BackgroundCerebral small vessel disease (CSVD) usually develops under the combined influence of vascular risk factors, chronic perfusion insufficiency, and age-related brain vulnerability; however, animal models driven by a single insult do not fully reproduce this multifactorial clinical context.MethodsWe established a composite CSVD rat model by combining spontaneous hypertension, bilateral common carotid artery stenosis (BCAS)-induced chronic cerebral hypoperfusion, and D-galactose (D-gal)-induced aging-related stress. Fourteen-week-old male Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs) were assigned to the WKY, SHR, SHR+BCAS, and SHR+BCAS+D-gal groups. Spatial learning and memory, exploratory behavior, spontaneous locomotion, and motor coordination were assessed using the Morris water maze, open field test, and balance beam test. T2-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) were used to quantify regional brain volumes and white matter microstructural integrity. Luxol fast blue (LFB) staining and transmission electron microscopy (TEM) were performed to examine corpus callosum myelin pathology, and enzyme-linked immunosorbent assay (ELISA) was used to assess molecular markers related to the blood-brain barrier (BBB), neuroinflammation, oxidative stress, myelin injury, axonal injury, and neuronal damage.ResultsCompared with WKY rats, SHR rats showed early spatial memory impairment, behavioral abnormalities, and structural brain changes. Superimposition of BCAS and D-gal progressively aggravated these abnormalities. SHR+BCAS+D-gal rats exhibited the longest escape latency, reduced target-quadrant dwell time and platform crossings, decreased locomotor and exploratory activity, prolonged balance beam crossing time, increased foot slips, and greater waiting/stopping behavior. MRI revealed ventricular enlargement and reduced hippocampal, cortical, and corpus callosum volumes. DTI showed lower fractional anisotropy in the genu of the corpus callosum, cingulum, dorsal hippocampus, and thalamic core region. LFB staining showed reduced myelin staining and disorganized fiber arrangement, whereas TEM revealed myelin lamellar loosening, irregularity, and deformation in the corpus callosum. Molecular analyses showed decreased Claudin-5, ZO-1, MBP, and SOD, and increased Iba1, GFAP, MDA, corpus callosum NfL, serum NfL, and serum NSE, especially in the SHR+BCAS+D-gal group.ConclusionIn male rats, the SHR+BCAS+D-gal composite model recapitulates the multifactorial background, chronic progression, and multimodal neurological impairment of clinical CSVD at behavioral, neuroimaging, histopathological, and molecular levels. This male rat model may provide a useful experimental platform for mechanistic and interventional studies targeting BBB protection, neuroinflammation, oxidative stress, and white matter repair.

BackgroundThe hippocampus is considered to be closely associated with the emergence of negative symptoms and cognitive impairments in schizophrenia (SCH). A single imaging modality is insufficient to capture the comprehensive structural, functional, and metabolic alterations in the hippocampus. This study employed multimodal magnetic resonance imaging (MRI) to investigate changes in hippocampal volume, white matter integrity, and metabolite levels in SCH rats, exploring the positive regulatory effects of risperidone.MethodsTen pregnant Wistar rats were randomly divided into two groups on gestational day 9: one was injected with poly(I:C) to establish SCH model, and the other received saline. Nine male offspring were selected and randomly assigned to three groups (n=3):Normal(from saline grop), SCH, and SCH+Risperidone (Treated) group (from poly(I:C)). From 76 days of age, the Treated group was administered risperidone solution by gastric lavage, whereas the other two groups received distilled water, for a 28-day period. Thereafter, multimodal MRI scans were conducted: Structural MRI (sMRI) for bilateral hippocampal volume; diffusion tensor imaging (DTI) for hippocampal FA and ADC values; and magnetic resonance spectroscopy (MRS) for metabolite-to-creatine ratios: N-acetylaspartate to creatine (NAA/Cr), choline to creatine (Cho/Cr), glutamate to creatine (Glu/Cr), myo-inositol to creatine (mI/Cr).ResultsHippocampus Volume: Compared to the normal group, the SCH group exhibited a significant reduction in bilateral hippocampus volume (P < 0.05). Risperidone-treatment significantly increased bilateral volume compared to the SCH group (P < 0.05). DTI: In the SCH group, FA was decreased in the left (P < 0.05) and right (P < 0.01) hippocampus compared to normals. Conversely, ADC was increased in the right hippocampus (P < 0.05). Following risperidone treatment, the FA was significantly increased in both hippocampus (P < 0.05). MRS: The SCH group showed lower ratios of NAA/Cr and Glu/Cr than the normal group (P < 0.05). Following risperidone treatment, the NAA/Cr was significantly elevated (P < 0.01).ConclusionsThe Poly(I:C)-induced schizophrenia rat model exhibits reduced hippocampal volume, neuronal damage, impaired white matter integrity, and glutamatergic system dysfunction. These preliminary findings suggest a potential modulatory effect of risperidone, warranting validation in larger cohorts.

