci006-2 groups (P < 0.05). Compared with the sham group, the serum levels of E₂, P₄, FSH and LH in the model group showed no significant changes (P > 0.05). Compared with the model group, the ovarian organ coefficient and serum P₄ levels of rats in the Triptorelin, GenSci006-1, and GenSci006-2 groups were significantly reduced (P < 0.05), while the serum LH levels of rats in the GenSci006-1 group were significantly increased (P < 0.05). However, there were no significant changes in serum E₂ and FSH levels in each group (P > 0.05). Compared with the model group, the expression levels of GnRHR mRNA in the pituitary tissue of rats in the triptorelin and GenSci006-2 groups were significantly downregulated (P < 0.05), with no significantly changes in the hypothalamus (P > 0.05). There were no significant changes in the expression level of GnRHR mRNA in the hypothalamus or the protein levels of ERα, ERβ and PR in the ectopic endometrial tissue in any group (P > 0.05). Conclusion The allogeneic endometriosis rat model is a suitable animal model for screening and evaluating drugs for treating endometriosis. The volume of ectopic endometrium, inhibition rate, uterine and ovarian organ coefficients, and serum E₂ levels may serve as indicators for detecting drug efficacy.

Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17 604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

Objective To explore the optimal method for preparing fresh and fixed skeletal muscle tissues,and to lay an experimental foundation for the rapid diagnosis of and research into the pathogenesis of skeletal muscle diseases.Methods The tibialis anterior muscle was extracted from C57BL/6J mice.Fresh tissue was treated by direct rapid freezing in liquid nitrogen,embedding combined with liquid nitrogen freezing,and foreign body alkane treatment combined with liquid nitrogen freezing.Fixed tissues were pre-treated by direct embedding with embedding agent combined with rapid liquid nitrogen freezing.The frozen sections were stained with hematoxylin and eosin.The cross-sectional areas of ice crystals and muscle fibers were calculated to evaluate the effects of the different pre-treatment method.Results The morphology of the muscle fiber bundles was disrupted and numerous ice crystal vacuoles were observed in fresh tissues after direct liquid nitrogen freezing and foreign body alkane treatment combined with liquid nitrogen freezing.In contrast,the muscle fiber bundles were intact and dense and there were no ice crystals in tissues treated with embedding agent combined with rapid liquid nitrogen freezing,indicating that this pre-treatment method was suitable for preparing fresh skeletal muscle tissue.Fixed tissue treated with embedding agent and liquid nitrogen freezing also showed complete muscle fiber bundles and no ice crystals.Conclusions Treatment of fresh and fixed skeletal muscle tissues with embedding agent combined with rapid liquid nitrogen freezing preserves muscle fiber bundles,with no ice crystals.Tissues prepared by this method are thus suitable for further examinations,such as immunohistochemistry and immunofluorescence.This method will therefore aid the accurate and rapid diagnosis of and research into the pathogenesis of skeletal muscle diseases.

Objective To clarify the distribution of traditional Chinese medicine(TCM)pattern and its associated risk factors after percutaneous coronary intervention(PCI),and evaluate the re-porting quality of existing studies to guide future research standardization. Methods English databases including PubMed,Cochrane Library,and Web of Science,as well as Chinese databases including China National Knowledge Infrastructure(CNKI),China Scientific Journal Database(VIP),and Wanfang Database were searched to retrieve papers about PCI.The time span for the paper retrieval was set from the foundation of the databases to October 1,2023.Statistical analyses were performed using Stata 12 and Python(V 3.9).The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement was used to assess the reporting quality of included studies. Results Overall,1 356 articles were selected,and 40 cross-sectional studies were included with 10 270 participants.The most common TCM patterns before,one to two weeks after,and six months to one year after PCI was Qi stagnation and blood stasis(n=261,36.45%),inter-twined phlegm and blood stasis(n=109,27.18%),and Qi deficiency and blood stasis(n=645,37.03%),respectively.Smoking[odds ratio(OR)=1.15,95%confidence interval(CI)(0.83-1.47),I2=24.7%,P=0.257],pattern of congealing cold and Qi stagnation[OR=4.62,95%CI(1.37-7.86),I2=61.6%,P=0.074],and low-density lipoprotein(LDL)[OR=1.38,95%CI(0.92-1.85),I2=12.2%,P=0.286]were risk factors for restenosis.Hypertension[OR=7.26,95%CI(3.54-14.88),I2=91.6%,P=0.001],and overweight[i.e.,body mass index(BMI)>23][OR=1.20,95%CI(1.07-1.35),I2=85.3%,P=0.009]were significant risk factors of concomi-tant anxiety. Conclusion This systematic review and meta-analysis revealed that patients with different TCM pattern types have distinct characteristics and risk factors after PCI.More high-quality studies are warranted to provide supportive evidence for future research and clinical practice.

