Background : Cerebral ischemia-reperfusion (I/R) injury remains a critical challenge in ischemic stroke management, with limited therapeutic options. Huangqi Chifeng Decoction (HQCF), a classical traditional Chinese medicine (TCM) formula, exhibits clinical efficacy in stroke treatment, yet its protective mechanisms remain poorly characterized. Purpose : This study aims to assess the protective effects of HQCF treatment on cerebral I/R injury in mice, and to uncover the underlying molecular mechanism. Methods : The therapeutic effects of HQCF on cerebral I/R injury were evaluated by neurobehavioral tests, TTC staining, H&E staining and Nissl staining using the mouse model of middle cerebral artery occlusion-reperfusion (MCAO/R). Then, the compositional analysis was conducted using Q-Orbitrap LC-MS/MS. Subsequently, multi-omics, including proteomics, transcriptomics, metabolomics were performed to elucidate HQCF's therapeutic mechanisms. Key pathways and targets were validated through western blot, molecular docking, cellular thermal shift assay (CETSA), and immunofluorescence. Pathway specificity was further validated using the NF-κB pathway agonist, NF-κΒ activator 2. Results : HQCF intervention markedly alleviated neurological deficits and reduced infarct volumes in MCAO/R mice, with concomitant improvement in histopathological features, as demonstrated by comparison with the positive control drug edaravone. Integrative multi-omics profiling revealed that HQCF mitigates I/R injury partially through inhibiting NF-κB/NLRP3 signaling, with NF-κB-inhibitor alpha (NFKBIA), PIAS1 and NF-κB1 p105, the critical inhibitors of NF-κB activation, as the key potential targets of HQCF. LC-MS/MS, molecular docking and CETSA studies confirmed NFKBIA, PIAS1 and NF-κB1 p105 represent novel pharmacological targets of Oleanolic acid, Astragaloside A and Formononetin, respectively, highlighting their critical roles in mediating HQCF’s neuroprotective effects. Mechanistically, HQCF promoted NFKBIA, PIAS1 and NF-κB1 p105-mediated inhibition of NF-κB activation, thereby suppressing NLRP3/GSDMD-driven pyroptosis, eventually attenuating neuronal injury in peri-infarct regions. Additionally, in vivo experiments revealed that NF-κΒ activator 2 reversed the protective effects of HQCF on cerebral I/R injury. Conclusion : This study systematically demonstrates that HQCF mitigates cerebral I/R injury via multi-dimensionally inhibiting NF-κB/NLRP3 signaling-mediated neuronal pyroptosis, including targeting the precursor NF-κB1 p105, binding the NFKBIA in the cytoplasm, and targeting PIAS1 in the nuclear. These findings provide novel mechanistic insights into HQCF’ therapy on cerebral I/R injury, further confirm the advantage of TCM in treating cerebrovascular disease via multitarget strategy and advance translational investigations of HQCF.

Neuronal apoptosis significantly contributes to brain damage in cerebral ischemia and reperfusion (I/R) injury, posing a serious threat to human health and lacking effective treatment. MicroRNA-15b-5p (miR-15b-5p) was previously reported to be significantly elevated in serum exosomes from ischemia patients and in freshly excised human stroke brain tissue. However, how miR-15b-5p regulates neuronal death in cerebral I/R injury remains elusive. In addition, we propose that encapsulating the miR-15b-5p inhibitor in TAT and RVG co-modified mesenchymal stem cell-derived exosomes (TAT RVG-Exo + miR-15b-5p inhibitor) could serve as an effective treatment for cerebral I/R injury. This study utilized a mouse model of intraluminal middle cerebral artery occlusion/reperfusion (MCAO/R) and HT22 hippocampal neuronal cells exposed to oxygen–glucose deprivation and reoxygenation (OGD/R) to simulate cerebral I/R injury. The impact of miR-15b-5p on neuronal death in cerebral I/R injury and its underlying mechanisms were investigated through bioinformatic analysis, qRT-PCR, Western blotting, immunofluorescent staining, flow cytometry, luciferase reporter assay, and RNA-Fluorescence in situ hybridization. Exosomes derived from MSCs were isolated and characterized using transmission electron microscopy and nanoparticle flow cytometer. Through surface modification and sonication, TAT-peptide and RVG-peptide co-decorated MSC-Exos carrying miR-15b-5p inhibitor (TAT RVG-Exo + miR-15b-5p inhibitor) were prepared. The protective effects of TAT RVG-Exo + miR-15b-5p inhibitor on cerebral I/R injury were evaluated using biodistribution imaging system, TTC staining, Western blotting and immunofluorescent staining. In cerebral I/R injury, both in vivo and in vitro, miR-15b-5p expression was significantly elevated, and its inhibition notably reduced neuronal apoptosis. Our findings indicate that miR-15b-5p enhances OGD/R-induced neuronal apoptosis through the HTR2C-ERK signaling pathway. TAT RVG-Exo + miR-15b-5p inhibitor demonstrated enhanced ability to traverse the BBB and target the peri-infarct region in cerebral I/R injured mice, exhibiting superior protective effects against cerebral I/R injury. TAT and RVG co-modified MSC-derived exosomes-mediated delivery of microRNA-15b-5p inhibitor alleviate cerebral I/R-induced neuronal apoptosis by promoting HTR2C-ERK signaling, which offers a potentially effective new treatment for cerebral I/R injury.