Background: Maternal infection or inflammatory stimulation during pregnancy can disrupt fetal brain development through immune activation, increasing the risk of psychiatric disorders in offspring, including schizophrenia. Using a maternal immune activation (MIA) model induced by polyinosinic-polycytidylic acid (Poly(I:C)) during pregnancy, this study employed multimodal magnetic resonance imaging (MRI)-including T2 structural imaging, diffusion tensor imaging (DTI), arterial spin labeling (ASL), and magnetic resonance spectroscopy (MRS)-to comprehensively assess offspring brain alterations across structure, white matter integrity, cerebral perfusion, and metabolite levels. Methods: Pregnant Wistar rats were randomly assigned to a Poly(I:C) model group or a saline control group. Adult male offspring underwent T2 structural imaging, DTI, ASL, and MRS. Voxel-based morphometry of T2 images evaluated structural changes; DTI quantified fractional anisotropy (FA) and diffusivity indices (mean diffusivity [MD], axial diffusivity [AD], radial diffusivity [RD]); ASL measured cerebral blood flow (CBF) in the prefrontal cortex and striatum; and MRS assessed metabolite levels in the prefrontal cortex. Group differences were analyzed (p<0.05). Results: Poly(I:C) offspring exhibited significant gray matter density reductions in the prefrontal cortex, hippocampus, striatum, cingulate cortex, and sensorimotor cortex, whereas the right posterior parietal cortex showed increased density and the left third ventricle was enlarged. DTI revealed elevated MD and RD in the hippocampal dentate gyrus, along with increased RD in the genu of the corpus callosum, indicating white matter microstructural damage and abnormalities in myelination. ASL demonstrated significantly increased CBF in the prefrontal cortex and striatum, reflecting abnormal regional perfusion. MRS showed a significant reduction in NAA/Cr in the prefrontal cortex, suggesting impaired neuronal function. Conclusion: Offspring rats exposed to maternal Poly(I:C) during pregnancy exhibited abnormalities across multiple domains, including brain structure, white matter microstructure, cerebral perfusion, and metabolism. This study provides additional evidence that maternal inflammation during pregnancy can interfere with offspring brain development and impair neurological function.

Objective To investigate the efficacy and mechanism of Ditan Qingnao Decoction (DTQND) in alleviating schizophrenia-like symptoms in a maternal immune activation (MIA)-induced rat model. Methods DTQND components were analyzed using high-performance liquid chromatography–tandem mass spectrometry. An MIA-induced rat model was established by injecting Poly I:C into pregnant dams on gestational day 9. Male offspring were administered DTQND (14.1 g/kg), risperidone (RIS; 0.4 mg/kg), or distilled water, while the controls received only distilled water via gavage for 4 weeks. Behavioral assessments were conducted using the open-field, Y-maze, prepulse inhibition, and sucrose preference tests. Serum levels of interleukin (IL)-6, IL-18, IL-1β, and tumor necrosis factor-α (TNF-α) were measured via an enzyme-linked immunosorbent assay. Hippocampal protein levels of nuclear factor kappa B p65 (NF-κB p65), phospho-NF-κB p65 (p-p65), inhibitor of kappa B-alpha (IκB-α), phospho-IκB-α (p-IκB-α), and nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) were assessed via western blots. Immunohistochemistry detected hippocampal expression of ionized calcium-binding adapter molecule 1 (Iba1) and cluster of differentiation 68 (CD68). Results Multiple DTQND compounds were identified, including stachyose, β-syringin, and isofraxidin, among others. DTQND treatment considerably enhanced spontaneous activity, reduced anxiety, improved spatial working memory, and alleviated sensory gating defects in male offspring with MIA. The DTQND group showed significantly lower serum levels of IL-1β (P = .002) and IL-18 (P = .046) than the model group, with no discernible variations in IL-6 or TNF-α levels. In the hippocampus, DTQND significantly suppressed the expression of p-p65 (P < .001), p-IκB-α (P = .023), and NLRP3 (P < .001) compared to the model group. Additionally, DTQND modulated microglial activation markers, decreasing CD68 expression (P = .004) without affecting Iba1 levels. Conclusions DTQND alleviated schizophrenia-like behavioral deficits and cognitive impairment by inhibiting the NF-κB/NLRP3 pathway, supporting its potential as an alternative therapy for schizophrenia.