Objective: To assess the associations between the single nucleotide polymorphism (SNP) rs 12225230 of salt inducible kinase 3 ( SIK 3) and obesity/central obesity in children, and to provide evidence for screening intervention for obesity in children and adolescents. Methods: A cluster sampling of 2 030 children aged 7-18 years in Beijing were enrolled and height, weight and waist circumference were measured according to the manufacturer. The genotype frequency of SNP rs 12225230 was detected by matrix assisted laser analysis/ionization time of flight mass spectrometry (MALDI TOF MS). Logistic regression and multiple linear regression were applied to analyze the associations between SNP rs 12225230 and overweight/obesity and central obesity. Polyphen2 database was used to predict the effect of SNP rs 12225230 on the protein function of SIK 3. GTEx database was used to explore expression quantitative trait loci (eQTL) of SNP rs 12225230. Results: C allele of SNP rs 12225230 was a risk allele for obesity and severe obesity in children ( OR obesity =1.50, 95% CI=1.10-2.04, P =0.01; OR severe obesity =1.72, 95% CI=1.23-2.39, P <0.01). The SNP rs 12225230 was positively associated with waist circumference and waist height ratio ( β waist circumference =1.40, 95% CI=0.28- 2.52 , P =0.01; β waist height ratio =0.01, 95% CI=0.00-0.02, P =0.01). C allele of SNP rs 12225230 may be harmful to the function of the protein encoded by the SIK 3, and was positively related to the expression of the APOA 1 in the heart tissue. Conclusion SNP rs 12225230 is associated with obesity and central obesity in children, and SNP rs 12225230 may affect the expression of the APOA 1 in children, but its association with lipid metabolism needs to be verified

Objective:To investigate the effects of histone deacetylase 6 (histone deacetylase 6, HDAC6) on oopherectomy (OOX) induced osteoporosis (OP) bone loss by binding to the promoter region of heat-shock protein 70 (HSC70) and regulating it’s acetylation.Methods:OP mouse model was established by using OOX methods. Then the mice were divided into sham operation group, OOX group, OOX+shHDAC6 group, OOX+shNC group and OOX+shHDAC6+shHSC70 group. The micro-CT system and Western blot experiment were used to detect the bone microscopic parameters of the mouse right femur and the protein expression levels of osteoblast-specific transcription factors. In vitro experiments, Westwen blot, alkaline phosphatase (ALP) staining and Alizarin Red S (ARS) staining were used to determine the effects of HDAC6 and HSC70 on the osteogenic differentiation of MC3T3-E1 cells. QRT-PCR was used to detect the expression levels of HDAC6 and HSC70 in tissue or cells. The relationship between HDAC6 and HSC70 was analyzed by ChIP experiment.Results:Compared with sham group, the expression of bone mineral density (BMD) , trabecular bone number (Tb. N) , trabecular thickness (Tb.th) and bone volume fraction (BV/TV) in the right femur of OOX group mice were decreased, the expression of TB. Sp was increased, protein expression of OSX and RUNX2 was increased. At the same time, compared with sham group (1±0.11) , the expression of HDAC6 was increased in OOX group (2.33±0.19) ( t=10.56, P<0.001) . Compared with pcDNA3.1-NC group, the protein level of Osterix (OSX) and runt-related transcription factor 2 (RUNX2) , ALP activity and mineralized area in pcDNA3.1-HDAC6 group were decreased (all P<0.05) . ChIP analysis showed that compared with the pcDNA3.1-NC group (5.26±0.47) , the acetylation level of the HSC70 promoter region in the pcDNA3.1-HDAC6 group (2.37±0.21) was significantly reduced ( t=9.72, P<0.001) . Compared with pcDNA3.1-HDAC6 group, the expression of OSX and RUNX2, ALP activity and mineralization were increased in pcDNA3.1-HDAC6+ pcDNA3.1-HSC70 group (all P<0.05) . Compared with OOX+shHDAC6 group, the expression of OSX and RUNX2 protein, BMD, Tb.N, Tb.th and BV/TV were decreased but the expression of Tb. Sp was increased in OOX+ shHDAC6+ shHSC70 group. Conclusions:HDAC6 regulates the acetylation level of HSC70 and then affects OOX-induced OP bone loss. Inhibition of HDAC6 can significantly improve OP bone loss.

Objective:To investigate the potential mechanism and effects of LncRNA BBOX1-AS1 in radiosensitivity of ovarian cancer.Methods:qRT-PCR was used to explore BBOX1-AS1, miR-185-5p expression in OC tissue and cells. Dual luciferase reporter assay was used to confirm the interaction of BBOX1-AS1, miR-185-5p and RHOA. MTT assay and flow cytometry were used to detect the proliferation and apoptosis of OC cells.Results:BBOX1-AS1 was up-regulated in OC tissue and cells, compared with the cell proliferative activity at 2, 3, 4 day (0.89±0.07) (1.48±0.13) (1.69±0.15) in si-NC group, proliferative activity in si-BBOX1-AS1 group (0.59±0.06) (0.97±0.09) (1.21±0.10) was obviously down-regulated (all P<0.05) . Compared with si-NC group (6.24±0.28) , silencing of BBOX1-AS1 induced apoptosis (12.07±1.33) (all P<0.05) . miR-185-5p was down-regulated in OC tissue and cells, the targeting relationship between BBOX1-AS1 and miR-185-5p, RHOA and miR-185-5p was confirmed. Inhibition of miR-185-5p reversed the effects of BBOX1-AS1 on OC cells (all P<0.05) . Conclusion:LncRNA BBOX1-AS1 inhibits radiotherapy sensitivity of OC cells via regulating miR-185-5p/RHOA axis.