BackgroundMigraine is a highly prevalent neurological disorder that significantly impairs quality of life. Understanding the comparative effectiveness and safety of oral preventive medications is essential to guide treatment decisions in adult patients. This study aims to evaluate and compare the efficacy and safety of oral pharmacological therapies for migraine prevention in adults using Network Meta-Analysis.MethodsA comprehensive search was conducted across The Cochrane Library, PubMed, SCOPUS, and Embase databases until 15 December 2024 to find relevant studies on preventing migraine among adult populations. Clinical trials involving adult individuals with migraine who received oral pharmacological interventions were included. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, data extraction was independently conducted by five researchers in duplicate. Model choice was based on heterogeneity with random-effects used for I2 ≥ 50% and fixed-effects for I2 < 50%. The main endpoint was the monthly frequency of migraine attacks. Secondary endpoints encompassed the response rate of ≥50%, migraine duration, pain intensity, and quality of life (QoL). Adverse events were assessed.ResultsFrom the 17,443 identified citations, we included 44 trials (4,612 participants) in our analysis. Topiramate, valproate, and propranolol demonstrated significant efficacy in the prevention of migraines. Memantine, melatonin, and vitamin D3 also showed potential preventive effects. Combination therapies, such as flunarizine plus topiramate, valproate plus magnesium, or folic plus pyridoxine, were associated with greater efficacy in migraine prevention compared to monotherapy and with a lower incidence of adverse events. Topiramate, flunarizine, propranolol, valproate, amitriptyline, cinnarizine, and nortriptyline were associated with improvements in quality of life (QoL), but these findings were based on limited evidence. Valsartan and a-dihydroergocryptine were linked to reduced migraine frequency, but these results were largely derived from single studies and require confirmation through larger, high-quality trials.ConclusionThis network meta-analysis confirmed the significant efficacy of topiramate, valproate, and propranolol in migraine prevention and identified potential benefits of memantine, melatonin, vitamin D3, and combination therapies. These findings provide evidence-based treatment options for migraine prevention and suggest promising directions for future research.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42024621316, Identifier: PROSPERO, CRD42024621316.

The toxic side effects of acetyl tributyl citrate (ATBC) on humans are concerning, but studies related to its effects on osteoarthritis (OA) are lacking. Therefore, this study aimed to explore the potential targets and mechanisms of action of ATBC in OA through network toxicology. We obtained ATBC-related targets from the ChEMBL, Swiss Target Prediction, and STITCH databases and OA-related targets from the GeneCards, DisGeNET, and OMIM databases and identified overlapping targets. Core targets (key molecules in the progression of diseases) were determined via the STRING database and Cytoscape software, followed by further Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses to determine potential mechanisms in depth. Moreover, a gene interaction and competing endogenous RNA (ceRNA) network for the core targets was constructed. Additionally, the expression levels of the core targets were preliminarily validated using single-cell data from the GEO database. Furthermore, in-depth validation of the core targets was carried out through molecular docking and molecular dynamics simulations. A total of 132 overlapping targets between ATBC and OA were identified, and six core targets (TP53, EZH2, HDAC1, HDAC2, SIRT1, and SMARCA4) were further screened. The results of the enrichment analysis revealed that the core pathways related to the effect of ATBC on OA mainly involved key signaling cascades, including the thyroid hormone signaling pathway, the Notch signaling pathway, and cellular senescence. Single-cell analysis revealed that the core target is expressed in different cell subpopulations. Molecular docking and molecular dynamics simulation results indicate that there is a stable binding interaction between ATBC and the core target. This study provides a theoretical foundation for the molecular mechanisms of OA triggered by ATBC, highlighting the value of network toxicology in assessing the toxicity of emerging environmental pollutants. However, further clinical and experimental investigations are needed to validate these findings.