Postpartum depression (PPD) is a prevalent mental disorder affecting approximately 20 % of mothers, with profound implications for maternal and infant health. Current pharmacotherapies pose risks during lactation, highlighting the urgent need for safer alternatives. Shenqi Jieyu Formula (SQJYF) is a traditional Chinese medicine herbal preparation that has demonstrated clinical efficacy in alleviating PPD symptoms, yet its neurobiological mechanisms remain unclear. This study nvestigated the effects of SQJYF on cerebral blood flow and microstructure in the hippocampus (HP) and prefrontal cortex (PFC) using a maternal separation-induced PPD rat model. We established a maternal separation model of PPD. 24 SD rats were randomized into normal group, PPD group, SQJYF-treated group and fluoxetine-treated group. Maternal separation was performed from the first day to the 21st day, 4 hours a day, controls remained undisturbed. Pharmacological intervention was applied from postnatal day 15, SQJYF (1.25 g/100 g/d) or Fluoxetine Hydrochloride Capsules or saline was administered by gavage for 1 week. Forced swim test, sucrose preference test and open field test were conducted post-intervention. Rats were scanned with functional magnetic resonance imaging, arterial spin labeling (ASL) measured cerebral blood flow, and diffusion tensor imaging (DTI) assessed fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in HP and PFC. Results demonstrated that maternal separation induced depressive-like behaviors and also caused hypoperfusion and impaired tissue integrity in the HP and PFC. SQJYF could alleviate depressive-like behavior in PPD rats, also restore cerebral perfusion levels and improve tissue integrity damage. Compared with the PPD group, the horizontal and vertical scores were significantly increased (P < 0.01), sucrose consumption was significantly increased (P < 0.01), and immobility time was significantly reduced (P < 0.01). the perfusion level of bilateral HP and PFC were significantly increased (P < 0.01, P < 0.05), ADC values of bilateral HP and PFC were significantly reduced (P < 0.01, P < 0.05), FA values of bilateral PFC and left HP were significantly increased (P < 0.01). These findings highlight SQJYF;s dual neurorestorative role in ameliorating PPD through enhanced cerebral perfusion and microstructural repair. This study provides the multimodal neuroimaging evidence supporting SQJYF’s efficacy, bridging traditional medicine with modern neurobiological insights to address a critical gap in PPD therapeutics.

Objective To investigate the efficacy and mechanism of Ditan Qingnao decoction (DTQND) in alleviating schizophrenia-like symptoms in a maternal immune activation (MIA)-induced rat model. Methods DTQND components were analyzed using high-performance liquid chromatographyu2013tandem mass spectrometry. An MIA-induced rat model was established by injecting Poly I:C into pregnant dams on gestational day 9. Male offspring were administered DTQND (14.1 g/kg), risperidone (RIS; 0.4 mg/kg), or distilled water, while the controls received only distilled water via gavage for 4 weeks. Behavioral assessments were conducted using the open-field, Y-maze, prepulse inhibition, and sucrose preference tests. Serum levels of interleukin (IL)-6, IL-18, IL-1u03B2, and tumor necrosis factor-u03B1 (TNF-u03B1) were measured via an enzyme-linked immunosorbent assay. Hippocampal protein levels of nuclear factor kappa B p65 (NF-u03BAB p65), phosphou2013NFu2013u03BAB p65 (p-p65), inhibitor of kappa B-alpha (Iu03BAB-u03B1), phospho-Iu03BAB-u03B1 (p-Iu03BAB-u03B1), and nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing protein 3 (NLRP3) were assessed via western blots. Immunohistochemistry detected hippocampal expression of ionized calcium-binding adapter molecule 1 (Iba1) and cluster of differentiation 68 (CD68). Results Multiple DTQND compounds were identified, including stachyose, u03B2-syringin, and isofraxidin, among others. DTQND treatment considerably enhanced spontaneous activity, reduced anxiety, improved spatial working memory, and alleviated sensory gating defects in male offspring with MIA. The DTQND group showed significantly lower serum levels of IL-1u03B2 (P =.002) and IL-18 (P =.046) than the model group, with no discernible variations in IL-6 or TNF-u03B1 levels. In the hippocampus, DTQND significantly suppressed the expression of p-p65 (P u0026lt;.001), p-Iu03BAB-u03B1 (P =.023), and NLRP3 (P u0026lt;.001) compared to the model group. Additionally, DTQND modulated microglial activation markers, decreasing CD68 expression (P =.004) without affecting Iba1 levels. Conclusions DTQND alleviated schizophrenia-like behavioral deficits and cognitive impairment by inhibiting the NF-u03BAB/NLRP3 pathway, supporting its potential as an alternative therapy for schizophrenia.

