Objective: To evaluate the efficacy of high-intensity focused ultrasound (HIFU) combined with endometrial thermal balloon ablation (TBEA) for treating adenomyosis-related hypermenorrhagia. Methods: This retrospective cohort study included 120 patients diagnosed with adenomyosis-related hypermenorrhagia. Patients were divided into three groups: the HIFU combined with TBEA group (HIFU + TBEA, 34 cases), the HIFU combined with gonadotropin-releasing hormone agonist and intrauterine levonorgestrel intrauterine system (HIFU + GnRH-a + LNG-IUS, 51 cases) group and the HIFU (35 cases) group. Efficacy and safety were assessed using the pictorial blood loss assessment chart (PBAC), dysmenorrhea scores evaluated by the Numerical Rating Scale (NRS), quality of life measured by the Uterine Fibroid Symptom and Quality of Life scale (UFS-QOL), reintervention rates, success rates, satisfaction, and adverse effects at pretreatment and 1, 3, 6, 9, and 12 months posttreatment. Results: The HIFU + TBEA group showed significantly greater reductions in PBAC scores at 6, 9, and 12 months compared to the HIFU + GnRH-a + LNG-IUS group, and consistently lower scores than the HIFU group at all follow-up points. No significant differences in NRS scores or reintervention rates were observed between groups. Additionally, the HIFU + TBEA group reported higher UFS-QOL scores at 6 and 12 months posttreatment and greater satisfaction at 12 months posttreatment. Its success rate exceeded that of the HIFU group but was comparable to the HIFU + GnRH-a + LNG-IUS group. Serious adverse reactions were rare across all groups. Conclusion: HIFU combined with TBEA demonstrates good efficacy and safety, providing an effective long-term treatment option for adenomyosis-related hypermenorrhagia in patients without fertility needs. Synopsis: Evaluating HIFU + TBEA as an effective long-term treatment for adenomyosis-related hypermenorrhagia in patients without fertility needs.

Major depressive disorder (MDD) is a prevalent mental disorder that significantly impacts social and psychological function, but no effective medication is currently available. Circular RNAs (circRNAs) have been reported to participate in the pathogenesis of MDD which are envisioned as promising therapeutic targets. However, nonviral-based delivery strategies targeting circRNA against MDD are not thoroughly investigated. Here, it is identified that circATF7IP is significantly upregulated in plasma samples and positively correlated with 24-Hamilton Depression Scale (HAMD-24) scores of MDD patients. Synergistic amine lipid nanoparticles (SALNPs) are designed to deliver siRNA targeting circATF7IP (si-circATF7IP) into the hippocampus brain region by intranasal administration. Intranasal delivery of SALNP-si-circATF7IP successfully alleviated the depressive-like behaviors in the LPS-induced mouse depression model via decreasing CD11b + CD45 dim microglia population and pro-inflammatory cytokine productions (TNF-α and IL-6). These results indicate that the level of circATF7IP positively correlates with MDD pathogenesis, and SALNP delivery of si-circATF7IP via intranasal administration is an effective strategy to ameliorate LPS-induced depressive-like behaviors.

With development of modern food industry, plant-based milk products are widely used to replace dairy products to cook different kinds of food. Due to different origins, it is necessary to assess the nutrition difference between dairy and plant-based milk products. Phospholipids and unsaturated fatty acids, as the important nutrients in cream and butter, were closely related to body development and health. This study developed a rapid determination of phospholipids and double bonds in creams and butters based on 31P NMR and 1H NMR for nutritional difference assessment. Unsupervised principal component analysis and supervised orthogonal least squares discriminant analysis showed marked differences between dairy and plant-based milk products. Eight compounds were screened by variable importance in projection, fold change and P-value. Furthermore, two biomarkers (phosphatidylserine and phosphatidylethanolamine) were identified to distinguish dairy and plant-based milk products. The study demonstrated that 31P NMR has great potential for rapidly distinguishing milk origins.

Danggui Buxue Decoction is a classic formula containing Astragali Radix and Angelicae Sinensis Radix in a 5:1 ratio and has been extensively used to treat blood deficiency for thousands of years. The aim of the study was to investigate the differences in plasma protein binding, pharmacokinetics, and tissue distribution of Danggui Buxue Decoction in normal and blood-deficient rats by ultra-performance liquid chromatography-tandem mass spectrometry. The effects on peripheral blood routine were verified. The compounds exhibited higher plasma protein binding and absorption in the model group compared to the control group, except formononetin. The six ingredients were distributed widely, and the highest concentrations were detected in the heart and uterus. As has been demonstrated in the previous study of the effect of Danggui Buxue Decoction, its potential is to serve as an effective traditional Chinese medicine formula for treating cardiovascular diseases and impacting estrogenic properties, which reveals the potential target organs of Danggui Buxue Decoction the heart and uterus. Our findings suggested that the absorption and distribution of different components in Danggui Buxue Decoction varies depending on the pathological state, molecular weight, lipid solubility, transporter-mediated efflux, and other factors.