Pesticide residues in cultivated herbal medicines pose significant health risks, with phorate (PHO) and dichlorodiphenyltrichloroethane (DDT) being of particular concern due to their high toxicity and persistence. Current detection methods, such as gas chromatography and mass spectrometry (GC-MS) and liquid chromatography and mass spectrometry (LC-MS), are often limited by their complexity, time consumption, and the need for specialized equipment, hindering rapid and on-site analysis. In this study, integrated the high sensitity of time-resolved fluorescent microspheres (TRFM) and the simplicity and cost-effectiveness of lateral flow immunoassay (LFIA), we creates a time-resolved immunochromatographic test strip (TRFIS) for simultaneously detection of PHO and DTT residues in herbal medicines. After systematically optimizing the TRFIS preparation and detection parameters and extraction solvents, this TRFIS enables for simultaneously quantitative detection of PHO and DDT within 12 min with limit of detections (LODs) of 0.0975 ng/g for PHO and 0.116 ng/g for DDT. Besides, the detection performance of the TRFIS is highly reproducible, with the intra-batch and inter-batch coefficients of variation (CV)% below 8 %. Additionally, the results of the TRFIS for detecting PHO/DDT residues are credible, with a significantly high correlation to the gold standard methods GC-MS and LC-MS (R2 = 0.9891). Collectively, our developed TRFIS offers a promising platform for simultaneous detection of PHO and DDT residues in herbal medicines, with the advantages of simple operation, high sensitivity, rapid determination, cost-effectiveness, and on-site detection.

Introduction The incidence of cerebral ischemia-reperfusion injury (I/R) is complex which seriously threatens the life safety of patients. Neither its prevention nor its treatment has been successful so far. Proteins that bind to DNA and belong to the C2/H2 zinc finger family are known as Krüppel-like factors (KLFs). Among them, KLF6 plays a vital role in proliferation, metabolism, inflammation, and damage responses, although its function in I/R remains largely unexplored. Methods In this study, we induced cerebral ischemia in rats using the middle cerebral artery occlusion (MCAO) model. Neural function, cerebral infarction volume, cognitive function, cortical pathological lesions, ferroptosis, and oxidative stress were measured. Results Our findings indicated that the MCAO model exhibited signs of ferroptosis and a concurrent increase in KLF6 levels. Inhibition of KLF6 resulted in a significant decrease in the escape latency during swimming tests ( p < .05), an increase in the frequency of platform crossings, and prolonged duration in the target quadrant compared to the control group. Additionally, silencing KLF6 mitigated MCAO-induced brain injury and reduced oxidative stress and ferroptosis, as evidenced by altered levels of Nrf2/HO-1 signaling proteins. Discussion In conclusion, our results suggest that silencing KLF6 may protect against MCAO-induced pyroptosis, oxidative stress, and neurological dysfunction by inactivating the Nrf2/HO-1 signaling pathway. This study offers new perspectives on the molecular mechanisms related to MCAO and emphasizes the significance of targeting KLF6 for future therapeutic approaches.

Multiple sclerosis（MS） is an immune-mediated disease characterized by inflammatory demyelination of the central nervous system, with pathogenesis remaining unclear. The economic burden of western medicine treatment is heavy, and adverse reactions are common. Professor Tu Jinwen believes that MS can be classified into the categories of "atrophy-flaccidity diseases" and "impediment diseases", and its pathogenesis is mainly attributed to the yin and yang deficiency of the liver and the kidney, deficiency of qi and blood, qi stagnation and blood stasis, wind cold and dampness-heat. It is distinguished by yin and yang. Following the principle of harmonizing yin and yang, Duhuo Jisheng Decoction combined with Huangqi Guizhi Wuwu Decoction and Simiao Pills with modifications can be used to treat MS, and good efficacy can be achieved.