BackgroundMaternal immune activation (MIA) is a mature means to construct a schizophrenia model. However, some preclinical studies have reported that a MIA-induced schizophrenia model seemed to have gender heterogeneity in behavioral phenotype. On the other hand, the MIA’s paradigms were diverse in different studies, and many details could affect the effect of MIA. To some extent, it is not credible and scientific to directly compare the gender differences of different MIA programs. Therefore, it is necessary to study whether the sex of the exposed offspring leads to behavioral differences on the premise of maintaining a consistent MIA mode.MethodsAn animal model of schizophrenia was established by the administration of 10 mg/kg Poly (I: C) when dams were on day 9 of gestation. Then, a number of female and male offspring completed a series of behavioral tests during postnatal days 61–75.ResultsCompared with the female control group (n = 14), female MIA offspring (n = 12) showed a longer movement distance (d = 1.07, p < 0.05) and higher average speed (d = 1.08, p < 0.05) in the open field test (OFT). In the Y maze test, the percentage of entering the novel arm of female MIA offspring was lower (d = 0.92, p < 0.05). Compared with the male control group (n = 14), male MIA offspring (n = 13) displayed less movement distance (d = 0.93, p < 0.05) and a lower average speed (d = 0.94, p < 0.05) in the OFT. In the Y maze test, the proportion of exploration time in the novel arm of male MIA offspring was lower (d = 0.96, p < 0.05). In the EPM, male MIA offspring showed less time (d = 0.85, p < 0.05) and a lower percentage of time spent in the open arms (d = 0.85, p < 0.05). Male MIA offspring also had a lower PPI index (76 dB + 120 dB, d = 0.81, p < 0.05; 80 dB + 120 dB, d = 1.45, p < 0.01).ConclusionsOur results showed that the behavioral phenotypes induced by prenatal immune activation were highly dependent on the sex of the offspring.

ObjectiveThis study aimed to observe the effect of edaravone dexborneol (EDB) on the incidence of early post-stroke depression (PSD) and explore its inflammatory mechanisms.MethodsA prospective, randomized controlled study was conducted from January 2022 to June 2023, involving patients with acute ischemic stroke (AIS) at the Neurology Department of the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine. The control group received routine treatment, while the experimental group received routine combined EDB treatment. The main outcome measures included PSD incidence, Patient Health Questionnaire (PHQ-9) and Hamilton Depression Scale (HAMD) scores on days 14 and 30, and inflammatory factor levels on day 14.ResultsA total of 93 patients were included in the study, 51 in the experimental group and 42 in the control group. On day 14, the PSD incidence was 13.7% in the experimental group, lower than 31.0% in the control group (95%CI 0.127–0.996; p = 0.044). Compared to the control group, the experimental group showed significantly lower concentrations of pro-inflammatory cytokines IL-1β (95%CI 3.353–5.184), IL-6 (95%CI 2.694–3.426), TNF-α (95%CI 4.985–12.196), IFN-γ (95%CI 0.163–0.451), MCP-1 (95%CI 0.335–0.787), IL-17A (95%CI 0.543–1.024), and IL-23p19 (95%CI 1.677–1.959) (all p < 0.001), and higher levels of anti-inflammatory cytokines IL-4 (95%CI −1.087 to −0.941), IL-10 (95%CI −6.125 to −1.662), and IL-13 (95%CI −6.078 to −2.953) (all p ≤ 0.001). On day 30, the PSD incidence in the experimental group was 15.7%, lower than 40.5% in the control group (95%CI 0.103–0.725; p = 0.007). Compared with the control group, the experimental group had lower PHQ-9 scores on day 14 (95%CI 0.034–1.577; p = 0.041) and day 30 (95%CI 0.018–1.573; p = 0.045), and also had lower HAMD scores on day 14 (95% CI 0.281–2.856; p = 0.018) and day 30 (95% CI 0.647–3.482; p = 0.005).ConclusionEDB could reduce the incidence of early PSD, reduce pro-inflammatory cytokine levels, and elevate anti-inflammatory cytokine levels, which was possibly related to the anti-inflammatory mechanism of EDB.Clinical trial registrationhttp://www.chictr.org.cn/, identifier [ChiCTR2300067750].

