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1.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 60-67, 2023.
Article in Chinese | WPRIM | ID: wpr-976540

ABSTRACT

ObjectiveTo establish and evaluate a mouse model of heart failure with Qi deficiency syndrome. MethodForty-four KM mice were randomly divided into sham operation group, model group, and modified Si Junzitang group (12.89 g·kg-1). The model group and the modified Si Junzitang group underwent thoracic aortic constriction (TAC), while the sham operation group only underwent suture without constriction. Echocardiography and pathological examination were used to assess the heart failure model and evaluate the pharmacological effects. Macroscopic characterization, microscopic biology, and formula identification were conducted to collect general signs, body weight, open-field behavior, grip strength, mitochondrial ultrastructure, and other macroscopic and microscopic characteristics of mice. Mitochondrial fission and fusion protein expression were measured to determine the syndrome type. ResultEight weeks after TAC, compared with the sham operation group, the model group showed a significant decrease in left ventricular ejection fraction (LVEF) (P<0.01), and modified Si Junzitang improved LVEF in mice (P<0.05). Hematoxylin-eosin (HE) staining of the heart showed inflammatory cell infiltration and thickening of blood vessel walls in the model group, which was significantly improved by modified Si Junzitang. After 6-8 weeks, compared with the sham operation group and the modified Si Junzitang group, the model group exhibited significant hair loss, hair yellowing, decreased activity, and depression. Moreover, compared with the sham operation group, the model group had a significantly lower increase in body weight (P<0.05), while the modified Si Junzitang group showed a significant increase in body weight (P<0.05) compared with the model group. After 6-8 weeks, compared with the sham operation group, the model group showed a significant decrease in open-field distance and speed (P<0.05), while the modified Si Junzitang group exhibited significantly improved open-field distance and speed in the 8th week (P<0.05). After 6-8 weeks, compared with the sham operation group, the model group exhibited a significant decrease in maximum grip strength (P<0.05), while the modified Si Junzitang group showed a significant increase in maximum grip strength 8 weeks after TAC (P<0.05). Transmission electron microscopy of the gastrocnemius muscle showed uneven muscle tissue matrix, mitochondrial swelling, increased volume, matrix dissolution, ridge loss, and vacuolization in the model group, while modified Si Junzitang improved mitochondrial swelling, ridge fracture, and matrix vacuolization. Western blot analysis showed that the expression of the kinetic associated protein 1 (DRP1) in the gastrocnemius muscle of the model group significantly increased (P<0.01), and the expression of mitochondrial fusion hormone 1 (MFN1) significantly decreased (P<0.05) as compared with those in the sham operation group. Furthermore, compared with the model group, the modified Si Junzitang group exhibited a significant decrease in the expression of DRP1 (P<0.05) and a significant increase in MFN1 expression (P<0.01). ConclusionMice exhibited significant manifestations of qi deficiency syndrome 6-8 weeks after TAC, accompanied by abnormal mitochondrial morphology and function in the gastrocnemius muscle, which were significantly improved by modified Si Junzitang.

2.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 28-34, 2022.
Article in Chinese | WPRIM | ID: wpr-940793