Ethnopharmacological relevance: Coptis chinensis Franch. (CC), as a commonly used heat-clearing and toxin -resolving traditional Chinese herbal medicine, has gained increased attention for its anti-tumor activity. How-ever, little is known about the anti-tumor angiogenesis effect of CC and its possible bioactive components. Also, it has been shown that temperature affects the quality of CC, albeit whether and how it affects the anti-angiogenic activity of CC is currently unknown.Aim of the study: To determine the processing temperatures (40, 60, 80, 120, 140, 150, 160 and 200 degrees C) at which CC has the strongest anti-angiogenic effect and speculate the possible bioactive components.Materials and methods: The q-CAM model was constructed to explore the anti-angiogenesis agents of CC. The angiogenesis inhibition effects of CC samples at different processing temperatures and its seven alkaloids were determined based on morphological observation and vascular area proportion analysis. UPLC-MS/MS was employed to screen the potent active components of CC on anti-angiogenesis.Results: All the intervention by CC at different processing temperatures and its seven alkaloids could inhibit angiogenesis on q-CAM vessels, as evidenced by a poor vasular development in morphological observation and a low vascular area proportion in vascular quantitative analysis, most evident in CC processed at 40 degrees C and pal-matine. LC-MS revealed that palmatine displayed strongest inhibitory effect on q-CAM vessels with a high ab-sorption due to its stable structure. And the maternal nucleus transformation phenomenon of CC alkaloids was found in the quail embryo metabolism.Conclusions: The q-CAM models in conjunction with the UPLC-MS/MS technique could be a useful tool for assessing tumor angiogenesis and screening tumor-targeted medicines. Processing temperature can affect the anti-angiogenesis effect of CC because of its function on the content of alkaloids, and palmatine can be considered as a prospective anti-angiogenic drug.

A novel fluorescent sensor was developed in this study based on glutathione-functionalized graphene quantum dots (GQDs@GSH) to detect organophosphorus pesticide residues in Radix Angelica Sinensis. GQDs@GSH was synthesized by a one-step pyrolysis method with a fluorescence quantum yield as high as 33.9% and its structure was characterized by transmission electron microscopy and X-ray photoelectron spectroscopy. GQDs@GSH exhibited excellent fluorescence property showing strong blue fluorescence under UV irradiation. The fluores-cence of GQDs@GSH could be quenched by Fe3+ by electron transfer and the quenched fluorescence could be recovered due to the strong chelating and reducing ability of phytic acid (PA). Under the catalyzation of acetylcholinesterase (AChE) and choline oxidase (ChOx), acetylcholine (ACh) could be decomposed to H2O2, which could further oxidize Fe2+ to Fe3+ thus quenching the fluorescence of GQDs@GSH once again. Couma-phos, a kind of organophosphorus pesticide, could inhibit AChE activity, thus making the quenched fluorescence turn on again. Several parameters influencing the fluorescence response such as Fe3+, PA, ACh and coumaphos concentration, pH value and reaction time were optimized. Based on such a fluorescence "off-on-off-on" ngkmechanism, GQDs@GSH was successfully applied to the detection of coumaphos in Radix Angelica Sinensis. A good linear relationship between the fluorescence intensity and coumaphos concentration was obtained in the range of 0.1-10.0 mu mol.L- 1. By a standard addition method, the recoveries were measured to be 101.44-117.90% with RSDs lower than 1.98%. The biosensor system is simple, sensitive and accurate. It has a good application prospect in the detection of organophosphorus pesticide residues in traditional Chinese medicine and agricultural products, and also expanded the application scope for glutathione as a highly selective biological molecule.

Objective: To observe the contents of 5-hydroxytryptamine（5-HT） and its metabolite 5-hydroxyindolenacetic acid（5-HIAA） in prefrontal cortex and hippocampus of postpartum depression rats separated from mother and infant, and to explore the intervention effect of different doses of Shenqi Jieyu Formula. Methods: Sixty SD pregnant rats were randomly divided into normal group, model group, high dose group, medium dose group, low dose group and western medicine group. Postpartum depression rats were prepared by mother-infant separation method. After intragastric administration, the behavior of rats was evaluated and the contents of 5-HT and its metabolite 5-HIAA in prefrontal cortex and hippocampus of each group were detected.Results: The forced swim immobility time in the model group was significantly increased compared with that in the normal group（P＜0.01）, and the sucrose water consumption, the open field test level score, and the vertical score were all significantly decreased compared with the normal group（P＜0.01）. The immobility time of forced swimming in the Chinese medicine high-, medium-,and low-dose groups and the western medicine group was significantly decreased compared with that in the model group（P＜0.01）;sucrose water consumption and open field test level scores in the high-, medium-, and low-dose Chinese medicine groups and the western medicine group were increased compared with those in the model group（P＜0.01, P＜0.05）. The vertical scores in the open field test in the high-, medium-dose groups, and western medicine group were significantly increased compared with those in the model group（P＜0.01）. The contents of 5-HT and its metabolite 5-HIAA in the prefrontal cortex and hippocampus in the model group were significantly lower than those in the normal group（P＜0.01）. The contents of 5-HT and its metabolite 5-HIAA in the prefrontal cortex and hippocampus in the high-, medium-and low-dose groups and the western medicine group were all higher than those in the model group（P＜0.01, P＜0.05）. Conclusion: Shenqi Jieyu Formula exerts antidepressant effects by regulating the levels of monoamine neurotransmitters and their metabolites in postpartum depressed rats.

