Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Elemene, derived from Curcuma wenyujin, one of the "8 famous genuine medicinal materials of Zhejiang province," exhibits remarkable antitumor activity. It has gained wide recognition in clinical practice for effectiveness on tumors. Dr. XIE Tian, introduced the innovative concept of "molecular compatibility theory" by combining Chinese medicine principles, specifically the "monarch, minister, assistant, and envoy" theory, with modern biomedical technology. This groundbreaking approach, along with a systematic analysis of Chinese medicine and modern biomedical knowledge, led to the development of elemene nanoliposome formulations. These novel formulations offer numerous advantages, including low toxicity, well-defined composition, synergistic effects on multiple targets, and excellent biocompatibility. Following the principles of the "molecular compatibility theory", further exploration of cancer treatment strategies and methods based on elemene was undertaken. This comprehensive review consolidates the current understanding of elemene's potential antitumor mechanisms, recent clinical investigations, advancements in drug delivery systems, and structural modifications. The ultimate goal of this review is to establish a solid theoretical foundation for researchers, empowering them to develop more effective antitumor drugs based on the principles of "molecular compatibility theory".
Humans ; Retrospective Studies ; Antineoplastic Agents/therapeutic use* ; Neoplasms/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Sesquiterpenes/therapeutic use*

Objective To discuss the clinical efficacy and safety of bilateral internal iliac artery Fogarty balloon occlusion in uterine curettage for patients with cesarean scar pregnancy(CSP).Methods The clinical data of a total of 80 CSP patients,who were admitted to the Fuyang People's Hospital of China between January 2021 and September 2022 to receive treatment,were retrospectively analyzed.The patients were divided into the observation group(n=40)and the control group(n=40).For the patients of the observation group,the hysteroscopic uterine curettage was carried out under the situation of bilateral internal iliac artery Fogarty balloon occlusion and during the operation the internal iliac artery was intermittently blocked.The embryo was removed,and the hemostasis was accomplished by electrocoagulation or surgical suture.For the patients of the control group,the hysteroscopic uterine curettage was performed within 1-2 days after uterine artery embolization(UAE).The digital subtraction angiography(DSA)fluoroscopy time,body surface radiation dose,blood loss during uterine curettage,time spent for uterine curettage,length of hospital stay,and postoperative follow-up results were compared between the two groups.Results Successful uterine curettage was accomplished and the uterus was retained in all the patients.In the observation group,no balloon-related complications occurred.In the control group,all the 40 patients developed different degrees of fever,pain at uterine area,and other post-embolization symptoms after UAE.In the observation group and the control group,the DSA fluoroscopy time was(9.2±1.1)seconds and(1 273.6±141.1)seconds respectively,the body surface radiation dose was(7.7±0.8)mGy and(1 503.8±101.8)mGy respectively,the differences between the two groups were statistically significant(both P＜0.05);the blood loss during uterine curettage was(30.3±14.7)mL and(27.5±13.2)mL respectively,the time spent for uterine curettage was(41.6±16.2)min and(42.8±15.0)min respectively,the differences between the two groups were not statistically significant(both P＞0.05);the length of hospital stay was(6.0±0.7)days and(7.3±0.8)days respectively,the difference between the two groups was statistically significant(P＜0.05).All patients were followed up for more than 3 months,the time of β-hCG turning to negative,time of vaginal bleeding,time of menstruation returning to normal,and patient satisfaction rate in the observation group were(21.1±2.4)days,(8.2±1.1)days,(29.5±2.2)days and 95.0%(38/40)respectively,which in the control group were(24.6±3.3)days,(13.6±2.6)days,(46.7±7.3)days and 67.5%(27/40)respectively,the differences in the above indexes between the two groups were statistically significant(all P＜0.05).Conclusion In performing uterine curettage for CSP patients,both bilateral internal iliac artery Fogarty balloon occlusion and UAE can significantly reduce the intraoperative blood loss,but bilateral internal iliac artery Fogarty balloon occlusion is superior to UAE in reducing radiation dose,in shortening the patient's hospital stay,the time of β-hCG turning to negative,the time of vaginal bleeding and the time of menstruation returning to normal,and in improving the patient satisfaction rate.

Objective To evaluate the postoperative analgesia efficacy and clinical safety of hydro-morphone patients-controlled intravenous analgesia(PCIA)in patients with scar pregnancy after auxiliary uterine artery embolization(UAE).Methods A total of 116 patients with scar pregnancy,who received auxiliary UAE at the Fuyang Municipal People's Hospital of China between January 2021 and September 2022,were enrolled in this study.According to the intravenous self-controlled analgesic drugs used after UAE,the patients were randomly and equally divided into observation group(n=58)and control group(n=58).Ten minutes before the procedure,intravenous injection of 2 mg hydromorphone(observation group)or 2 μg/kg sufentanyl(control group)was performed,and the PCIA pump was connected.In the observation group,the mixed solution of 10 mg hydromorphone+100 mg flurbiprofen axetil+100 mL saline was put in the analgesic pump,while in the control group,the mixed solution of 2 μg/kg sufentanyl+flurbiprofen axetil 100 mg+100 mL saline was put in the analgesic pump.The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h visual analogue scale(VAS)scores,the Bruggrmann comfort scale(BCS)scores,the number of pressing analgesic pump times within postoperative 48 hours,the used dosage of analgesic drugs,the adverse reactions,and the incidence of postoperative complications were recorded.Results The difference in the post-UAE 0.5-h VAS scores between the observation group and the control group was not statistically significant(P＞0.05),while the post-UAE 4-h,8-h,12-h,24-h and 48-h VAS scores in the observation group were significantly lower than those in the control group,and the differences were statistically significant(all P＜0.05).The post-UAE 0.5-h,4-h,8-h,12-h,24-h and 48-h BCS scores in the observation group were significantly higher than those in the control group,and the differences were statistically significant(all P＜0.05).The number of pressing analgesic pump times and the used dosage of analgesic drugs within postoperative 48 hours in the observation group were lower than those in the control group,and the differences were statistically significant(all P＜0.05).No statistically significant differences in the complications such as drowsiness,skin itching,hypoxia,or respiratory depression,etc.existed between the two groups,while the difference in the incidence of adverse reactions between the two groups was statistically significant(P＜0.05).Conclusion Hydromorphone and sufentanil PCIA can relieve the pain in scar pregnancy patients after UAE.Hydromorphone is superior to sufentanil in reducing the number of pressing analgesic pump times within postoperative 48 hours,reducing the used dosage of analgesic drugs,and decreasing the incidence of adverse reactions,therefore,hydromorphone PCIA has a certain promotion value.(J Intervent Radiol,2024,33:240-244)