ABSTRACT

ObjectiveTo explore the mechanism of Si Junzitang in regulating the expression of NKG2A to affect the anti-colon cancer function of natural killer (NK) cells. MethodNK cells isolated from healthy honors were cultured and used to construct the three incubation models of NK cells, human colon cancer HCT116 cells, and NK cells + HCT116 cells (co-incubation). real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was conducted to determine the mRNA levels of natural killer group 2 member A (NKG2A) and interleukin (IL)-15 in NK cells, as well as the mRNA level of histocompatibility leucocyte antigen E (HLA-E) in HCT116 cells. The secretion of IL-15 was detected by enzyme-linked immunosorbent assay (ELISA). Methyl thiazolyl tetrazolium (MTT) assay was employed to determine the applicable concentration of IL-15 and test the effects of Si Junzitang and IL-15 on the activities of NK cells and the HCT116 cells in the co-incubation model. The effects of Si Junzitang and IL-15 on the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells were detected by Real-time PCR. Monalizumab (M, anti-NKG2A mab) was used to block the NKG2A-HLA-E pathway in co-incubation model, and then the proliferation of HCT116 cells was detected by MTT assay. ResultThe interaction of NK cells and HCT116 cells up-regulated the mRNA levels of NKG2A in NK cells and HLA-E in HCT116 cells (P<0.05), as well as the expression level and secretion of IL-15 (P<0.05). Compared with the blank group, Si Junzitang and Si Junzitang + IL-15 promoted the proliferation and improved the anti-colon cancer function of NK cells (P<0.01). Furthermore, they down-regulated the mRNA levels of NKG2A in NK cells and HLA-E in the HCT116 cells co-incubated with NK cells (P<0.01). M and IL-15 + M inhibited the proliferation of HCT116 cells compared with the groups without M (P<0.01). ConclusionThe interaction of NK cells and HCT116 cells can induce activation of NKG2A-HLA-E pathway to impair NK cell function. Si Junzitang can inhibit the activation of NKG2A-HLA-E pathway to restore the anti-colon cancer function of NK cells.

3.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 30-36, 2021.
Article in Chinese | WPRIM | ID: wpr-906513

ABSTRACT

Objective:To observe the effect of modified Si Junzitang on the level of lactic acid in gastric mucosa and the expression of Carboxylic acid transporter 1(MCT1), monocarboxylic acid transporter 4(MCT4), and extracellular matrix metalloproteinase inducer (CD147)in rats with gastric precancerous lesions(GPL). Method:Seventy-four SD male rats were randomly divided into normal group (12 rats) and model group (62 rats). <italic>N</italic>-methyl-<italic>N'</italic>-nitro-<italic>N</italic>-nitrosoguanidine(MNNG)-ammonia compound method was used to establish GPL rat models, and at the 9<sup>th</sup> week, the model rats were randomly divided into model group, folic acid group(2.7 mg·kg<sup>-1</sup>), modified Si Junzitang high, medium and low dose groups(12.6, 6.3, 3.15 g·kg<sup>-1</sup>), with 12 rats in each group. After intragastric administration for 12 weeks, the general conditions of the rats were observed. Hematoxylin-eosin(HE)staining was used to observe the histopathological changes of gastric mucosa in rats, chemical colorimetry was used to detect the content of lactic acid in gastric mucosa; immunohistochemistry and real-time polymerase chain reaction(Real-time PCR)were used to detect MCT1, MCT4, CD147 protein and mRNA expression in gastric mucosal tissues. Result:Modified Si Junzitang significantly improved the pathological manifestations in GPL rats such as gastric mucosal epithelial gland structure, disorder of arrangement and cell atypia. Compared with the normal group, the lactic acid content of the gastric mucosa tissue in the model group increased significantly(<italic>P</italic><0.01), and the protein and mRNA expressions of MCT1, MCT4, CD147 significantly increased(<italic>P</italic><0.05, <italic>P</italic><0.01). Compared with the model group, the lactic acid content in each dose group of modified Si Junzitang was significantly reduced(<italic>P</italic><0.05, <italic>P</italic><0.01), and the protein expression levels of MCT4 and CD147 were also significantly reduced in each dose group of modified Si Junzitang(<italic>P</italic><0.05, <italic>P</italic><0.01). The mRNA expression of MCT4 was significantly reduced in the middle and high dose groups(<italic>P</italic><0.05, <italic>P</italic><0.01), and the mRNA expression of CD147 was significantly reduced in the high dose group(<italic>P</italic><0.05). Modified Si Junzitang showed no significant regulatory effect on MCT1. Conclusion:Modified Si Junzitang can significantly improve the abnormal histopathology of gastric mucosal epithelium in GPL model rats. Its mechanism may be related to down-regulating the overexpression of MCT4 and CD147, inhibiting lactic acid outflow, and improving the acidic microenvironment of gastric mucosal epithelium.

