ETHNOPHARMACOLOGICAL RELEVANCE:According to traditional Chinese medicine (TCM) theory, post-traumatic stress disorder (PTSD) is a kind of depression syndrome, and its occurrence is related to deficiencies of the heart and kidney. Polygonatum cyrtonema Hua replenishes Qi and blood and tonifies the five zang organs, so it is widely used in TCM as a prescription for the treatment of depression syndrome. The polysaccharides in P. cyrtonema Hua (PSP) are the main active components of the herb, but the effects of PSP on PTSD and the mechanisms remain unclear.AIM OF THE STUDY:To investigate the preventive effect of PSP on PTSD-like behaviors and to determine the mechanisms.METHODS:We used behavioral tests to evaluate PTSD-like behaviors in mice. Synaptic changes were assessed by transmission electron microscopy. Hematoxylin-eosin staining was used to assess pathological changes to the hippocampus, and immunofluorescence staining was used to observe changes in astrocytes. Serum corticosterone (CORT), cytokine, and hippocampal oxidation-related indicator levels were evaluated by ELISA. We detected the expression levels of synaptic, oxidative, and inflammation-related proteins in the hippocampus by western blotting.RESULTS:Single prolonged stress (SPS)-modeled mice exhibited significant PTSD-like phenotypes, including increased fear memory acquisition and anxiety-like behaviors. These behavioral changes were prevented by PSP administration. Compared to controls, SPS modeling increased serum CORT, cytokine, and hippocampal malondialdehyde levels; decreased superoxide dismutase activity; and caused losses in pyramidal neurons, astrocytes, and synapses in the CA1 region. At the molecular level, the expression of brain-derived neurotrophic factor, postsynaptic density protein 95, nuclear factor erythroid 2-related factor 2 (Nrf2), phospho-tyrosine kinase receptor B, activity-regulated cytoskeleton-associated protein, heme oxygenase-1 (HO-1), and GluA1 decreased in SPS mice compared with the control group, while the expression of NOD-like receptor protein 3 (NLRP3), GluN2B, and apoptosis-associated speck-like protein increased in SPS mice. Treatment with PSP counteracted these abnormal changes. Importantly, ML385, an Nrf2 inhibitor, blocked PSP's ability to ameliorate PTSD behaviors and abnormal protein expression. The NLRP3 inhibitor MCC950 reduced the PTSD-like behaviors and normalized protein expression in SPS mice.CONCLUSION:PSP prevents SPS-induced PTSD-like behaviors and synaptic damage by regulating oxidative stress and NLRP3-mediated inflammation, probably in an Nrf2/HO-1 signaling pathway-dependent manner.

BACKGROUND:G1 is a specific agonist of G protein-coupled estrogen receptor 1 (GPER1), which binds and activates GPER1 to exert various neurological functions. However, the preventive effect of G1 on post-traumatic stress disorder (PTSD) and its mechanisms are unclear. OBJECTIVE:To evaluate the protective effect of G1 against synaptic and mitochondrial impairments and to investigate the mechanism of G1 to improve PTSD from brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrkB) signaling. METHODS:This study initially detected GPER1 expression in the hippocampus of single prolonged stress (SPS) mice, utilizing both Western blot and immunofluorescence staining. Subsequently, the effects of G1 on PTSD-like behaviors, synaptic, and mitochondrial functions in SPS mice were investigated. Additionally, the involvement of BDNF/TrkB signaling involved in the protection was further confirmed using GPER1 antagonist and TrkB inhibitor, respectively. RESULTS:The expression of GPER1 was reduced in the hippocampus of SPS mice, and G1 treatment given for 14 consecutive days significantly improved PTSD-like behaviors in SPS mice compared with model group. Electrophysiological local field potential (LFP) results showed that G1 administration for 14 consecutive days could reverse the abnormal changes in the gamma oscillation in the CA1 region of SPS mice. Meanwhile, G1 administration for 14 consecutive days could significantly improve the abnormal expression of synaptic proteins, increase the expression of mitochondria-related proteins, increase the number of synapses in the hippocampus, and ameliorate the damage of hippocampal mitochondrial structure in SPS mice. In addition, G15 (GPER1 inhibitor) and ANA-12 (TrkB inhibitor) blocked the ameliorative effects of G1 on PTSD-like behaviors and aberrant expression of hippocampal synaptic and mitochondrial proteins in SPS mice and inhibited the reparative effects of G1 on structural damage to hippocampal mitochondria, respectively. CONCLUSION:G1 improved PTSD-like behaviors in SPS mice, possibly by increasing hippocampal GPER1 expression and promoting BDNF/TrkB signaling to repair synaptic and mitochondrial functional impairments. This study would provide critical mechanism for the prevention and treatment of PTSD.