近年来研究发现恶性肿瘤与人体的关系相对独立,既自成一体又与人体有着密切的联系.经过近20年临床考证,胡凯文教授在传统中医肿瘤思想的基础上提出恶性肿瘤是阴阳俱盛的独立产物,于形成期窃取人体阴阳而生,形成后与人体阴阳相对独立的现代中医肿瘤观.故此提出"离决肿瘤阴阳法",即借助现代中医内治、外科手段,只针对恶性肿瘤进行单阴或单阳属性的干预,使肿瘤阴阳失和,阴阳离决而亡.基于此法,在内治用药方面,胡教授提出"引经-入瘤-离决"组方理念;在现代中医外科方面,胡教授提出冷消融"决阳"和热消融"离阴"的治疗理念.经过前期研究与临床验证,"离决肿瘤阴阳法"疗效显著.

腺鳞状细胞癌是一种少见的肺恶性肿瘤病理类型，以前胸壁区域聚集性、多发性蕈状肿物为表现的皮肤转移癌更为罕见。现报道1例以前胸壁聚集性多发蕈状肿物为表现的肺腺鳞状细胞癌皮肤转移病例的诊疗情况并文献复习，以帮助临床对此类皮肤转移癌的早期诊断及治疗。

干燥综合征病机复杂,病情顽固,迁延难愈,且可累及其他系统,与伏毒凶猛、顽固、难治、痼结、杂乱的证候特点相合,可从伏毒论治.正虚毒伏是干燥综合征的基本病机,燥、痰、瘀互结成毒,伏于体内暗耗气血为干燥综合征发病的关键,治疗上通过采用扶正托毒、祛湿化痰消毒、活血化瘀散毒、滋阴清热解毒、调理阴阳等方法扶助正气,祛除伏毒.从伏毒论治干燥综合征能够执简驭繁,便于临床推广应用.

纤维肌痛综合征(FMS)是以周身弥漫性疼痛及睡眠障碍、疲劳、精神障碍等为核心症状群的身心疾病,多归于中医周痹、筋痹、气痹、郁证等范畴."阳气者,精则养神,柔则养筋"出自《素问·生气通天论》,高度概括了阳气具有神、筋共养的作用.基于阳气濡养筋、神的生理功能,结合FMS痹痛与神志异常并发的临床特点,从外邪易侵人体致不通则痛与筋失濡养致不荣则痛两方面,论述阳气不足致筋骨关节疼痛;从阳气亏虚致五脏功能异常进而神失所养论述FMS患者疲劳乏力、情志异常等非疼痛症状.治疗方面以温补阳气为主,内治以补肾助阳为核心,外治以温通督脉为关键,内外同治提高临床疗效,改善患者生活质量.

中医早期常用疮疡代指肿瘤,经过后世的医家不断补充与完善逐渐形成了肿瘤疮疡理论,在很长一段时间内指导中医肿瘤的治疗.随着现代科技的进步,越来越多的肿瘤新特性理论被发现,其中慢性炎症理论及肿瘤内微生物理论为中医肿瘤疮疡理论提供了新的证据.文章旨在基于肿瘤内微生物及肿瘤慢性炎症理论对中医肿瘤疮疡理论的现代化内容进行浅析.

恶性肿瘤为有形之阴邪,生长迅速、具有阳动之性,是故体阴而用阳.微创外科的蓬勃发展为肿瘤患者的治疗提供了新的机遇与挑战,在中医"孤阳不生,独阴不长"、"坚者削之""衰其大半而止"等理论指导下的肿瘤微创外科治疗可能激活机体的免疫功能,具有新的治疗前景和意义.

多梦症是指睡眠不实,睡眠中梦境纷纭不休,醒后神疲乏力、头昏的一种病症.根据多梦症的临床表现,结合古代医籍,笔者提出"魂魄飞扬"是多梦症的发病机制,认为因脏腑虚损或邪气侵扰而出现魂不定、魄不平,发病为"多梦症",据此提出"定魂平魄"的治疗法则,临证治疗时根据患者病因病症灵活用药,可平肝定魂、益肺平魄,使得魂定于肝,魄平于肺.