4.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 112-120, 2021.
Article in Chinese | WPRIM | ID: wpr-905071

ABSTRACT

Objective:To investigate the effect of modified Si Junzitang on the expression of fibrous protein-5(Fibulin-5), phosphorylated protein kinase B(p-Akt )in hippocampus of rats after cerebral ischemia-reperfusion (I/R) injury and the anoikis of nerve cells. Method:The 60 male SD rats of SPF grade were randomly divided into sham operation group, model group, Edaravone group (3.2 mg·kg-1)and modified Si Junzitang high, medium and low-dose groups(19.08,9.54,4.77 g·kg-1).The middle cerebral artery occlusion (MCAO) model was established by suture method,the rats were killed 7 days later,neurological deficit score was evaluated before the death,histopathological observation was performed by hematoxylin eosin staining, apoptosis index of nerve cells was detected by TdT-mediated dUTP nick end labeling(TUNEL)staining, the expression of Fibulin-5, p-Akt and protein in ischemic hippocampus were detected by immunohistochemistry and Western blot. Result:The neurological deficit score showed that,compared with the sham operation group, the neurological deficit score of the model group was significantly increased (P<0.01), compared with model group, the neurological deficit score of Edaravone group,the high, medium, low dose groups of modified Si Junzitang were decreased (P<0.05,P<0.01). Immunohistochemical results showed that,compared with the sham operation group, the expression of Fibulin-5, p-Akt protein and the apoptosis index of nerve cells in the model group were significantly increased (P<0.05,P<0.01), compared with model group, the protein expressions of Fibulin-5 and p-Akt in Edaravone group, high, medium and low-dose groups of modified Si Junzitang were significantly increased (P<0.05,P<0.01), and the apoptosis index of nerve cells was obvious,there was a significant decrease (P<0.05,P<0.01). Western blot results showed that,compared with the sham operation group, the relative expression of Fibulin-5 and p-Akt protein in the model group was significantly down-regulated (P<0.01), compared with model group, the protein expressions of Fibulin-5 and p-Akt in the Edaravone group, the high, medium and low-dose groups of modified Si Junzitang were significantly up-regulated (P<0.05,P<0.01). Conclusion:The modified Si Junzitang may stabilize the extracellular matrix (ECM) Fibulin-5, increase the adhesion of ECM to cells and promote the expression of p-Akt protein, thus inhibiting neuronal apoptosis and protecting cerebral ischemia injury.

5.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 57-62, 2020.
Article in Chinese | WPRIM | ID: wpr-873249

ABSTRACT

Objective::To observe the effect and mechanism of modified Si Junzitang combined with heat-sensitive moxibustion on interleukin-17(IL-17), interleukin-22(IL-22), interleukin-1α(IL-1α) and serum cystatin C(Cys-C )in serum and exhale breath condensate(EBC) of patients with chronic obstructive pulmonary disease at stable stage(COPD, Qi deficiency of lung and spleen). Method::Totally 120 cases of COPD(Qi deficiency of lung and spleen) treated in pulmonary department and thermal moxibustion department of Affiliated Hospital of Jiangxi University of traditional Chinese medicine from January 2019 to June 2019 were included and randomly divided into traditional Chinese medicine group, heat-sensitive moxibustion group and control group. The patients in traditional Chinese medicine group were treated with Si Junzitang, the patients in heat-sensitive Moxibustion group were treated with heat-sensitive moxibustion in addition to traditional Chinese medicine group, and the patients in control group were treated with placebo. All of the 3 groups were treated with oxygen and bronchodilator according to the guidelines. All groups received 3 consecutive courses of treatment, 20 days per course. After 3 courses of treatment, the clinical efficacy of the three groups, the forced expiratory volume in one second (FEV1), the forced expiratory volume in the estimated value in one second (FEV1%), the forced vital capacity (FVC), and IL-17, IL-22, IL-1α in serum and exhale breath condensate (EBC) were measured. Result::There were no statistically significant difference in general clinical data, lung function levels (FEV1, FEV1%, FVC), serum and EBC levels of IL-17, IL-22, IL-1α and Cys-C in the first three groups. The total clinical effective rate of traditional Chinese medicine group was better than the control group (P<0.05), the heat-sensitive moxibustion group was better than the traditional Chinese medicine group (P<0.05) and significantly better than the control group (P<0.01). Compared with the patients before treatment, the level of lung function was improved, while IL-17, IL-22, IL-1α and Cys-C in serum and EBC were reduced(P<0.05). The traditional Chinese medicine group was superior to that in the control group (P<0.05), the heat-sensitive moxibustion group was superior to that in the traditional Chinese medicine group (P<0.05) and significantly superior to that in the control group (P<0.01). Conclusion::Modified Si Junzitang combined with heat-sensitive moxibustion has an anti-inflammatory effect on COPD by stimulating bullishness of human body, improving body immunity, inhibiting inflammatory cytokines, reducing levels of inflammation cytokines IL-17, IL-22, IL-1α, and chronic inflammation markers serum Cys-C and inflammatory reaction, increasing the lung capacity, improving ventilation function and pulmonary function, so as to effectively relieve chest tightness asthma and other symptoms in COPD patients, and improve the clinical efficacy.