BACKGROUND:Neurovascular glial unit (NVGU) dysfunction has been reported to be an early and critical event in the pathophysiology of Alzheimer's disease (AD) and vascular dementia (VD). Although herbal medicines, with their favorable safety profiles and low adverse effects, have been suggested to be useful for the treatment of cognitive impairment, the potential role of the NVGU as the target of the effects of herbal medicines is still unclear.PURPOSE:This review aimed to retrieve evidence from experimental studies of phytopharmaceuticals targeting the NVGU for the treatment of cognitive impairment in AD and VD, and discussed the potential of phytopharmaceuticals to improve cognitive impairment from the perspective of the NVGU.STUDY DESIGN AND METHODS:We systematically searched PubMed, Google Scholar, Web of Science, and CNKI. The keywords used for searching information on the NVGU in the treatment of cognitive impairments included "Alzheimer's disease," "Vascular dementia," "Herbal medicines," "Natural products," "Neurovascular," "Adverse reaction," and "Toxicity, etc." We selected studies on the basis of predefined eligibility criteria.RESULTS:NVGU mainly consists of endothelial cells, pericytes, astrocytes, microglia, oligodendrocytes, and neurons, and damage to these cells can induce cognitive impairment by impairing the blood-brain barrier (BBB) and cerebral blood flow (CBF) as well as neuronal function. The active components of herbal medicines, including Ginkgo biloba L., Ginseng Radix et Rhizoma, Epimedium Folium, Chuanxiong Rhizoma, Carthami flos, and Acorus tatarinowii Schott, as well as traditional Chinese medicine prescriptions have shown the potential to improve BBB function and increase CBF to prevent cognitive impairment by inhibiting astrocyte and microglia activation, protecting oligodendrocyte myelin function, reducing neuronal apoptosis, and promoting angiogenesis.CONCLUSIONS:Herbal medicines demonstrate great potential to prevent cognitive impairment. Multiple components from herbal medicines may function through different signaling pathways to target the NVGU. Future studies using novel drug-carrier or delivery systems targeting the NVGU will certainly facilitate the development of phytopharmaceuticals for AD and VD.

目的 运用关联规则和复杂系统熵聚类分析耳穴贴压治疗糖尿病合并失眠的选穴规律.方法 计算机检索中国知网、万方数据库、维普网、中国生物医学文献数据库中有关耳穴贴压治疗糖尿病合并失眠的相关研究,检索时限均为建库至2023年1月.采用Excel 2019建立耳穴处方数据库,并采用中医传承辅助平台进行数据分析.结果 最终纳入文献81篇,涉及耳穴27个,糖尿病合并失眠高频证型为心脾两虚、肝郁化火、心胆气虚、痰热内扰.高频耳穴为神门、皮质下、交感等;得到由神门、心、皮质下、交感交叉配伍组成的耳穴组合8组,获取强关联耳穴组合规则14条.提取包含3个耳穴的核心组合15组;演化出耳穴新方5个,包括心、额、颞、肾;心、垂前、睡眠深沉穴、失眠;肝、垂前、脑点、胃、脾;额、内分泌、交感、口;胃、脾、胰胆、肝、肾、胆.结论 本次研究发现的配伍规律、核心组合及耳穴新方,可为今后护理人员使用耳穴贴压治疗糖尿病合并失眠的临床选穴提供新的思路与启发.