胆固醇栓塞性肾病是动脉粥样硬化的严重并发症之一,现代研究认为本病与血脂、免疫功能异常有关.肝主疏泄、主藏血、主生生之气,肝体阴而用阳,与人体部分合成代谢及免疫功能密切相关.少阳属胆络肝,与厥阴肝经互为表里.笔者对于代谢及免疫相关疾病常从少阳厥阴经论治,屡见良效.本文中胆固醇栓塞性急性肾衰病例,经激素治疗1年出现撤药综合征,肾功能坏转.笔者通过辨证与辨病相结合,少阳厥阴同治,从少阳经疏泄三焦、清热利湿,从厥阴经活血化瘀、软坚散结,用吴门验方柴妙饮、甘露消毒丹合升麻鳖甲汤化裁,随经辨治随诊近2年,激素完全撤减、肾功能恢复,展示出中医药治疗疑难疾病的优势.分享此病例,供同仁参考.

骨骼的结构及功能与玄府相类被称为骨玄府,骨玄府是气液疏布的门户,通过骨玄府,气液进行交换,骨骼源源不断的获得气血津液的濡养,保持功能的正常.骨玄府结构精微,多为网状、管道状结构,易受邪气侵袭出现堵塞、变形及萎缩.风寒湿等外来之邪导致气液运行失常,骨玄府堵塞而不通.亦可因肝肾亏虚,气血不足,骨玄府失荣萎缩变形而不通.若因内外因素导致骨玄府闭密,气液流通受阻,则骨玄府失养,导致骨关节炎的发生.骨关节炎的病因病机是内外因素导致骨玄府闭密,气液交换受阻.根据骨玄府"以通为顺"的特性,治疗骨关节炎应以"通"字立法.然通之之法不应局限于通下之法,凡能去除导致不通之病因者皆为通法.通过综合运用风药通玄、祛瘀通玄、辛温通玄、填精通玄、调血通玄、外治通玄等方法使闭密的骨玄府恢复通畅,则气液交换正常,骨骼得养.

慢性结肠炎是多发于结肠、乙状结肠和直肠的一种慢性、反复性、多发性的消化系统疾病,常迁延难愈.国家名老中医周平安先生认为慢性结肠炎实为本虚标实,属内疡,在治疗时应注重健脾胃,调升降,标本兼治."三两三"为民间验方,因其药物分量故又称"三两三钱三分",多由4～5位药组成.周老在"三两三"思想基础上,结合多年临床治疗经验总结经验方"芪英三两三",由黄芪一两(30 g)、蒲公英一两(30 g)、当归一两(30 g)、生甘草三钱(9 g)组成,随证加减,以此调升降兼调气水,标本兼治,用于治疗慢性结肠炎,疗效显著,在此笔者通过验案举隅及文献复习探讨其组方和用药思想.

目的 对乳腺、甲状腺等超声人工智能系统联合远程医疗的临床价值进行探讨.方法 乳腺、甲状腺等超声人工智能系统通过联合远程医疗,进行实时动态远程超声检测,专家在线实时会诊,给予基层及地方医院指导及诊断.结果 共检测612例患者,其中女563例,男49例,甲状腺检测379例,乳腺检测221例,其他检测12例.手术患者5例,转诊医疗4例.结论 通过乳腺、甲状腺等超声人工智能系统联合远程医疗,基层医院的超声诊疗水平得到大幅度提高,减少了由于误诊、漏诊造成的过度治疗,进而促进优质医疗资源输出,对于健全"互联网+医疗健康"的服务体系具有重要的社会意义.

肿瘤患者术后免疫力明显下降,创口长期不愈,很多患者无法按时接受后续的放化疗,直接影响了生活质量和病情预后.经过多年临床总结,姜苗主任医师认为治疗肿瘤术后创口久不愈合需重视"三两三"为体、补托为法、脾胃为基、气血为根、以血为用等角度,临床应用"芪英三两三"组方加减治疗肿瘤患者术后伤口长期不愈合疗效显著,本文拟探讨姜苗主任医师治疗肿瘤术后创口久不愈合的思路及用药方案.

本文从结肠癌的病机着手,即正气亏虚为本,痰饮、湿浊、血瘀凝聚为标,风邪是其发病的重要因素,具体论述风药在增效除弊等方面医治结肠癌的机制.风药具有辛、温、升、散、行之特性,不仅能直接祛除风邪,还可以通过健脾益气、辛温燥湿、疏肝理气、祛瘀通络等多途径地治疗结肠癌,从而为其防治提供新的研究思路与方法.