ObjectiveTo explore the mechanisms associated with Mahoniae Caulis alkaloids （MA） in ameliorating depression by network pharmacology， molecular docking， and animal experiments. MethodsThe component targets of MA were obtained through Swiss Target Prediction and TCMIP database. The depression targets were collected through TCMIP， Genecards， HPO， DrugBank and OMIM database. The depression targets were collected through TCMIP， Genecards， HPO， DrugBank and OMIM database. Protein-protein interaction （PPI） network was constructed by protein interaction analysis （STRING） database. Gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses were performed through Bioinformatics （DAVID） database. The docking of components and targets was performed by AGFR. The mouse model of depression was established by intraperitoneal injection of corticosterone （CORT） once a day for 35 consecutive days. Sixty mice were randomly allocated into control （0.9% normal saline）， model （CORT， 20 mg·kg^-1）， positive control （fluoxetine hydrochloride， 3.6 mg·kg^-1）， and MA （10， 5， and 2.5 mg·kg^-1） groups. Each group was administrated with corresponding medicine or normal saline once a day for 28 consecutive days. The depression-like behavior of mice was observed. The pathological changes of prefrontal cortex in mice were observed by hematoxylin-eosin staining. Terminal deoxynucleotidyl dUTP transferase nick end labeling （TUNEL） was employed to observe the apoptosis of neurons in the prefrontal cortex. Enzyme-linked immunosorbent assay was employed to assess the serum levels of brain-derived neurotrophic factor （BDNF）， dopamine （DA）， 5-hydroxytryptamine （5-HT）， and norepinephrine （NE） in mice. The mRNA levels of cyclic adenosine monophosphate （cAMP） pathway-related factors and inflammatory factors were determined by Real-time PCR. Western blot was employed to determine the expression of cAMP pathway-related factors and connexin 43 （Cx43）. ResultsA total of 434 component targets and 545 depression targets were obtained， including 84 common targets， among which 10 core targets were screened out. GO analysis predicted 34 biological processes， 15 cell components， and 11 molecular functions. The KEGG pathways were mainly related to gap junction and cAMP signaling pathway. The core components had good binding affinity with the core targets. The results of animal experiments showed that compared with the control group， CORT prolonged the immobility time of mice in forced swimming and tail suspension tests （P<0.01）， lowered the serum levels of NE， BDNF， and 5-HT （P<0.05）， up-regulated the mRNA levels of nuclear factor-κB （NF-κB） and interleukin-6 （IL-6） in the brain tissue （P<0.05）， and down-regulated the mRNA levels of cyclic adenosine monophosphate effector binding protein （CREB） and BDNF （P<0.05） and the protein levels of protein kinase （PRKACA）， phosphorylation （p）-CREB/CREB， BDNF， and Cx43 （P<0.05） in the brain tissue. Compared with the model group， high-dose MA reduced the immobility time of mice in forced swimming （P<0.05） and tail suspension （P<0.01） tests， raised the serum levels of NE， BDNF， and 5-HT （P<0.01）， down-regulated the mRNA level of NF-κB （P<0.01）， and up-regulated the mRNA level of BDNF （P<0.01） and protein levels of PRKACA， p-CREB/CREB， BDNF， and Cx43 （P<0.05）. ConclusionMA alleviates the CORT-induced depressive behavior of mice. It may play an antidepressant role by regulating cAMP signaling pathway and gap junction pathway， improving synaptic plasticity and gap junction function， and reducing neuroinflammation.