6.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 183-188, 2020.
Article in Chinese | WPRIM | ID: wpr-872874

ABSTRACT

Objective:To observe clinical effect of addition and subtraction therapy of Si Junzitang combined with Simotang to outlet obstructive constipation (OOC) after stapled trans-anal rectal resection (STARR). Method:One hundred and twenty-four patients were randomly divided into control group (62 cases) and observation group (62 cases) by random number table. Patients in control group got Qirong Ruichang oral liquid, 20 mL/time, 3 times/day. After operation, patients in observation group got addition and subtraction therapy of Si Junzitang combined with Simotang, 1 dose/day. And courses of treatment in two groups were 4 weeks, and 8 weeks' follow-up was recorded. Before the operation and at the second and fourth week after treatment, and the eighth week of follow-up, scores of main symptoms of constipation and Longo ODS were graded. Before the operation and at the fourth week after treatment, levels of superoxide dismutase (SOD), malondialdehyde (MDA), constipation patients quality of life self-assessment scale (PAC-QOL), anorectal pressure, anal resting pressure (ARP), maximum anal systolic pressure (MSP), rectal defecation pressure (RSP), FSV, CRS and MTV were recorded. And incidence, recurrence, normal defecation, satisfaction at the fourth week after the operation and safety were evaluated. Result:The clinical rate in observation group was better than that in control group (Z=2.096, P<0.05). At the second, fourth after treatment and eigh weeks' for follow-up, score of main symptoms of constipation and Longo ODS were both lower than those in control group (P<0.01). Levels of ARP, FSV, FSV, CRS and MDA were lower than those in control group (P<0.01), levels of MSP, RSP and SOD were higher than those in control group (P<0.01). Incidence and recurrence rate in observation group were 20.97% (13/62) and 4.84% (3/62) were all lower than 39.71% (24/62) and 16.13% (10/62) in control group (P<0.05). Normal defecation rate in observation group was 91.94% (57/62) higher than 80.65% (50/62) in control group, but there was no statistical significance in two groups. And total score of PAC-QOL and scores of each factor were all lower than those in control group (P<0.01). Then there was no adverse reaction related to the traditional Chinese medicine. Conclusion:Addition and subtraction therapy of Si Junzitang combined with Simotang can reduce constipation symptoms and the degree of illness, improve the quality of life, reduce the incidence of postoperative complications and recurrence rate, and improve anorectal dynamic indicators and oxidative stress indicators, improve the clinical efficacy.

