BackgroundSchizophrenia， as a common chronic mental disorder， although second-generation antipsychotic drugs have shown significant efficacy in alleviating positive symptoms， the widespread cognitive dysfunction among patients remains a challenge in clinical treatment. Traditional Chinese medicine has unique advantages in the treatment of mental disorders. However， the current clinical research on the combination of Wendan Decoction and antipsychotic drugs for schizophrenia varies in quality， and there is a lack of systematic reviews evaluating its effects on cognitive improvement and safety. ObjectiveTo systematically evaluate the effects of modified Wendan Decoction combined with antipsychotic drugs on schizophrenia symptoms and cognitive improvement， providing evidence-based support for the clinical application of Wendan Decoction. MethodsLiterature searches were conducted in China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP Information， China Biomedical Literature Service System， China Clinical Trial Registry， PubMed， Web of Science， the Cochrane Library， and Embase to collect randomized controlled trials （RCTs） of modified Wendan Decoction combined with antipsychotic drugs for the treatment of schizophrenia. The search period was from the establishment of the databases to March 19， 2026. The quality of the included literature was evaluated using the Cochrane 6.3. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 11 studies were included， involving 1 130 patients with schizophrenia. Among them， 566 cases were in the study group （receiving modified Wendan Decoction combined with antipsychotic drugs）， and 564 cases were in the control group （receiving antipsychotic drugs only）. Meta-analysis showed that the effective rate of improvement in psychotic symptoms in the study group was higher than that in the control group （RR=1.21，95% CI： 1.15–1.27， P<0.01）. In terms of psychotic symptoms， the Positive and Negative Symptom Scale （PANSS） positive symptom score （MD=-3.69， 95% CI： -5.87–-1.51， P<0.01） and PANSS total score （MD=-9.20， 95% CI： -11.80–-6.59， P<0.01） of the study group were lower than those of the control group. In cognitive function assessments， the Mini-Mental State Examination （MMSE） score （MD=2.51， 95% CI： 1.33–3.68， P<0.01） and the Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） score （MD=11.85， 95% CI： 2.55–21.15， P=0.010） of the study group were higher than those of the control group， and the Wisconsin Card Sorting Test （WCST） score was lower than that of the control group （MD=-9.34， 95% CI： -12.57–-6.11， P<0.01）. The levels of brain-derived neurotrophic factor （BDNF） （SMD=1.34， 95% CI： 0.63–2.05， P<0.01） and nerve growth factor （NGF） （MD=6.94， 95% CI： 4.00–9.89， P<0.01） of the study group were higher than those of the control group. In terms of safety， there was no statistically significant difference in the incidence of adverse reactions between the two groups （RR=0.60， 95% CI： 0.31–1.18， P=0.14）. ConclusionThe modified Wendan Decoction combined with antipsychotic drugs may be more effective than antipsychotic drugs alone in improving positive symptoms and cognitive function in patients with schizophrenia， and it also exerts a favorable neurotrophic regulatory effect. ［Funded by Postgraduate Education Reform and Quality Improvement Project of Henan Province （number， YJS2023AL060）； Key Scientific Research Projects of Higher Education Institutions in Henan Province （number， 24B320018， 25B310004）］

Objective: To explore the types and levels of exosomes in cryoprecipitate from donors of different blood types, genders, and age groups, and to preliminarily characterize their specific proteins. Methods: Exosomes were extracted from cryoprecipitate using the polymer precipitation method. The exosomes were identified by particle size analysis, transmission electron microscopy, and Western blot. Finally, the specific proteins CD63, CD81, CD9, Cytochrome C, Syntenin-1, and VLA-4 of exosomes were characterized using Luminex. Results: The purified exosomes exhibited a double-membrane vesicle structure under microscopy, appearing saucer-shaped or as hemispheres with a concave side. They specifically expressed the CD63 and TSG101 proteins, while the endoplasmic reticulum protein Calnexin was not expressed. The particle sizes(nm) of exosomes from blood types A, B, O, and AB were 119.6±47.5, 120.5±47.4, 133.3±54.1 and 103.1±35.3, respectively. Taking the exosomal specific protein CD63 as an example, its expression levels(pg/mL) in cryoprecipitate from female and male donors were 128.22±63.52 and 117.39±40.84, respectively; the expression(pg/mL) levels in the 20-40 and 40-60 age groups were 114.20±37.28 and 131.41±64.98, respectively; and the expression levels(pg/mL) in the four blood types A, B, O, and AB were 109.58±37.79, 127.45±44.46, 131.89±40.59, and 122.29±78.68, respectively. The expression levels of CD63 in exosomes from different blood types, genders, and age groups were similar, with no statistically significant differences (all P>0.05). The distribution of the other five exosomal-specific proteins was also comparable among the normal blood donors. Conclusion: The expression levels of exosomal-specific proteins in cryoprecipitate from normal blood donors are not associated with blood type, gender, and age group.