Depression is a prevalent mental illness worldwide, its multifaceted pathogenesis is still in the exploratory stage. MicroRNA (miRNA), as a crucial epigenetic regulator, plays an important role in depression. miR-124 is one of the most abundant miRNAs in the central nervous system including neurons and microglia, and involved in various biological events like neuron development and differentiation, synaptic and axonal growth, neural plasticity, inflammation and autophagy. Recent studies have reported abnormal expression of miR-124 in both depression patients and animal models. Most of the studies showed that miR-124 is upregulated in the hippocampus or prefrontal cortex in stress-induced rodent depression animal models such as CUMS, CSDS, CORT, CRS and LH but some evidence for divergence. Upregulation of miR-124 expression may be involved in depression-like behavior via CREB/BDNF/TrkB pathway, GR pathway, SIRT1 pathway, apoptosis and autophagy pathways by directly targeting these genes including Creb, Bdnf, Sirt1, Nr3c1, Ezh2 and Stat3. The downregulation of miR-124 expression in neurons is mainly involved in the neurogenesis and neuroplasticity impairments in depression by targeting the Notch signaling pathway and DDIT4/TSC1/2/mTORC1 pathway. The downregulation of miR-124 expression also was found in the activated microglia in the stress-induced models, and resulted in neuroinflammation. In summary, the abnormal expression of miR-124 in the brain of depression-related models and its related mechanisms are complex and even contradictory, and still need further research. This review provides a summary of the research progress of miR-124 in depression.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

It is believed that traditional Chinese medicine （TCM） Daoyin （conduction exercise） therapy has potential in treating diabetic foot， which is a concrete embodiment of HUANG Yuanyu's theory of one qi circulation applied in practice. Based on Daoyin therapy of Baduanjin and the Origin and Indicators of Disease （《诸病源候论》）， a Daoyin prescription for diabetic foot was compiled and created. Based on the zang-fu concept of "One Qi Circulation"， combined with the theory of chief， deputy， assistant and envoy， this article explained the theoretical basis and functional mechanism of the Daoyin prescription for diabetic foot. This Daoyin therapy is mainly based on the prone position movements， which includes seven movements， namely， pull-up， knee bending， toe tilting， phoenix nodding， internal rotation of taiji， two hands climbing feet and closing. With "phoenix nodding" and "tilting toes" as the chief， with the help of toes opening-closing and pointing-pressing momentum in prone position， regulating the central qi； with "bending the knee" and "internal rotation of taiji" as the deputy， knee and ankle flexion and extension can unblock the meridians of liver and lungs； with "pull-up" and "two hands climbing feet" as the assistant， on the one hand， assisting to unblock zang-fu organs， on the other hand， applying the yang of the foot taiyang bladder channel and du mai to warm the cold and dampness； with "closing" as the envoy to regulate all organs， so that the blood return to the natural flow of circulation. Diabetic foot Daoyin therapy could regulate internal organs and qi circulation of body， and provides a new idea for the treatment of diabetic foot.

Objective:To investigate the impact of daily activities on cognitive function in retired elderly people in Changsha.Methods:A study was conducted on retired individuals aged 60 years or older who participated in our hospital's community free clinic from January 2021 to October 2021.A total of 325 elderly people were surveyed.After obtaining their informed consent, they were evaluated in a relatively quiet environment using the Mini-Mental State Examination(MMSE), the Athens Insomnia Scale, and a self-made questionnaire.Multifactorial logistic regression analysis was used to analyze the factors influencing cognitive function.Results:A total of 304 valid questionnaires were collected, consisting of 180 individuals in the normal cognition group and 124 in the cognitive impairment group.The cognition scores for the two groups were(25.77±2.08)and(18.86±3.74), respectively.Comparisons were made between the two groups in terms of general information, sleep conditions, and daily activities.Multifactorial regression analysis revealed that engaging in labor before retirement( OR, 2.105; 95% CI: 1.040-4.262)higher education levels( OR, 0.416; 95% CI: 0.182-0.950), maintaining contact with relatives and friends( OR, 0.205; 95% CI: 0.080-0.529), nurturing plants or pets( OR, 0.264; 95% CI: 0.124-0.563), and caring for grandchildren( OR, 0.325; 95% CI: 0.158-0.665)were identified as protective factors against cognitive impairment( P<0.05). Conclusions:Encouraging active participation of elderly individuals in beneficial community activities is crucial, while also emphasizing the importance of social relationships among retired individuals to mitigate the onset of cognitive impairment.