Network Meta-analysis was employed to compare the efficacy of Chinese medicine injections for activating blood and resolving stasis combined with conventional western medicine in the treatment of acute ischemic stroke and the effects on platelet aggregation rate, fibrinogen(FIB), and hypersensitive C-reactive protein(hs-CRP), with a view to providing evidence-based medicine reference for clinical medication. CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library, and EMbase were searched for randomized controlled trial(RCT) on the treatment of acute ischemic stroke with Salvia Miltiorrhiza Ligustrazine Injection, Danhong Injection, Shuxuetong Injection, Xueshuantong Injection, Shuxuening Injection, Safflower Yellow Pigment Injection, and Ginkgo Diterpene Lactone Meglumine Injection combined with conventional western medicine. The retrieval time was from database inception to March 18, 2023. The articles were extracted by two researchers and their quality was evaluated. R 4.2.2 was used for network Meta-analysis. A total of 87 RCTs involving 8 580 patients were included. Network Meta-analysis showed that, in terms of reducing National Institutes of Health stroke scale(NIHSS) scores, the surface under the cumulative ranking curve(SUCRA) showed the order of Xueshuantong Injection + conventional western medicine(88.7%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(73.7%) > Shuxuetong Injection + conventional western medicine(69.7%) > Shuxuening Injection + conventional western medicine(51.8%) > Danhong Injection + conventional western medicine(43.7%) > Safflower Yellow Pigment Injection + conventional western medicine(36.8%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(35.3%) > conventional western medicine(1.7%). In terms of improving clinical total effective rate, SUCRA showed the order of Danhong Injection + conventional western medicine(63.0%) > Shuxuening Injection + conventional western medicine(59.0%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(58.9%) > Safflower Yellow Pigment Injection + conventional western medicine(57.1%) > Xueshuantong Injection + conventional western medicine(56.8%) > Shuxuetong Injection + conventional western medicine(54.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(50.5%) > conventional western medicine(0.03%). In terms of improving Barthel index, SUCRA showed the order of Danhong Injection + conventional western medicine(84.7%) > Shuxuetong Injection + conventional western medicine(72.4%) > Safflower Yellow Pigment Injection + conventional western medicine(61.6%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(44.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(43.2%) > Shuxuening Injection + conventional western medicine(42.2%) > conventional western medicine(1.4%). In terms of reducing platelet aggregation rate, SUCRA showed the order of Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(82.4%) > Shuxuetong Injection + conventional western medicine(81.6%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(40.7%) > Danhong Injection + conventional western medicine(37.3%) > conventional western medicine(8.0%). In terms of reducing FIB, SUCRA showed the order of Danhong Injection + conventional western medicine(81.0%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(71.9%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(70.0%) > Shuxuetong Injection + conventional western medicine(46.7%) > Xueshuantong Injection + conventional western medicine(22.6%) > conventional western medicine(8.7%). In terms of reducing hs-CRP, SUCRA showed the order of Shuxuening Injection + conventional western medicine(89.9%) > Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine(78.8%) > Ginkgo Diterpene Lactone Meglumine Injection + conventional western medicine(52.4%) > Danhong Injection + conventional western medicine(47.6%) > Xueshuantong Injection + conventional western medicine(43.5%) > Shuxuetong Injection + conventional Western medicine(35.6%) > conventional western medicine(2.3%). The results indicated that Xueshuantong Injection + conventional western medicine, Danhong Injection + conventional western medicine, and Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine ranked the top three. Xueshuantong Injection + conventional western medicine had the best effect on reducing NIHSS scores. Danhong Injection + conventional western medicine showed the best performance of improving clinical total effective rate, improving Barthel index, and reducing FIB in the blood. Salvia Miltiorrhiza Ligustrazine Injection + conventional western medicine had the best effect on reducing platelet aggregation rate in the blood. Shuxuening Injection + conventional western medicine had the best effect on reducing hs-CRP. However, more high-quality RCTs are needed for verification in the future to provide more reliable evidence-based medical reference.