背景　后循环缺血性眩晕（PCIV）常可作为脑梗死的先兆症状，具有反复发作、缠绵不愈等特点，严重影响患者生命质量，而常规的西医治疗临床疗效有限。目前中成药注射液在控制和缓解眩晕的发作方面具有显著疗效，但鉴于中成药制剂种类繁多，缺乏相关循证医学证据评估各种中成药注射液的优劣。目的　运用网状Meta分析对不同中药注射液联合常规西药治疗后PCIV的疗效和安全性进行评价。方法　全面检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、Web of Science、EMbase、Cochrane Library数据库建库至2024-05-07有关中药注射液治疗PCIV的随机对照试验（RCT）。运用Cochrane风险偏倚工具对纳入文献进行质量评价，采用Stata 17.0、RevMan 5.4软件进行统计学分析。结果　最终纳入50项RCT，4 616例患者，涉及丹参川芎嗪注射液、丹红注射液、参芎葡萄糖注射液、参麦注射液、天麻素注射液、灯盏花素注射液、疏血通注射液、红花黄色素注射液、舒血宁注射液、苦碟子注射液、葛根素注射液、醒脑静注射液、银杏达莫注射液13种中药注射液。网状Meta分析结果显示，眩晕症状改善［即眩晕障碍量表（DHI）评分］方面：累积排序概率图下面积（SUCRA）排名前3的干预措施为醒脑静注射液（87.2%）、参麦注射液（73.5%）、舒血宁注射液（59.6%）分别联合常规西药；临床总有效率方面：排名前3的干预措施为银杏达莫注射液（88.3%）、天麻素注射液（63.3%）、葛根素注射液（57.6%）分别联合常规西药；左、右椎动脉血流速度改善方面：排名前3的干预措施为醒脑静注射液（96.2%、99.2%）、灯盏花素注射液（90.2%、85.6%）、红花黄色素注射液（69.3%、79.4%）分别联合常规西药；基底动脉血流速度改善方面：排名前3的干预措施为灯盏花素注射液（97.6%）、红花黄色素注射液（85.8%）、醒脑静注射液（80.6%）分别联合常规西药；全血高切黏度改善方面：排名前3的干预措施为参麦注射液（85.6%）、丹红注射液（80%）、疏血通注射液（77.5%）分别联合常规西药；全血低切黏度改善方面：排名前3的干预措施为疏血通注射液（90.3%）、天麻素注射液（77.5%）、参麦注射液（73%）分别联合常规西药。安全性方面：所有研究中均未发生严重的服药不良反应。结论　醒脑静注射液联合常规西药治疗在改善PCIV眩晕症状、椎-基底动脉血流速度方面均表现出优异的临床疗效，给临床用药提供了一定参考性，且中成药注射液与常规西药的联合应用均优于单用常规西药，且具有良好的用药安全性。上述结论受限于当前相关研究的数量与质量，仍需更多高质量的RCT进一步验证。

Background and purposeThis study aimed to explore the correlation and causal relationship between fibrinogen, D-dimer, and the severity of cerebral white matter hyperintensity (MMH).MethodsA retrospective analysis of 120 patients with cerebral small vessel disease (CSVD) confirmed by head MRI attending the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from August 2021 to February 2023 was performed. According to the Fazekas scale score, the patients were divided into 42 cases in the mild group, 44 cases in the moderate group, and 34 cases in the severe group. The levels of fibrinogen and D-dimer were compared among the three groups; the correlations between fibrinogen, D-dimer, and WMH severity were further analyzed; and independent risk factors for WMH severity were explored using the multivariate ordered logistic regression analysis. Furthermore, a two-sample Mendelian randomization (MR) analysis was performed to investigate the genetically predicted effect of fibrinogen and D-dimer on WMH.ResultsAs the severity of WMH increased, the levels of D-dimer and fibrinogen also gradually increased, and the results showed a positive correlational association, with significant differences within the groups (all p < 0.05); the multivariate ordered logistic regression model showed that after adjusting for the relevant covariates, D-dimer (OR = 5.998, 95% CI 2.213–16.252, p < 0.001) and fibrinogen (OR = 9.074, 95% CI 4.054–20.311, p < 0.001) remained independent risk factors for the severity of WMH. In the MR study, the random-effect inverse variance weighted (IVW) model showed that increased levels of genetically predicted D-dimer (OR, 1.01; 95% confidence interval 0.95–1.06; p = 0.81) and fibrinogen (OR, 1.91; 95% confidence interval 0.97–3.78; p = 0.06) were not associated with increased risk of WMH. The authors did not obtain strong evidence of a direct causal relationship between D-dimer, fibrinogen, and WMH.ConclusionIn this retrospective-based study, the authors found possible associations between D-dimer, fibrinogen, and WMH, but there was no obvious causal evidence. Further efforts are still needed to investigate the pathophysiology between D-dimer, fibrinogen, and WMH.

