Objective: To evaluate the safety and efficacy of preoperative autologous blood donation (PABD) under anesthesia monitoring in elective surgical procedures, and to provide scientific data for promoting its clinical application. Methods: 1) A total of 1 164 patients scheduled for elective surgery and met the criteria for stored autologous blood transfusion in our hospital from March 2022 to September 2023 were enrolled. Prior to surgery, stored autotransfusion was performed under anesthesia monitoring. During the operation, blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO ) and other basic life indicators before and after blood collection were recorded and analyzed. Adverse reactions during blood collection were documented, and potential influencing factors were analyzed. 2) The autologous transfusion group (experimental group, patients receiving intraoperative autologous blood reinfusion) was compared with the allogeneic transfusion group (control group, patients without PABD during the same period) using propensity score matching. The length of hospital stay, transfusion-related costs, perioperative hemoglobin (Hb), hematocrit (Hct), platelet count (Plt) and coagulation function were compared between the two groups after matching. Results: 1) Three patients (0.26%) had adverse reactions during blood collection. Autologous blood transfusion was performed in 443 patients (38.1%) during or after operation, with no adverse reaction during blood transfusion. 2) The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients after blood collection were lower than before blood collection, and the SpO was higher than before blood collection, with statistically significant differences (P<0.05); There was no significant difference in heart rate before and after blood collection (P>0.05); Our analysis found that age, gender, blood collection volume, department, or mild-to-moderate circulatory system complications didn’t significantly affect BP, HR and SpO fluctuations (P>0.05). 3) The experimental group had shorter hospital stays and lower transfusion costs than the control group (P<0.05). 4) No significant differences were observed in Hb, Hct, Plt levels or coagulation function (PT, APTT) between the two groups after operation (P>0.05). The hospitalization duration and transfusion related expenses in the experimental group were lower than those in the control group (P<0.05). Conclusion: PABD under anesthesia monitoring is safe and feasible in elective surgeries across diverse patient groups and surgical fields. It reduces the costs and conserves blood resources, which is worthy of further promotion.

Serotonin-selective reuptake inhibitors （SSRIs）， as widely used antidepressants in clinical practice， exhibit significant individual differences in antidepressant efficacy. Gut microbiota plays an important role in the development and progression of depression， and the use of SSRIs exerts a significant impact on the gut microbiota of patients with depression. Based on this， this article reviews the research progress on the interactions between the antidepressant effects of SSRIs and gut microbiota. It has been found that SSRIs can influence the diversity， abundance， and function of the gut microbiota directly or indirectly. Conversely， the composition of the gut microbiota and differences in its functional metabolic pathways， and other factors， can in turn affect the antidepressant effects of SSRIs. Therefore， in clinical practice， gut microbiota diversity can be utilized as a predictive indicator for the antidepressant effects of SSRIs. Probiotics can be employed as an adjunct therapy alongside SSRIs， and dietary adjustments， as well as fecal microbiota transplantation， can be used to enhance the therapeutic efficacy of SSRIs. In the future， large-scale， multicenter clinical studies should be conducted， enrolling a broadly representative cohort of patients with depression， to uncover the true association between the antidepressant effects of SSRIs and gut microbiota， thereby opening up more effective avenues for the comprehensive treatment of depression.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

AIM:To obtain new typical compounds with dual mechanism,antagonizing Ca2+and inhibiting acetylcholinesterase,on Alzheimer's disease.METHODS:Resorcinol was chosen as primitive substrate,and AD-mix-β as asymmetrically dihydroxylated reagent;all products were screened against acetylcholinesterase in vitro.RESULTS:cis-3′R,4′R-disubstituted angular dihydropyranocoumarins were synthesized enantioselectively,however,its inhibitory activity on acetylcholinesterase is distinctively lower than that of cis-3′R,4′R-disubstituted linear dihydropyranocoumarins.

AIM:Bioactive constituents were expected to be obtained from the roots of Angelica morri Hayata. METHOD:They were extracted with 95% alcohol and isolated by using column chromatography and recrystallization methods. The structures were elucidated by means of physico-chemical data and UV,IR,1HNMR, 13CNMR,and EIMS. The inhibitory effect on the constriction of rat aortic rings was induced by K+ or Ca2+. RESULT:3′S-(-)-hamaudol,3′S-(-)-Ο-acetylhamaudol,3′R-(+)-hamaudol,and (±)-hamaudol were isolated from the pieces of Radix Angelica Morri. The inhibitory rate of 3′S-(-)-Ο-acetylhamaudol and (±)-hamaudol on the above pharmacologic model appears the relation of quantity response. CONCLUSION:All the above compounds were found in this species for the first time,and(±)-hamaudol is a new. One of effect mechanisms of 3′S-(-)-Ο-acetylhamaudol and (±)-hamaudol diluted aorta could contribute to be inhibiting Ca2+ influx of vascular smooth muscle.

Objective To investigate chemical constituents in the leaves of Euphorbia soongarica(Xinjiang origin).Methods The leaves were extracted with 95% EtOH and partitioned with petroleum ether,CHCl3,and n-BuOH,respectively.Compounds were isolated by using repeated silical gel column chromatography and Sephadex LH-20 column chromatography.Results Eight compounds were identified on the basis of physiochemical properties and spectral data as chrysoeriol(Ⅰ),phthalic acid,bis-(2,5-dimethylhexyl) ester(Ⅱ),fraxetin(Ⅲ),3-(4-O-?-D-glucopyranosyloxy-3,5-dimethoxy)-phenyl-2E-propenol(Ⅳ),fraxin(Ⅴ),3-methylellagic acid-3′-O-?-D-xylopyranoside(Ⅵ),3,3′-dimethylellagic acid-4-O-sulphate(Ⅶ),and(+)-isolariciresinol-9-O-?-D-xylopyranoside(Ⅷ).Conclusion Compound Ⅶ is a new natural product,the other seven compounds are obtained from this plant for the first time.