目的 对中医护理适宜技术临床研究中设置安慰对照组别的随机对照研究进行范围综述.方法 按照范围综述的方法框架,计算机检索八大数据库建库至2023年8月26日的中英文文献,并对文献进行提取,收集并总结.结果 初检获得4087篇文献,最终纳入36篇文献,15项中医护理适宜技术设置了安慰对照组,以治疗疼痛性疾病为主.安慰对照主要通过降低刺激强度、改变施术部位及更换介质实现.结论 未来护理研究者应重点关注安慰剂效应控制的影响因素,强化安慰对照意识,完善已有的对照形式,并积极探索新的效应控制途径,促进中医护理适宜技术临床研究高质量证据的产生.

目的 评价终止高血压膳食疗法(dietary approaches to stop hypertension,DASH)对糖尿病患者代谢结局水平的影响.方法 检索中英文共 10 个数据库中关于DASH饮食干预糖尿病的随机对照试验及队列研究,检索时限为建库至 2022 年12 月.2 名研究者独立进行文献筛选、资料提取、文献质量评价.运用RevMan 5.4 软件对RCT进行Meta分析,对队列研究进行描述性分析.结果 纳入9 项研究(8 项RCT、1 项队列研究),共990 名患者.Meta分析结果显示,与对照组相比,DASH饮食在空腹血糖水平、空腹胰岛素水平、胰岛素抵抗稳态模型水平、总谷胱甘肽水平、总抗氧化能力水平方面有统计学差异(P<0.05).在糖化血红蛋白、超敏C-反应蛋白方面,两组差异无统计学意义.同时,队列研究结果表明,DASH饮食在改善空腹胰岛素、胰岛素抵抗稳态模型水平方面,差异无统计学意义(P=0.89,P=0.55).结论 DASH饮食可改善糖尿病患者多项代谢指标,但仍需更多高质量的大样本研究予以验证.

药食同源中药干预糖尿病的药理作用机制主要有改善胰岛素抵抗、抑制炎症反应、抗氧化应激、调节糖脂代谢紊乱等.药食同源中药可以改善糖尿病微血管病变,在糖尿病肾病、糖尿病视网膜病变、糖尿病心肌病、糖尿病周围神经病变中被广泛应用.基于降血糖药食同源中药的作用特点,在临床治疗和日常食疗保健中应注意以下几个问题:①目前,药食同源性降糖中药治疗糖尿病的研究大多处于动物实验阶段,而实验研究时动物模型的制备方法以及模型的判定尚未形成统一标准,且临床试验较少.未来的研究应使用现代科学方法,深入开展系统性的药理作用机制研究,为药食同源中药治疗糖尿病及其并发症机制研究提供更多依据.②应明确各类药食同源中药的降血糖活性成分作用以及其对应治疗的中医证型,为临床辨证分型和辨证论治提供依据.由于现有研究质量的局限,药食同源中药降糖产品目前处于缓慢发展阶段,今后,需要在辨证论治和辨证施食的基础上,开展更多大样本、多中心的试验,探索药食同源中医药治疗糖尿病的作用机制.

目的:对穴位贴敷干预慢性阻塞性肺疾病的系统评价和Meta分析进行质量评价.方法:计算机检索Web of Science、the Cochrane Library、EMbase、PubMed、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普期刊(VIP)和万方数据服务平台(Wanfang)中穴位贴敷干预慢性阻塞性肺疾病的系统评价/Meta分析,检索时限为建库起至2022 年4 月.两名研究人员按照纳排标准独立筛选文献、提取数据,并运用AMSTAR 2、GRADE 进行方法学质量和证据质量评价.结果:最终纳入9 篇Meta分析,使用AMSTAR 2 行方法学质量评价,发现9 篇文献均为极低质量.GRADE证据分级显示,在39 个结局指标中,中等质量 14 个,低质量 18 个,极低质量7 个,无高级别证据.结论:穴位贴敷干预慢性阻塞性肺疾病有低质量循证医学证据支持,但系统评价方法学质量较低,且证据质量等级不高,有待进一步研究考证.