Objective: To investigate the impact of milk and egg supplementation on body composition and bone mineral density of rural primary school students in Yunnan Province, so as to provide a reference for developing targeted nutritional intervention strategies. Methods: In December 2023, a cluster sampling method was adopted to select students from grades one to three in four primary schools each from Jinggu and Shidian countys of Yunnan Province, as the intervention group (662 students). Additionally, two boarding primary schools were selected from each county based on the principle of matching scale and student numbers as the control group (455 students). Starting from April 2023, the intervention group received 200 mL milk and 50 g eggs during the break on school days for 8 months, while the control group maintained their usual diet behavior. Body composition was measured by using bioelectrical impedance analysis, and distal radial bone mineral density was assessed via dual energy X-ray absorptiometry in April and December 2023. The intervention effects were analyzed by using a difference in-differences approach. Results: The final measurements of body fat percentage, skeletal muscle mass and fat free mass of the intervention group and the control group of primary school students were significantly higher than the baseline values, and the net effect of milk and egg intervention on these body composition indicators was not statistically significant ( P >0.05, both before and after adjustment). In contrast, bone mineral density increased significantly by 0.02 g/cm 2 in the intervention group. The net intervention effect on bone mineral density was statistically significant ( β=0.02, 95%CI =0.00-0.04), and remained significant after model adjustment ( β=0.02, 95%CI =0.00-0.04) (both P < 0.05). Subgroup analysis showed statistically significant effects of the intervention among girls ( β=0.02, 95%CI =0.00-0.04), day students ( β=0.04, 95%CI =0.01-0.07), and students with normal nutritional status ( β=0.02, 95%CI =0.00-0.04) (all P <0.05). No significant effect of milk and egg supplementation was observed on body composition indicators (all P <0.05). Conclusions Milk and egg supplementation can improve bone mineral density among rural primary school students in Yunnan Province. It is recommended that rural school aged children should increase intake of milk and eggs to support growth and development.

Over the past three decades， China has made significant progress in the prevention and control of viral hepatitis， and the incidence rates of new-onset pediatric hepatitis B virus infections and acute viral hepatitis in the population have reduced to a relatively low level； however， there is still a heavy disease burden of chronic viral hepatitis in China， which severely affects the health status of the population. This study systematically summarizes the achievements of viral hepatitis prevention and control in China， analyzes existing problems and challenges， and proposes comprehensive prevention and control strategies and measures to eliminate viral hepatitis as a public health threat based on the national conditions of China， in order to provide a reference for related departments in China on how to achieve the action targets for eliminating viral hepatitis as a public health threat by 2030.

Objective:To explore the differences in clinical phenotype characteristics and auxiliary test results of Gerstmann-Str?ussler-Scheinker syndrome (GSS) patients in the same family with GSS carrying a P102L mutation in the PRNP gene. Methods:A family with GSS carrying a P102L mutation in the PRNP gene, which was identified and treated at the Department of Neurology, Xuanwu Hospital, Capital Medical University in January 2024 was collected. A comprehensive evaluation was conducted on the proband, including neuropsychological examination, imaging studies, electroencephalogram, cerebrospinal fluid (CSF) analysis, real-time quaking-induced conversion (RT-QuIC) assay of skin biopsy samples, and genetic testing. At the same time, a survey and analysis were conducted on the family members. Skin RT-QuIC, genetic testing and neuropsychological evaluation were performed on some of the family members. Results:Among the 4-generation members of the GSS family, there were 5 GSS patients, including the proband′s father, younger brother, uncle and cousin. The proband, her younger brother and cousin all carried the P102L mutation in the PRNP gene, and her son was a carrier of the P102L mutation in the PRNP gene. The proband was a 53 years old female, and had a typical GSS phenotype, with the initial symptom of ataxia. The CSF 14-3-3 protein was negative and there were no abnormalities observed on her brain magnetic resonance imaging. The skin and CSF RT-QuIC test results of the proband were both negative. The cousin of the proband had a typical GSS phenotype, and his skin RT-QuIC test result was negative. The younger brother of the proband had a GSS phenotype of Creutzfeldt-Jakob disease type, with the initial symptom of rapidly progressing dementia and a positive skin RT-QuIC test result. The first symptoms of the proband′s father and uncle were both ataxia, and they had passed away without undergoing genetic testing. The son of the proband was a carrier of the P102L mutation in the PRNP gene and had no clinical symptoms. Conclusion:Different family members in the same GSS family may exhibit different clinical phenotypes, and GSS with different phenotypes have differences in RT-QuIC results.

Anaplastic lymphoma kinase (ALK) rearranged renal cell carcinoma (ALK-RCC) is an exceedingly rare malignancy, recently classified as a distinct molecular entity in the 5th edition of the WHO classification for urinary and male genital tumors. Due to its non-specific clinical symptoms and diverse histopathological patterns, accurate diagnosis is difficult. This paper reports a case of ALK-RCC with morphology and immunophenotype resembling papillary renal cell carcinoma. After second-generation sequencing, EML4-ALK gene fusion was found, and positive staining for ALK was confirmed by immunohistochemistry subsequently. Following informed consent from the patient, targeted therapy with crizotinib was initiated. During a 17-month follow-up period, no recurrence or metastasis was observed.