Background: Herbal medicine can provide adjunctive therapy for adults with post-stroke depression. This study summarizes the latest evidence regarding the harms and benefits of herbal antidepressants.Methods: The literature searched from the Cochrane Library (using the OVID platform), Embase, PubMed, the China National Knowledge Infrastructure (CNKI), the Wan Fang Data Knowledge Service Platform, and the China Scientific Journal Database (VIP) from their inception to 18 August 2021, for randomized controlled trials of herbal medicine in adults with post-stroke depression, were included in this systematic review and network meta-analysis. The search was updated on 1 December 2022. To summarize the evidence, the frequentist random-effect network meta-analyses were conducted. To categorize interventions, rate the certainty of the evidence, and present the findings, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) frameworks were carried out. The registration number of this study on PROSPERO website is CRD 42021273956.Findings: Of 1132 citations identified from the search, 51 randomized clinical trials, totaling 4,507 participants, met the inclusion criteria for this study. For response rate, Shugan Jieyu capsule (SJC) plus selective serotonin reuptake inhibitors (SSRI), Jie-Yu Pills plus SSRI, and Wuling capsule plus SSRI were shown to be among the most effective with moderate certainty of evidence (RR: 1·45, 95%CI: 1·23 to 1·7; RR: 1·35, 95%CI: 1·09 to 1·68; RR: 1·32, 95%CI: 1·09 to 1·59). In terms of mean changes in Hamilton depression scale (HAMD) score after the completion of treatment, Wuling capsule plus Hypericum and Wuling capsule plus SSRI were found to be among the most effective in reducing symptoms of depression with moderate certainty of evidence (MD: 10·12, 95%CI: −17·25 to −2·99; MD: −3·81, 95%CI: −6·19 to −1·42). The network meta-analysis (NMA) showed that SJC may be a safer intervention than SSRI in terms of both total gastrointestinal and total nervous system events with moderate certainty of evidence (RR:0.34, 95%CI:0.18, 0.62 and RR: 0.11, 95%CI: 0.03, 0.35, respectively).Interpretation: SJC plus SSRI, Jie-Yu Pills plus SSRI, and Wuling capsule plus SSRI were among the most effective in terms of HAMD score reduction response rates. Low to very low certainty of evidence revealed no increased risk of gastrointestinal and nervous system events.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=273956; Identifier: CRD42021273956.

The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine (TCM) and Western medicine (WM) is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world. First, clinical practice guidelines (CPGs) of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives: (1) perspective of TCM and WM integration in guidelines, (2) diagnosis Using integrated TCM and WM, (3) integration of TCM and WM treatment, (4) promoting TCM and WM integration. Secondly, the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020-2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines. And last this study aimed to lay a foundation for the further establishment of Chinese characteristic, repeatable, and calculable clinical practice guidelines of TCM and WM integration.

逍遥散是健脾疏肝的重要方剂,也是养血调肝的基础用方.凃晋文教授在临证中常灵活运用逍遥散治疗,根据不同疾病辨证分析,灵活施治,用于治疗多种神经系统疾病,疗效确切.该文介绍凃晋文教授运用逍遥散治疗特发性震颤、失眠、原发性头痛的验案,以期为临床诊疗提供新的思路.

凃晋文教授对神经系统疑难疾病治疗经验丰富,尤其对小脑型多系统萎缩的治疗有独到见解.本文从小脑型多系统萎缩的病因病机、治疗方法、典型病例等方面对凃晋文教授治疗该病证的经验进行介绍,从而丰富和发展多系统萎缩的中医治疗方法.

俗话说,养好大脑,身心不老.中医认为,脑为元神之府、精髓之海,是生命的枢机,主宰人体的生命活动、精神意识、感觉运动等.人步入老年后,易出现记忆力减退、精神不振、反应迟钝、头晕眼花等问题.因此,老年人在养生的过程中,要特别注重健脑.

毒损脑络与毒损脉络是现代阐释中风病发生发展的重要学说,其"毒邪可破坏形体,损伤脑络"之论在对症状性颅内动脉粥样硬化性狭窄(简称症状性脑动脉狭窄)发病的认识中亦具有重要意义.通过阐释本病正气虚的发病基础,详述火毒、浊毒等毒损证素对脑血管狭窄的影响,分析"络虚—络滞—络损"病理演变过程,总结络虚毒损是症状性脑动脉狭窄的核心病机;治疗以扶正、解毒与通络分阶段并行,细分补气解毒与清热解毒之别,强调分期治疗,为临床治疗该病提供新的思路与方法.