ObjectiveTo explore the mechanisms associated with Mahoniae Caulis alkaloids （MA） in ameliorating depression by network pharmacology， molecular docking， and animal experiments. MethodsThe component targets of MA were obtained through Swiss Target Prediction and TCMIP database. The depression targets were collected through TCMIP， Genecards， HPO， DrugBank and OMIM database. The depression targets were collected through TCMIP， Genecards， HPO， DrugBank and OMIM database. Protein-protein interaction （PPI） network was constructed by protein interaction analysis （STRING） database. Gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses were performed through Bioinformatics （DAVID） database. The docking of components and targets was performed by AGFR. The mouse model of depression was established by intraperitoneal injection of corticosterone （CORT） once a day for 35 consecutive days. Sixty mice were randomly allocated into control （0.9% normal saline）， model （CORT， 20 mg·kg^-1）， positive control （fluoxetine hydrochloride， 3.6 mg·kg^-1）， and MA （10， 5， and 2.5 mg·kg^-1） groups. Each group was administrated with corresponding medicine or normal saline once a day for 28 consecutive days. The depression-like behavior of mice was observed. The pathological changes of prefrontal cortex in mice were observed by hematoxylin-eosin staining. Terminal deoxynucleotidyl dUTP transferase nick end labeling （TUNEL） was employed to observe the apoptosis of neurons in the prefrontal cortex. Enzyme-linked immunosorbent assay was employed to assess the serum levels of brain-derived neurotrophic factor （BDNF）， dopamine （DA）， 5-hydroxytryptamine （5-HT）， and norepinephrine （NE） in mice. The mRNA levels of cyclic adenosine monophosphate （cAMP） pathway-related factors and inflammatory factors were determined by Real-time PCR. Western blot was employed to determine the expression of cAMP pathway-related factors and connexin 43 （Cx43）. ResultsA total of 434 component targets and 545 depression targets were obtained， including 84 common targets， among which 10 core targets were screened out. GO analysis predicted 34 biological processes， 15 cell components， and 11 molecular functions. The KEGG pathways were mainly related to gap junction and cAMP signaling pathway. The core components had good binding affinity with the core targets. The results of animal experiments showed that compared with the control group， CORT prolonged the immobility time of mice in forced swimming and tail suspension tests （P<0.01）， lowered the serum levels of NE， BDNF， and 5-HT （P<0.05）， up-regulated the mRNA levels of nuclear factor-κB （NF-κB） and interleukin-6 （IL-6） in the brain tissue （P<0.05）， and down-regulated the mRNA levels of cyclic adenosine monophosphate effector binding protein （CREB） and BDNF （P<0.05） and the protein levels of protein kinase （PRKACA）， phosphorylation （p）-CREB/CREB， BDNF， and Cx43 （P<0.05） in the brain tissue. Compared with the model group， high-dose MA reduced the immobility time of mice in forced swimming （P<0.05） and tail suspension （P<0.01） tests， raised the serum levels of NE， BDNF， and 5-HT （P<0.01）， down-regulated the mRNA level of NF-κB （P<0.01）， and up-regulated the mRNA level of BDNF （P<0.01） and protein levels of PRKACA， p-CREB/CREB， BDNF， and Cx43 （P<0.05）. ConclusionMA alleviates the CORT-induced depressive behavior of mice. It may play an antidepressant role by regulating cAMP signaling pathway and gap junction pathway， improving synaptic plasticity and gap junction function， and reducing neuroinflammation.

As the major part of mesencephalic locomotion region, pedunculopontine tegmental nucleus (PPN) participates in motor initiation, rhythmic and speed regulation. In addition, PPN is regarded as a novel deep brain stimulation target for patients with Parkinson′s disease due to its dramatic effect on the gait disturbance and postural instability. However, PPN also has an important role in muscle tone control and dystonia. This review is aimed at summarizing the involvement of PPN in dystonia, providing fundamental for targeting PPN for treatment of dystonia in the future.

Objective:To explore the spatial and temporal distribution patterns of emerging snail-infested sites in different environmental types in Yunnan Province.Methods:The data of snail-infested sites in Yunnan Province from 1950 to 2014 (from Yunnan Institute for Endemic Diseases Control and Prevention), were collected and sorted out, a spatial and temporal database on the distribution of emerging snail-infested sites were established, and the changes in the spatial and temporal distribution of emerging snail-infested sites in different environments types (ditches, tangerines, paddy fields, dry land, beaches and other environments) were studied by using spatial autocorrelation analysis and scanning statistics analysis.Results:From 1950 to 2014, the annual number of emerging snail-infested sites in Yunnan Province reached a peak (1 730) in 1955 and then showed a fluctuating downward trend. From 1993 to 2014, the number of emerging snail-infested sites remained below 100, and increased to 160 and 131, respectively, in 2004 and 2013. The longest mean duration of 43.85 years was recorded for the beaches environment for emerging snail-infested sites, followed by the paddy fields environment with a mean duration of 37.01 years, and the shortest mean duration of 20.44 years for the tangerines environment. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the duration of emerging snail-infested sites of different environmental types (global Moran's I ranged from 0.43 to 0.64, P < 0.05). Scanning statistics analysis showed that emerging snail-infested sites of different environmental types had spatial and temporal aggregation ( P < 0.001), with 3- 6 clusters of statistically significant aggregation detected respectively. Conclusion:The emerging snail-infested sites in different environments types in Yunnan Province have spatial and temporal aggregation, and it is necessary to strengthen monitoring and prevention and control of the aggregation areas of different environment types to prevent further spread of the snail.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To study the effects of different duty cycles [modulated by pulse repetition frequency(PRF)] of diagnostic ultrasound on enhancing blood perfusion in hypovascular tumors.Methods:Walker-256 tumor cells were injected subcutaneously into the inner thigh of 15 SD rats, and the rats were randomly divided into 3 groups according to PRF: group A(PRF=50 Hz), group B(PRF=1.0 kHz) and group C(PRF=2.0 kHz), with 5 rats in each group. The tumor-bearing rats in each group were treated with ultrasound combined with microbubbles for 10 minutes. Contrast-enhanced ultrasound was performed before treatment, immediately after treatment, and 4 hours after treatment, respectively, to compare the peak intensity(PI), area under curve(AUC), and tumor perfusion area in each group.Results:Immediately after treatment, PI and AUC values of group A and B increased compared with those before treatment (all P<0.05); 4 hours after treatment, PI and AUC values of group B continued to increase, superior to that immediately after treatment (all P<0.05), while PI and AUC values of group A and C were decreased compared with those immediately after treatment (all P>0.05). Immediately after treatment, the tumor blood perfusion area in group A and B increased significantly compared with that before treatment (all P<0.05); 4 hours after treatment, the tumor blood flow perfusion area of group B continued to increase, which was better than that immediately after treatment ( P<0.05), and the tumor blood perfusion areas of group A and C decreased compared with that immediately after treatment (all P>0.05). Conclusions:Low-intensity diagnostic ultrasound stimulated microbubble cavitation with PRF=1.0 kHz can enhance tumor blood flow significantly which can last for more than 4 hours.

