Potential mechanisms of depression involving herbal medicines and their specific compounds include elevated 5‐HT level and downstream BDNF pathway. To identify potentially new combined therapeutic strategies, 3,6'‐disinapoylsucrose (DISS) and tenuifoliside A (TFSA) have been observed to show antidepressant‐like effects and its related 5‐HT‐BDNF pathway. We have tried to investigate whether combined administration of DISS and TFSA exerted more effective in the treatment of depression, as assessed through tail suspension test (TST) and forced swimming test (FST). In addition, we also analyzed the expression of three important proteins, cyclic adenosine monophosphate (cAMP) response element binding (CREB), brain‐derived neurotrophic factor (BDNF), and cAMP‐regulated transcriptional coactivators (CRTC1), which have been shown to be involved in the regulation of the neurotrophic factors in the hippocampus. The DISS and TFSA separately, both at a dose of 5 mg/kg each, displayed small effect in the immobility time. However, combined treatment of these two in multiple doses exhibited better effect. Moreover, combined treatment of DISS and TFSA also demonstrated enhanced levels of 5‐hydroxytryptamine (5‐HT), and stronger increase in the phosphorylation levels of CREB, BDNF, and CRTC1 proteins in the hippocampus. Overall, our results indicated that coadministration of these two oligosaccharide esters at low dose may induce more pronounced antidepressant activity, in comparison with individual treatment even at high dosage. Thus, the antidepressant properties of both these compounds can be attributed to their ability to influence 5‐HT and BDNF pathway, and thereby suggesting that this combination strategy can definitely act as alternative therapy for depression disorder with very limited side effects.

Objective This study compares survival of four different surgical approaches including ARH, LRH, RRH and VRH for early-stage cervical cancer in order to define the best effects and survivals for patients. Design Retrospective study. Setting The First Medical Center of the PLA General Hospital. Population 238 women diagnosed early-stage cervical cancer between January 2013 and December 2017 and followed up until September 2020. Methods All patients with early-stage cervical cancer were retrospective collected in the first medical center of the PLA general hospital. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier’s method, and survival curves were compared using log-rank test. Main outcome measures Outcomes were the comparison of patients’ DFS and OS between the four different radical hysterectomy approaches. Results The intraoperative blood loss and postoperative exhaust time of LRH, RRH and VRH groups are better than that in ARH group. The total 5-year OS was significant difference among the four groups. However, the difference of 5-year DFS was not statistically significant among the four groups. Furthermore, patients with early-stage cervical cancer had a significantly better DFS and OS in ARH and RRH groups than that in LRH and VRH groups. Conclusions This retrospective study demonstrated that both ARH and RRH obtained higher rate of 5-year DFS and 5-year OS compared with LRH and VRH for early-stage cervical cancer, and the survival outcomes between ARH and RRH were similar. Keywords Cervical cancer, ARH, LRH, RRH, VRH, survival.

Background This study compared the survival outcomes of abdominal radical hysterectomy (ARH) (N = 32), laparoscopic radical hysterectomy (LRH) (N = 61), robot-assisted radical hysterectomy (RRH) (N = 100) and vaginal radical hysterectomy (VRH) (N = 45) approaches for early-stage cervical cancer to identify the surgical approach that provides the best survival. Methods Disease-free survival (DFS) and overall survival (OS) were calculated using the Kaplan–Meier method, and survival curves were compared using the log-rank test. Results The volume of intraoperative blood loss was greater in the ARH group than in the LRH group, the RRH group or the VRH group [(712.50 ± 407.59) vs. (224.43 ± 191.89), (109.80 ± 92.98) and (216.67 ± 176.78) ml, respectively; P < 0.001]. Total 5-year OS was significantly different among the four groups (ARH, 96.88%; LRH, 82.45%; RRH, 94.18%; VRH, 91.49%; P = 0.015). However, no significant difference in 5-year DFS was observed among the four groups (ARH, 96.88%; LRH, 81.99%; RRH, 91.38%; VRH, 87.27%; P = 0.061). Conclusion This retrospective study demonstrated that ARH and RRH achieved higher 5-year OS rates than LRH for early-stage cervical cancer.