Objective To observe hierarchical differences in brain functional networks in unilateral mesial temporal lobe epilepsy(mTLE)patients with different outcomes after surgery.Methods A total of 69 unilateral mTLE patients who underwent resection of epileptogenic lesion on the affected side were retrospectively enrolled.Based on Engel classification 1 year after surgery,the patients were divided into seizure free(SF)group and non-seizure free(NSF)group.Functional connectivity gradient analysis was employed to extract principal gradient explaining the highest variance on preoperative resting-state functional MRI(rs-fMRI),then the whole-brain gradient characteristics and principal gradient values within specific functional networks were compared between groups.Results Principal gradient connected default mode network(DMN)with sensorimotor network(SMN)along a continuous axis.Compared to SF group,NSF group showed a contracted gradient range at both ends(DMN and SMN)of the functional network and weakened hierarchical differentiation,and principal gradient value of DMN was higher,while that of SMN was lower than those in SF group(both P＜0.05).Conclusion Hierarchical differences in brain functional networks in unilateral mTLE patients with different outcomes after surgery mainly present as enhanced DMN and weakened SMN in NSF ones,and the latter two might serve as important neuroimaging markers for evaluating postoperative seizure recurrence.

Objective To observe hierarchical differences in brain functional networks in unilateral mesial temporal lobe epilepsy(mTLE)patients with different outcomes after surgery.Methods A total of 69 unilateral mTLE patients who underwent resection of epileptogenic lesion on the affected side were retrospectively enrolled.Based on Engel classification 1 year after surgery,the patients were divided into seizure free(SF)group and non-seizure free(NSF)group.Functional connectivity gradient analysis was employed to extract principal gradient explaining the highest variance on preoperative resting-state functional MRI(rs-fMRI),then the whole-brain gradient characteristics and principal gradient values within specific functional networks were compared between groups.Results Principal gradient connected default mode network(DMN)with sensorimotor network(SMN)along a continuous axis.Compared to SF group,NSF group showed a contracted gradient range at both ends(DMN and SMN)of the functional network and weakened hierarchical differentiation,and principal gradient value of DMN was higher,while that of SMN was lower than those in SF group(both P＜0.05).Conclusion Hierarchical differences in brain functional networks in unilateral mTLE patients with different outcomes after surgery mainly present as enhanced DMN and weakened SMN in NSF ones,and the latter two might serve as important neuroimaging markers for evaluating postoperative seizure recurrence.

Anaplastic lymphoma kinase (ALK) rearranged renal cell carcinoma (ALK-RCC) is an exceedingly rare malignancy, recently classified as a distinct molecular entity in the 5th edition of the WHO classification for urinary and male genital tumors. Due to its non-specific clinical symptoms and diverse histopathological patterns, accurate diagnosis is difficult. This paper reports a case of ALK-RCC with morphology and immunophenotype resembling papillary renal cell carcinoma. After second-generation sequencing, EML4-ALK gene fusion was found, and positive staining for ALK was confirmed by immunohistochemistry subsequently. Following informed consent from the patient, targeted therapy with crizotinib was initiated. During a 17-month follow-up period, no recurrence or metastasis was observed.

Objective:To explore the differences in clinical phenotype characteristics and auxiliary test results of Gerstmann-Str?ussler-Scheinker syndrome (GSS) patients in the same family with GSS carrying a P102L mutation in the PRNP gene. Methods:A family with GSS carrying a P102L mutation in the PRNP gene, which was identified and treated at the Department of Neurology, Xuanwu Hospital, Capital Medical University in January 2024 was collected. A comprehensive evaluation was conducted on the proband, including neuropsychological examination, imaging studies, electroencephalogram, cerebrospinal fluid (CSF) analysis, real-time quaking-induced conversion (RT-QuIC) assay of skin biopsy samples, and genetic testing. At the same time, a survey and analysis were conducted on the family members. Skin RT-QuIC, genetic testing and neuropsychological evaluation were performed on some of the family members. Results:Among the 4-generation members of the GSS family, there were 5 GSS patients, including the proband′s father, younger brother, uncle and cousin. The proband, her younger brother and cousin all carried the P102L mutation in the PRNP gene, and her son was a carrier of the P102L mutation in the PRNP gene. The proband was a 53 years old female, and had a typical GSS phenotype, with the initial symptom of ataxia. The CSF 14-3-3 protein was negative and there were no abnormalities observed on her brain magnetic resonance imaging. The skin and CSF RT-QuIC test results of the proband were both negative. The cousin of the proband had a typical GSS phenotype, and his skin RT-QuIC test result was negative. The younger brother of the proband had a GSS phenotype of Creutzfeldt-Jakob disease type, with the initial symptom of rapidly progressing dementia and a positive skin RT-QuIC test result. The first symptoms of the proband′s father and uncle were both ataxia, and they had passed away without undergoing genetic testing. The son of the proband was a carrier of the P102L mutation in the PRNP gene and had no clinical symptoms. Conclusion:Different family members in the same GSS family may exhibit different clinical phenotypes, and GSS with different phenotypes have differences in RT-QuIC results.