Objective To discuss the clinical value of IL-6 combined with CA125 and HE4 as a new association marker in the diagnosis of early ovarian cancer.Methods The expression of IL-6, CA125 and HE4 in 21 cases of early ovarian cancer (stageⅠ-Ⅱ), 36 cases of advanced ovarian cancer (stageⅢ-Ⅳ), 40 cases of benign ovarian tumor and 40 healthy women were measured by the Roche automatic chemiluminescence analyzer (electrochemiluminescence).The sensitⅣity, specificity, positive predictive value, negative predictive value and ROC curves were used to evaluate the diagnostic value.Results The serum levels of IL-6, CA125 and HE4 in patients with ovarian cancer were significantly higher than those in the benign ovarian tumor and the healthy control (P＜0.05).The sensitⅣity, specificity, positive predictive value and negative predictive value of IL-6 combined with CA125 and HE4 were respectively 85.7％, 90％, 81.8％, 92.3％in the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients and respectively 94.4％, 97.5％, 97.1％and 95.1％for advanced ovarian cancer (stageⅢ-Ⅳ) patients.For IL-6 combined with CA125 and HE4, the ROC AUC was respectively 0.955 4 and 0.974 0 for early ovarian cancer (stageⅠ-Ⅱ) patients and advanced ovarian cancer (stageⅢ-Ⅳ) patients.It performed significantly better than any single test of IL-6, CA125 and HE4 and the 2-marker combination of CA125+HE4.Conclusion The marker panel, IL-6, CA125 and HE4, shows higher sensitⅣity, positive predictive value and ROC AUC.It is an ideal serum marker combination for the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients, which can improve the diagnostic efficiency of early ovarian cancer.

Total parathyroidectomy (PTX) can be used to treat secondary hyperparathyroidism (SHPT)in uremic patients,relieving the patient's osteolytic destruction.Complete resection of bilateral parathyroid glands is key to successful operation.Recently,2 patients successfully received surgical treatment,in which carbon nanoparticles suspension injection were used.With the help of carbon nanoparticles suspension injection,all of the 4 hyperplastic parathyroid glands were found successfully.The parathyroid hormone(PTH) was significantly decreased after operations and the clinical symptoms were relieved simultaneously.We conclude that the use of carbon nanoparticles suspension injection is helpful for total parathyroidectomy operation in uremic patients with SHPT,which can protect the normal thyroid and recurrent laryngeal nerve.

Objective To establish computer assisted virtual ureteroscopy (VU) through data from computerized tomography urography (CTU) of patients with renal stones and make validation of effectiveness.Methods From June of 2015 to January of 2016,23 cases of renal stones cases was selected by 5 experts in 3 different centers.There were 21 unbilateral cases and 2 bilateral cases.The age ranged from 31 to 79(54.7 ± 12.5).Mean stone burden was (19.0 ± 6.2) mm.Stone number ranged from 1 to 5 (2.7 ± 1.2).VU generation was accomplished by specialized software (Crusher) with incorporating CTU data.After patientspecific VUs were presented to the experts,and the FURS surgeries were all finished successfully,face and content validations about VU using modified Likert questionnaire ordinal 10-point rating scales were made.20 trainee were selected to do the flexible ureteroscopy lithotripsy with assistance of VU.After observation of CTU and VU,the numbers of renal calyces and stones found by the experts and trainees were recorded.The statistical analysis were made before and after observation of VU between the experts and trainees.Result Face and content validation of VU:overall usefulness 7.6 ± 0.5,graphics 7.6 ± 0.5,intrarenal collecting system 8.4 ± 0.5,stone details 8.4 ± 0.5,usefulness in surgical planning and training 8.0 ± 0.7.Significant improvement was found when the trainees doing the surgery with the help of VU.Compared with using CTU only,VU could help the trainees had better understanding of intrarenal structure and stone information [the number of calyces (16.7 ±3.7)vs.(24.6 ± 1.8),P ＜0.001;the number of stones (4.9 ± 1.4)vs.(8.2 ± 1.3),P ＜0.001].Before observation of VU,trainees found much fewer calyces and stones compared with experts (P =0.004 and P ＜ 0.001 respectively).However,this gap disappeared after VU observation (P =0.327 and 0.292 respectively).Conclusions Establishing computer assisted VU through CTU data from renal stone patients is feasible and rapid.VU can significantly improve trainee's view of intrarenal collecting system and stone information before practicing FURS.