7.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 131-136, 2020.
Article in Chinese | WPRIM | ID: wpr-872709

ABSTRACT

Objective:To evaluate effect of addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture to poststroke fatigue (PSF) and syndrome of Qi deficiency and blood stasis, at the same time we studied the antioxidant and anti-inflammatory effects. Method:One hundred and forty-four patients were randomly divided into control group and observation group (1∶1) by random number table. 66 patients in control group completed the therapy (4 patients were falling off or missing visit, 2 patients were eliminate), 67 patients in observation group completed the therapy (2 patients were falling off or missing visit, 3 patients were eliminate). In control group, patinets got acupuncture, 1 time/day, 6 times/week, they also got Geqi Tongmai grain, 10 g/time, 3 times/day. Patients in observation group got acupuncture (the same as which in control group), and addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang, 1 dose/day, and courses of treatment in two groups were 4 weeks. Before and after treatment, fatigue severity scale (FSS), NIH stroke scale (NIHSS), syndrome of Qi deficiency and blood stasis, stroke specific quality of life scale (SS-QOL), and scores of ability of daily life (ADL) were recorded. And levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), homocysteine (Hcy), interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were detected. And the safety evaluated. Result:Disease effect in observation group was better than which in control group (Z=2.118, P<0.05). And effect after using traditional Chinese medicine (TCM) was also better than that in control group (Z=2.046, P<0.05). Scores of FSS, syndrome of Qi deficiency and blood stasis, NIHSS, and levels of IL-1β, IL-6, Hcy, CRP, TNF-α and MDA in observation group were all lower than those in control group (P<0.01), and scores of SS-QOL, ADL, and levels of GSH-Px and SOD were all higher than those in control group (P<0.01). Then there was no related safety issues caused by drug. Conclusion:Addition and subtraction therapy of Buyang Huanwutang combined with Si Junzitang and acupuncture had effect of anti-oxidation and anti-inflammatory, and can significantly reduce fatigue and degree of neurological impairment and can improve patients' quality of life and daily life ability. The clinical effect is significant and safe, which is worthy of further research and application.

8.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 71-75, 2020.
Article in Chinese | WPRIM | ID: wpr-872700

ABSTRACT

Objective:To observe the immune factors, coagulation and curative effect of modified Shoutaiwan with Si Junzitang combined with dydrogesterone tablets in advanced age patients with early threatened abortion, and to explore its mechanism of action. Method:The 90 advanced age patients with threatened abortion and kidney deficiency and blood stasis syndrome differentiation in traditional Chinese medicine (TCM) were randomly divided into control group and observation group by random number table, with 45 cases in each group. Both groups took oral dydrogesterone tablets for luteal support. The control group additionally received natural vitamin E soft capsules by oral administration, while observation group received modified Shoutaiwan with Si Junzitang. The course of treatment was 10 days in both groups. The clinical efficacy, TCM syndrome score, immune factors and coagulation factors of the two groups were compared before and after treatment. Result:There was no statistically significant difference in TCM symptom scores, immune factors, and coagulation factors between two groups before treatment. After treatment, the scores of TCM syndromes were reduced in both groups (P<0.05), the proportion of helper T lymphocyte (Th), Th/Ts ratio, D-dimer (D-D) level and fibrinogen (FIB) were reduced while prothrombin time (PT) and the ratio of suppressor T lymphocyte (Ts) were increased in observation group (P<0.05). After treatment, the proportion of Th, Th/Ts, D-D, and FIB levels in observation group were lower than those in control group, while PT and the proportion of Ts were higher than those in control group (P<0.05). The proportion of natural killer cells (NK) had no significant change after treatment, also with no significant difference between two groups. The total effective rate was 84.4%(38/45) in observation group, higher than 64.4%(29/45) in control group (χ2=4.398,P<0.05). There was no obvious adverse reaction in both groups during the treatment. Conclusion:Modified Shoutaiwan with Si Junzitang combined with dydrogesterone tablets can improve symptoms and the therapeutic effect for fetal protection by regulating the immune balance and coagulation function in advanced age patients with threatened abortion.