Objective:To reveal the medication rules in the treatment of depressive psychosis and mania by data mining from ancient medical records.Methods:The Ancient and Modern Medical Records Cloud Platform was searched for the medcial records with relevant keywords, and a library of ancient medical records of the treatment of depressive psychosis and mania by famous physicians was built.EXCEL and SPSS were employed to perform frequency statistics, association analysis, and cluster analysis, and Gephi to perform complex network analysis, on the basis of which the medication rules were mined.Results:A total of 223 articles were included in this study, The articles included 283 Chinese medicine prescriptions, which involved 271 Chinese medicines.The high-frequency Chinese medicines were Glycyrrhizae Radix et Rhizoma, Acori Tatarinowii Rhizoma, Poria cum Radix Pini, Ginseng Radix et Rhizoma, Polygalae Radix, Coptidis Rhizoma, and Pinelliae Rhizoma.The association analysis predicted the herb pairs such as Poria cum Radix Pini-Ziziphi Spinosae Semen and Polygalae Radix-Acori Tatarinowii Rhizoma.The cluster analysis revealed Xiaoyao Powder, Wendan Decoction, and Mangshi Guntan Pills.The core prescription was modified Shiwei Wendan Decoction.Conclusion:Ancient physicians focus on phlegm in the treatment of depressive psychosis and mania while differentiating the deficiency and excess.On the basis of syndrome differentiation, the therapies of regulating qi and relieving depression, clearing liver and promoting bile secretion, relaxing bowls and removing excess, tonifying heart and replenishing spleen, nourishing yin and purging fire, and tranquilizing mind with heavy sedatives are employed, which demonstrate good efficacy.

Objective By analyzing the traditional Chinese medicine syndrome and cerebral glucose metabolism of dementia with lewy bodies（DLB） and Alzheimer’s disease（AD）, this study intends to find the features of effective differential diagnosis of DLB and AD. Methods From January 2020 to December 2020, a total of 60 patients meeting the criteria were included, including 30 patients with DLB and 30 patients with AD.The general demographic data of the patients were collected. The total score of the Clinical Dementia Rating Scale（CDR） was used to assess the severity of dementia and the dementia syndrome factor weighting scale was used to determine the syndrome types of the patients. Positron emission computer tomography was performed after intravenous injection of the tracer 18 F-fluorodeoxyglucose. Results Yin deficiency and yang hyperactivity, qi deficiency of lung and kidney, liver-kidney deficiency were the most common syndromes in DLB patients.The syndromes of spleen deficiency and phlegm turbid, heat-toxity and blood stasis, spleen-kidney deficiency were the most common in AD patients. The changes of brain metabolism in DLB patients with suspected dementia were mainly reduced in the parietal lobe and temporal lobe. The metabolism of frontal, parietal and temporal lobes was decreased in DLB patients with mild and moderate dementia. In AD patients with non-severe dementia, the metabolism of the parietal lobe, temporal lobe and frontal lobe is decreased, while in some AD patients with moderate dementia, the metabolism of the occipital lobe is decreased.In patients with DLB, the changes in brain metabolism in patients with syndrome of yin deficiency and yang hyperactivity were mainly reduced metabolism in frontal lobe, parietal lobe, temporal lobe and occipital lobe; the changes in brain metabolism in patients with syndrome of qi deficiency of lung and kidney were mainly reduced metabolism in frontal lobe, parietal lobe and temporal lobe; the changes in brain metabolism in patients with liver-kidney deficiency syndrome were mainly reduced metabolism in parietal lobe and temporal lobe. However, patients with AD with different TCM syndromes mainly have low metabolism in frontal lobe, parietal lobe and temporal lobe. Conclusion There are significant differences in TCM syndrome and cerebral glucose metabolism characteristics between DLB and AD patients, which is helpful for the differential diagnosis of DLB and AD. The brain metabolic characteristics of DLB patients with different syndromes are different, which is conducive to the precise treatment of DLB.