目的:运用关联规则和复杂系统熵聚类分析治疗儿童和青少年近视的选穴规律.方法:计算机检索中国知网(CNKI)、万方(Wan-fang)、维普(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of science、Embase等中英文数据库自建库以来有关耳穴贴压治疗儿童青少年近视的临床研究,建立耳穴处方数据库,并采用中医传承辅助平台(V2.5)进行数据分析.结果:最终纳入文献 231 篇,包含61310 例患者,涉及耳穴51 个;选穴数量多为6～8 个,干预周期平均6.5 周;高频耳穴为肝穴、眼穴、肾穴等;得到由肝穴、眼穴、肾穴、屏间前穴和屏间后穴交叉配伍组成的常用耳穴组合 10 组,获取强关联耳穴组合规则18 条;提取包含3 个耳穴的核心组合19 组;演化出耳穴新方 6 个,包括心穴+脑干穴+胰胆穴+肾穴+脾穴、皮质下穴+角窝中穴+脑干穴+胃穴、屏间后穴+屏间前穴+耳背心穴+肝穴+肾穴、屏间后穴+眼穴+大肠穴+肾穴、脑干穴+新眼穴+胃穴+胰胆穴、交感穴+神门穴+新眼穴+内分泌穴+胰胆穴.结论:本研究探索出的耳穴配伍规律、核心组合及新处方,可为今后临床治疗儿童和青少年近视提供诊治新思路.

目的 借助数据挖掘技术探究穴位贴敷治疗小儿腹泻的选穴规律.方法 系统检索PubMed、知网等中英文数据库有关穴位贴敷治疗小儿腹泻的文献.运用Lantern 5.0、SPSS Modeler 18.0 软件,分别对数据进行症状-穴位隐结构分析和取穴处方关联规则分析.结果 纳入 95 篇文献,涉及 5434 个病例、132 项症状,包括舌淡、神疲、腹痛等;高频穴位有神阙、中脘、足三里,任脉、足阳明胃经、足太阳膀胱经归属多,部位集中在腹、背部及下肢.挖掘穴位配伍关联 3 项,"关元→神阙"支持度最高;证-穴关联 5 项,"风寒证→神阙"支持度最高.分析隐结构模型,得出症-证-穴关联 4 项.结论 穴位贴敷治疗小儿腹泻临床选穴以对症取穴、改善症状为主,并根据脏腑辨证进行配穴加减,实现"标本配穴",为临床辨证施穴提供了理论指导.

目的 应用Meta分析系统评价耳穴贴压防治癌症相关性便秘的临床疗效及对患者生活质量的影响.方法 双人独立检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、The Cochrane Library中有关耳穴贴压防治癌症相关性便秘的随机对照试验,检索时限为建库至2022年6月.运用RevMan5.3软件进行Meta分析.结果 纳入21篇文献,共2 149例患者Meta分析结果显示,试验组总有效率[OR=6.18,95％CI(4.04,9.46),P＜0.000 01]、便秘发生率[OR=0.17,95％CI(0.12,0.22),P＜0.000 01]、生活质量评分[SMD=-2.58,95％CI(-3.37,-1.79),P＜0.000 01]、便秘症状评分[SMD=-1.50,95％CI(-2.38,-0.61),P=0.000 9]高于对照组,两组大便性状评分[MD=3.24,95％CI(-0.37,6.86),P=0.08]、不良反应发生率[OR=1.51,95％CI(0.61,3.73),P=0.37]差异无统计学意义.结论 耳穴贴压可提高癌症相关性便秘的临床疗效,改善生活质量,且安全性较好.