目的 系统评价活血类口服中成药联合阿替普酶静脉溶栓术对急性脑梗死神经功能、凝血功能及出血风险的影响.方法 计算机检索中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊全文数据库(VIP)、万方数据库、中国临床试验注册中心、PubMed、the Cochrane Library、Web of Science、和Embase数据库中活血类口服中成药联合阿替普酶静脉溶栓术治疗急性脑梗死的临床随机对照试验(RCTs),检索时间均为建库至2021年7月1日,依据RoB量表评价偏倚风险,用RevMan 5.4软件进行Meta分析.结果 共纳入13个RCTs,Meta分析结果显示:相较于对照组,阿替普酶静脉溶栓术联用活血类口服中成药更能提高临床总有效率[OR=3.42,95％CI(2.25,5.18),P＜0.000 01];改善美国国立卫生研究院卒中量表评分[MD=-3.21,95％CI(-4.02,-2.40),P＜0.00001]、延长活化部分凝血活酶时间[MD=3.47,95％CI(1.84,5.09),P＜0.000 1]及凝血酶原时间[MD=1.15,95％CI(0.36,1.94),P=0.004];降低纤维蛋白原水平[MD=-0.69,95％CI(-1.10,-0.29),P=0.000 7];两组出血不良反应发生率比较,差异无统计学意义[RR=0.17,95％CI(0.02,1.34),P=0.09].结论 活血类口服中成药联合阿替普酶静脉溶栓术可提高急性脑梗死患者的临床总有效率,改善神经功能缺损评分及凝血功能,进一步促进神经功能恢复、血栓溶解,且安全性较好.但受限于文献质量,尚需更多严格设计的RCTs以进一步验证.

目的 探讨基于子午流注法的辨证施乐对急性脑梗死患者焦虑情绪及生活质量的影响.方法 选取2021年1月至12月于湖北省中医院住院的76例急性脑梗死合并焦虑症患者,根据随机数字表法将其分为观察组(38例)和对照组(38例).两组均采用基础治疗、康复与护理常规,观察组在此基础上联合子午流注法辨证实施音乐治疗.两组均干预14d,比较干预前后两组汉密尔顿焦虑量表(HAMA)、焦虑自评量表(SAS)、健康调查量表36(SF-36)评分及睡眠脑电图参数变化.结果 干预后,两组HAMA、SAS评分均低于干预前,且观察组低于对照组,差异有统计学意义(P＜0.05).干预后,两组SF-36中躯体疼痛、生理职能、情感职能评分均高于干预前,观察组总体健康、活力、社会功能、精神健康评分均高于本组干预前,且观察组躯体疼痛、生理职能、总体健康、活力、社会功能、情感职能、精神健康评分均高于对照组,差异有统计学意义(P＜0.05).干预后,两组睡眠潜伏期、觉醒时间低于干预前,睡眠总时间长于干预前,观察组觉醒次数低于本组干预前,且观察组睡眠潜伏期、觉醒时间、觉醒次数均低于对照组,睡眠总时间长于对照组,差异有统计学意义(P＜0.05).结论 结合子午流注法的辨证施乐可提高急性脑梗死患者睡眠质量,有效改善该类患者焦虑情绪及生活质量,临床效果显著.

To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction. CNKI, CBM, Wanfang, VIP, PubMed, Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P. notoginseng saponins in the treatment of acute cerebral infarction. The retrieval time was from the time of database establishment to January 2021. After two researchers independently screened out the literature and extracted the data, AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews, GRADE system was used to grade the quality of evidences of the outcome indicators, and the efficacy evaluation was summarized. A total of 5 systematic reviews were included. AMSTAR-2 evaluation results showed that 3 items were relatively complete, while 4 items had a poor overall quality. P. notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function, enhancement of the total effective rate in clinic, and improvement of activities of daily living. GRADE evaluation results showed that the quality of evidence was from low quality to very low quality. In conclusion, in the treatment of acute cerebral infarction, P. notoginseng saponins can improve the clinical efficacy, with a good safety but a not high methodological quality and a low evidence quality. It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P. notoginseng saponins in the treatment of acute cerebral infarction.

《医学正传》谓:"麻者,非痒非痛,……唧唧然不知痛痒,如绳扎缚初松之状"[1].《医学入门》云:"木者,不痒不痛,按之不知,搔之不觉,如木之厚"[2].临床上肢体麻木可见于多种疾病,如颈腰椎病变、脑血管病变、植物神经功能紊乱、贫血等,常采用营养神经、扩张血管、改善微循环等对症治疗,虽可短时间起到一定缓解作用,但容易反复发作,远期疗效欠佳.凃晋文教授为国家级名老中医,首届湖北中医大师,第3、4 批全国名老中医药专家学术经验继承工作指导老师,其耕耘杏林近 60 载,治学严谨,精通医理.凃晋文教授从肢体麻木的根本病机出发,采用传统中医药辨证论治,取得良好的效果.笔者有幸侍诊抄方,亲聆教诲,受益匪浅,现将凃教授治疗肢体麻木的部分案例及个人体会整理如下,以飨读者.