目的 采取数据挖掘方法,探析中药治疗血管性痴呆(VaD)的组方配伍规律.方法 收集中国知网、维普数据库、PubMed等数据库自建库日至2022年3月1日中关于中医或中西医治疗VaD的临床研究中的内服处方,建立VaD方剂数据库,并运用频次及使用剂量统计、聚类分析、关联规则等方法,探索组方配伍规律.结果 共纳入302篇文献,涉及内服方剂334首,中药185味,得到频次≥40的中药29味.挖掘出核心中药为石菖蒲、川芎、远志、熟地黄、黄芪.得到熟地黄-肉苁蓉、远志-山药、石菖蒲-人参、黄芪-当归、石菖蒲-天南星、石菖蒲-郁金、川芎-地龙9对药物配伍,总结出高频药物组合四组.结论 VaD的病机在脑,与精血相关,涉及肾精亏虚、气血两虚、血瘀阻络、痰蒙神窍等证型.中医药治疗VaD注重补肾益精、补气养血,并标本兼治,辅以豁痰开窍、祛瘀通络、清热化痰等治法.

书院教育是中国古代教育的重要模式之一,重视讲学、思辨、体悟、育人相融合的过程,其模式以系统的讲学论道、开放的学派会讲、庄严的祭祀典礼、平等的质疑辩难、严格的学业课考、惬意的外出游学为主要内容,对中医学传承具有启迪作用.通过仲景书院的教育实践发现,中医学的书院教育可以在传统书院教育模式基础上,通过祭拜先贤、大师讲学、经典研修、学派争辩、经验传承、拜师跟诊、中药辨识、国学熏陶等方式,结合中医学自身的学科特点进行创新和探索,形成独具特色的书院教育模式,对学院教育和传统的师承教育进行补充,在中医药传承中发挥更大的作用.

Objective:To observe the clinical effect of nourishing the heart and spleen on major depressive disorder(MDD)with suicidal ideation.Methods:From January 2017 to April 2018,366 MDD patients(deficiency of heart and spleen)in 13 hospitals including traditional Chinese medicine(TCM)hospitals,integrated Chinese and Western medicine hospitals and psychiatric hospi-tals were taken as the study subjects in this cohort.Three cohort groups(TCM,Western medicine,and integrated Chinese and West-ern medicine)were formed naturally according to treatment regime,and they were divided into high,medium and low levels based on the TCM exposure time(TCM-ET).The follow-up interval was 3 months,and the Montgomery-Asberg Depression Rating Scale(MADRS)was used in the follow-up to assess the dynamic status of MDD patients and the occurrence of the endpoint events.Re-sults:The 2-year incidence of suicidal ideation of MDD patients in the TCM,Western medicine,and integrated Western and Chi-nese medicine cohorts was 39.0％,49.1％,and 29.0％,respectively.In the multifactorial comparison of suicidal ideation,com-pared with the condition in Western medicine cohort,the risk of suicidal ideation was reduced by 28.1％(HR=0.719,95％CI 0.476 to 1.087,P＞0.05)in TCM cohort,and by 42.1％(HR=0.579,95％CI 0.373 to 0.899,P＜0.01)in integrated Chinese and Western medicine cohort.In TCM cohort,compared with the condition under low-level TCM-ET,the risk of suicidal ideation was reduced by 22.2％(HR=0.778,95％CI 0.404 to 1.500,P＞0.05)under medium-level TCM-ET,and by 66.6％(HR=0.394,95％CI 0.167 to 0.931,P＜0.05)under high-level TCM-ET.In integrated Chinese and Western medicine cohort,com-pared with the condition under low-level TCM-ET,the risk of suicidal ideation was lowered by 70.3％(HR=0.419,95％CI 0.189 to 0.927,P＜0.05)with medium-level TCM-ET,and by 83.1％(HR=0.217,95％CI 0.094 to 0.501,P＜0.01)with high-level TCM-ET.Conclusion:Western medicine and TCM method of nourishing the heart and spleen present the same effect,and integrat-ed Chinese and Western medicine is more significant in reducing the suicidal ideation of MDD patients(deficiency of heart and spleen).Compared with low-level TCM-ET,medium-level and high-level TCM-ETs are more clinically effective in reducing the sui-cidal ideation.