目的 对虚拟现实(virtual reality,VR)在心肺复苏实践教学中应用的研究进行范围审查.方法 采用范围综述的研究范式,检索中英文数据库,系统总结VR在心肺复苏实践教学中应用的设备类型、结局指标、干预效果及存在的问题.结果 共纳入28篇文献,发表于2009-2022年,涉及的VR设备包括桌面式、沉浸式及增强式,我国多采用桌面式VR系统.效果评价包括干预的有效性、实施的可行性及学员的使用体验等.部分学员佩戴VR眼镜时出现晕动感和视觉疲劳,存在按压深度不足等问题.结论 VR在心肺复苏实践教学中的应用效果良好,未来应在5G时代背景下深入优化VR技术,将其与传统培训有机结合,促进VR在医学专业技能教学和急救培训中的应用.

目的 探讨穴位贴敷干预糖尿病周围神经病变的辨证选穴规律,为临床护士穴位贴敷干预提供参考.方法 检索中国知网、PubMed等中英文数据库建库至2021年2月,关于穴位贴敷干预糖尿病周围神经病变的相关文献,采用Lantern5.0及Weka3.8.5进行隐结构、取穴处方关联规则分析.结果 最终纳入43篇文献共3 685例患者,涉及122项症状、37个腧穴.高频腧穴有足三里、三阴交等,高频症状包括四肢麻木、四肢疼痛、神疲等.腧穴频繁项集分析显示,足三里→三阴交支持度最高;隐结构模型分析得出主要证型有阴虚血瘀、肝肾亏虚、痰瘀阻络等;挖掘症状—腧穴频繁项集8项,症状—证型—腧穴频繁项集4项.结论 穴位贴敷干预糖尿病周围神经病变多以足三里、三阴交、阳陵泉、涌泉为主穴,并根据具体证型予以配穴,可作为临床护士辨证选穴参考.

Ginseng has been used in China as a superior medicinal material for thousands of years that can nourish the five internal organs, calm the mind and benefit wisdom. Due to its anti-inflammatory, antioxidant and neuroprotective activities, one of the active components of ginseng, ginsenoside Rg1, has been extensively investigated in the remedy of brain disorders, especially dementia and depression. In this review, we summarized the research progress on the action mechanisms of Rg1 ameliorating depression-like behaviors, including inhibition of hyperfunction of hypothalamic-pituitary-adrenal (HPA) axis, regulation of synaptic plasticity and gut flora. Rg1 may alleviate Alzheimer's disease in the early phase, as well as in the middle-late phases through repairing dendrite, axon and microglia- and astrocyte-related inflammations. We also proposed that Rg1 could regulate memory state (the imbalance of working and aversive memory) caused by distinct stimuli. These laboratory studies would further the clinical trials on Rg1. From the prospective of drug development, we discussed the limitations of the present investigations and proposed our ideas to increase permeability and bioavailability of Rg1. Taken together, Rg1 has the potential to treat neuropsychiatric disorders, but a future in-depth investigation of the mechanisms is still required. In addition, drug development will benefit from the clinical trials in one specific neuropsychiatric disorder.

目的:探究近20年穴位按摩干预术后腹胀的选穴原则与规律,以供临床参考.方法:检索中国知网(CNKI)、万方(Wanfang Data)、维普数据库(VIP)、中国生物医学文献数据库(CBM)与PubMed中有关穴位按摩干预术后腹胀的相关研究,行穴位频次分析、Apriori关联分析.结果:最终纳入186篇文献,涉及穴位58个,腧穴频次580次,得到4条强关联腧穴配伍.应用较广的科室为妇产科、胃肠外科及骨科,其术后腹胀强关联腧穴配伍分别为"上巨虚→足三里""合谷→足三里""中脘→天枢".频次较高的腧穴为足三里、中脘、天枢等8穴,选穴部位集中在上下肢、腹部.足阳明胃经、任脉和手阳明大肠经是常选经络,应用较广的特定穴有下合穴、五输穴、募穴.结论:穴位按摩干预术后腹胀已在临床广泛应用,临床选穴多采用局部选穴和循经取穴,并结合辨证配穴.基于数据挖掘技术得出的高频经络、腧穴配伍对精准干预术后腹胀具有一定的参考意义.