Oxidative stress-induced neuronal damage is a main cause of ischemia/reperfusion injury. Curcumin (Cur), the principal constituent extracted from dried rhizomes of Curcuma longa L. (turmeric), exhibits excellent antioxidant effects. Previous studies have indicated that miR-1287-5p was downregulated in patients with ischemic stroke. Additionally, we predicted that Lon Peptidase 2, Peroxisomal (LONP2), which is involved in oxidative stress regulation, is targeted by miR-1287-5p. The aim of the current study is to investigate the effect of Cur on ischemia/reperfusion damage and its underlying mechanism. To mimic ischemia/reperfusion damage environment, SH-SY5Y cells were subjected to oxygen-glucose-deprivation/reperfusion (OGD/R). OGD/R treatment downregulated miR-1287-5p and upregulated LONP2 in SH-SY5Y cells, but Cur alleviated OGD/R-induced oxidative damage and reversed the effect of OGD/R on the expression of miR-1287-5p and LONP2. Furthermore, we confirmed the interactive relationship between miR-1287-5p and LONP2 (negative regulation). We revealed that miR-1287-5p overexpression alleviated OGD/R-induced oxidative damage alleviation, similar to the effect of Cur. MiR-1287-5p inhibition accentuated OGD/R-induced oxidative damage in SH-SY5Y cells, which was reversed by Cur. The expression of LONP2 in OGD/R-treated SH-SY5Y cells was decreased by miR-1287-5p overexpression and increased by miR-1287-5p inhibition, and Cur counteracted the increase in LONP2 expression induced by miR-1287-5p inhibition. In conclusion, we suggest that Cur alleviates OGD/R-induced oxidative damage in SH-SY5Y cells by regulating the miR-1287-5p/LONP2 axis. The findings provide a theoretical basis for the clinical application of curcumin.

Background Parkinson’s disease (PD) is a prevalent neurodegenerative disease. Long noncoding RNA small molecule RNA host gene 1 (SNHG1) has been reported to play critical roles in Parkinson’s disease (PD) progression. The study aimed to further elucidate the mechanism of SNHG1 in PD pathogenesis. Methods The levels of SNHG1, miR-125b-5p and mitogen-activated protein kinase 1 (MAPK1) were determined by quantitative real-time polymerase chain reaction (qRT-PCR) or Western blot. Cell viability and apoptosis were evaluated by Cell Counting Kit-8 (CCK-8) assay and flow cytometry, respectively. The activity of Caspase-3 or Caspase-9 was measured using a Caspase-3 or Caspase-9 Assay Kit. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, lactic dehydrogenase (LDH) activity, reactive oxygen species (ROS) generation and superoxide dismutase (SOD) activity were gauged by enzyme-linked immunosorbent assay (ELISA). Dual-luciferase reporter assay was performed to identify the relationship between miR-125b-5p and SNHG1 or MAPK1. The MPTP-induced PD mouse was used as an in vivo model of PD and MPP+-treated SK-N-SH and MN9D cells were used as in vitro models of PD. Results SNHG1 and MAPK1 were significantly up-regulated while miR-125b-5p was down-regulated in the MPTP-induced PD mouse model and MPP+-induced PD cell models. SNHG1 silence or miR-125b-5p overexpression protected against MPP+-evoked apoptosis, oxidative stress and inflammation in SK-N-SH and MN9D cells. Moreover, SNHG1 acted as a molecular sponge of miR-125b-5p, and the protective impact of SNHG1 silence on MPP+-evoked cell damage was reversed by miR-125b-5p inhibition. Furthermore, MAPK1 was a functional target of miR-125b-5p and its overexpression attenuated the effects of miR-125b-5p restoration in MPP+-triggered cell injury. In addition, the behavioral changes in MPTP-induced PD mouse in vivo model were relieved by SNHG1 silence. Conclusion SNHG1 knockdown exerted neuroprotective effects in MPP+-evoked cytotoxicity through regulating the miR-125b-5p/MAPK1 axis both in human and mouse PD cell models, highlighting a possible target for PD therapy.