The modified multi-platform method (MMPM) is used to induce animal models of paradoxical sleep deprivation and impairs memory in rodents. However, variations in MMPM protocols have contributed to inconsistent conclusions across studies. This meta-analysis aimed to assess the variations of the MMPM and their effects on memory in rats and mice. A comprehensive search identified 60 studies, and 50 were included in our meta analysis. Overall, the meta-analysis showed that the MMPM significantly reduced the percentage of time spent in target quadrants (I2 = 54 %, 95 % confidence interval [CI] = [-1.83, -1.18]) and the number of platform-area crossings (I2 = 26 %, 95 % CI = [-1.71, -1.07]) in the Morris water maze (MWM) and shortened the latency to entering the dark compartment in the passive avoidance task (I2 = 68 %, 95 % CI = [-1.36, -0.57]), but it increased the number of errors in the radial arm water maze (RAWM) (I2 = 59 %, 95 % CI = [1.29, 2.07]). Additionally, mice performed worse on the MWM, whereas rats performed worse on the passive avoidance task. More significant memory deficits were found in cross-learning and post-learning MMPM in the MWM and RAWM, respectively. This study provided evidence that the MMPM can be used in preclinical studies of memory deficits induced by paradoxical sleep deprivation.

缺少运动、睡眠不足、精神压力大是大多数人的一种生活常态,这使得大脑大部分时间处于紧张疲劳的状态,长期如此,还会出现头晕、耳鸣、健忘、失眠、慢性疲劳等多种继发的症状,相信有些读者深有体会. 现代社会的人文环境和自然环境与古代有天壤之别,那么传承数千年的中医疗法能不能解决新环境孕育的新问题呢?

目的 采取大样本、多中心的横断面研究方法,探讨精神分裂症患者的中医证候分布规律.方法 2020年5月—2021年4月,在北京市12个分中心(北京中医药大学第三附属医院、北京市朝阳区第三医院、首都医科大学附属北京安定医院、北京回龙观医院、北京市大兴区心康医院、北京市昌平区中西医结合医院、北京市石景山区精神卫生保健所、清华大学垂杨柳医院、北京市延庆区精神病医院、北京市平谷区精神病医院、中国中医科学院广安门医院、北京中医药大学东直门医院)招募精神分裂症患者.共纳入精神分裂症患者4734例,男性2529例,女性2205例,平均年龄50.81岁.通过中医证候学量表、阳性和阴性精神症状评定量表、四诊资料,评价患者精神状态并记录症状,填写《精神分裂症中医证候观察表》.构建症状关系网络图,从中提取证候靶位及证候要素.然后将证候靶位和证候要素应证组合,形成基础证.分别通过关联规则、贝叶斯网络、聚类分析对基础证进行证候提取,最后汇总3种方法得出的证候类型,结合中医理论和专家组意见,同类合并,提取共同的证候.结果 运用关联规则构建了162项症状之间的关系网络图,提取了16个基础证.关联规则提取了痰火扰神、心肝火旺、气滞血瘀、阴虚火旺、肾虚肝郁、痰蒙神窍、脾肾阳虚、心脾两虚、痰气郁结9个证候,聚类分析提取了心肝火旺、痰火伤阴、气滞血瘀、阴亏血少、脾肾阳虚、痰湿内阻、心脾两虚、肾气亏虚、胆气亏虚9个证候,贝叶斯网络提取了痰火扰神、心肝火旺、阴虚火旺、气滞血瘀、瘀热互结、肾虚肝郁、痰蒙神窍、脾肾两虚、心脾两虚、心肾不交和肝肾亏虚11个证候.经过汇总,提取了3种方法重合的痰火扰神、心肝火旺、气滞血瘀、阴虚火旺、痰蒙神窍、心脾两虚、脾肾阳虚和肾虚肝郁8个证候类型.精神分裂症的临床症状包括阴性症状(2893例,占61.11％)和阳性症状(1841例,占38.89％),前者属中医学"癫证"范畴,证候为脾肾阳虚(22.94％)、痰蒙神窍(17.79％)、心脾两虚(13.98％)、肾虚肝郁(6.40％);后者属中医学"狂证"范畴,证候为痰火扰神(12.63％)、气滞血瘀(11.03％)、阴虚火旺(10.25％)、心肝火旺(4.99％).结论 本研究探索了精神分裂症的中医证候规律,总结了常见的8个证候类型,为中医药论治精神分裂症提供了辨证基础.

"五脏苦欲补泻"理论源自《素问·藏气法时论篇》,是以藏象为基础,以五行生克为原则,依据脏腑的生理、病理特性,对脏腑的气血阴阳进行调整而形成的指导临床遣方用药的法则.长期临床实践发现,采用五脏苦欲补泻理论治疗心身疾病,每获良效.结合临床案例,说明心肝苦欲补泻的理论内涵和应用思路,并指出酸味药在不同疾病的理法方药中起不同作用的机理.