9.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 1-7, 2019.
Article in Chinese | WPRIM | ID: wpr-802158

ABSTRACT

Objective:To investigate the effect of modified Si Junzitang on angiogenesis in transplanted tumor of H22 tumor-bearing mice. Method:The effect of modified Si Junzitang on tumor inhibition and growth of peripheral blood vessels in tumor-bearing mice was observed by tumorigenesis experiment in mice. Hematoxylin-eosin (HE) staining and immunohistochemistry (IHC) were used to detect the distribution of blood vessels and the expression of vascular endothelial markers (CD31) in tumor-bearing mice. Reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the mRNA expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR2) and tumor necrosis factor-α (TNF-α) in tumor tissue. Result:The inhibition rates of modified Sijunzi Tang in low-dose group (ig, 11.83 mg·kg-1·d-1), middle-dose group (ig, 23.66 mg·kg-1·d-1) and high-dose group (ig, 47.32 mg·kg-1·d-1) were 29.97%, 59.80%and 82.34%, respectively. Compared with the model group, the average tumor weight was lower in middle and high-dose groups, with statistically significant differences (PPPα in middle and high-dose modified Si Junzitang groups were lower than those in the model group (PConclusion:Modified Si Junzitang can inhibit the tumor growth of H22 tumor-bearing mice and the angiogenesis of transplanted tumors, which may be related to the reduction of TNF-α, VEGF and VEGFR2 expression levels.

10.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 25-30, 2019.
Article in Chinese | WPRIM | ID: wpr-802127

ABSTRACT

Objective: To explore the effect of modified Si Junzitang (MSJZT) drug serum on the expression of apoptosis-related molecules of gastric cancer cell SGC-7901 and further its anti-tumor mechanism.Method: A total of 40 SD rats were randomly divided into four groups:low-dose,middle-dose,high-dose MSJZT (0.213,0.426,0.853 g·kg-1) groups and normal group (n=10).The treatment groups were administrated through gastric perfusion,and the normal group was given the equivalent volume of normal saline for 10 days.1.5 h after the last treatment,chloral hydrate peritoneal anesthesia was performed,blood was collected from heart,and different doses of serum were separated to prepare drug-containing serum of low-dose,middle-dose,high-dose MSJZT groups,in order to incubate SGC-7901 gastric cancer cell.Early and late apoptosis rates were detected with flow cytometry.Afterwards,the tumor suppressor gene p53,c-nucleoprotein gene (c-Myc),cysteine-aspartic acid protease-3(Caspase-3),B-cell lymphoma-2(Bcl-2) mRNA expressions were confirmed by fluorescence quantitative polymerase chain reaction (Real-time PCR).The protein expressions of p53,c-Myc,Caspase-3,Bcl-2 were detected by immunofluorescence.Result: Compared with the normal group,the high-dose MSJZT group could obviously increase the apoptosis rate to 22.58%(PPPPPPConclusion: MSJZT drug serum could exert an anti-tumor effect by inhibiting the expression of the anti-apoptotic protein Bcl-2,and promoting the expressions of pro-apoptotic-related molecules p53,c-Myc,Caspase-3.

11.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 31-36, 2019.
Article in Chinese | WPRIM | ID: wpr-801996

ABSTRACT

Objective: To study the protective effect of Huayu Qutan decoction on vascular dementia (VD) gerbils and to explore whether its mechanism is related to Calcium ion-calmodulin-dependent protein kinase Ⅱ (CaMKⅡ)/cyclic adenosine effect element binding protein (CREB)/brain-derived neurotrophic factor (BDNF) signaling pathway. Method: Forty healthy gerbils were randomly divided into sham operation group, model group, low, medium and high dose groups (5.35, 10.7, 21.4 g·kg-1) of removing blood stasis and expelling phlegm. Eight gerbils in each group were divided into model group and removing blood stasis and expelling phlegm group. Gerbils were given corresponding drugs twice a day after operation. Water maze experiment was conducted 21 days later to investigate the spatial learning and memory ability of gerbils. The expression of p-CaMKⅡ/CaMKⅡ, p-CREB/CREB and BDNF in the hippocampus of gerbils were detected by Western blot and immunohistochemistry. Result: Compared with sham operation group, the incubation period and the number of platform trips of gerbil in the model group were significantly reduced, p-CaMKⅡ/CaMKⅡ, p-CREB/CREB, and BDNF protein expression were significantly reduced (PPPConclusion: Huayu Qutan decoction improves the learning and memory abilities of gerbils with vascular dementia, and its mechanism may be related to the activation of CaMKⅡ/CREB/BDNF signaling pathway.

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