2.Sex‑specific trends and demographic vs. epidemiologic drivers of alcohol‑related cirrhosis in United States, 2021–2040: Letter to the editor on "Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the United States"
Clinical and Molecular Hepatology 2026;32(2):e155-e157
3.Differential Improvement in Memory and Executive Functions:Personalized Exercise versus Acupuncture for Mild Cognitive Impairment in Stroke-prone Individuals
Yaoyao XING ; Haoran HU ; Qingping MA ; Jianjun YANG ; Xin WANG
Clinical Psychopharmacology and Neuroscience 2026;24(1):67-83
Objective:
This study compared the effects of personalized exercise versus acupuncture on multidimensional cognitive function in individuals at high risk for stroke with mild cognitive impairment (MCI).
Methods:
A randomized controlled trial enrolled 200 stroke-risk adults aged 50−80 years. Ninety participants diagnosed with MCI (MMSE, HIS, CDR criteria) were randomly assigned to exercise (n = 30), acupuncture (n = 30), or control (n = 30) groups. Interventions lasted 6 months. Cognitive outcomes (MMSE, Raven’s Progressive Matrices, Digit Symbol Substitution Test, Animal Fluency, Rey-Osterrieth test, Stroop test) were assessed before and after intervention. Multivariate regression identified risk factors for MCI. ANOVA was used for group comparisons.
Results:
Hypertension (aOR = 1.5) and diabetes (aOR = 1.3) were significant risk factors for MCI. After intervention, the exercise group showed the largest MMSE improvement (Δ = 5.0), compared with acupuncture (Δ = 3.0) and control (Δ = 1.0) (p < 0.001). Exercise produced greater gains in non-verbal reasoning (31.8% vs. 26.1% in acupuncture, p < 0.01). Acupuncture more effectively enhanced processing speed and attention (DSST: Δ = 26 vs. Δ = 20 in exercise, p = 0.03) and executive function (Stroop interference time: Δ = 16 vs. Δ = 15 seconds in exercise, p = 0.04). Both interventions significantly improved verbal fluency (p < 0.001), with larger benefits in those with baseline MMSE ≤ 20.
Conclusion
Hypertension and diabetes are key risk factors for MCI in stroke-prone individuals. Exercise yields greater improvement in global cognition and memory, whereas acupuncture is more effective for enhancing attention and executive function. Both modalities benefit verbal fluency, particularly in lower-functioning participants.
4.Innovation and Practice in the Construction of "Three-in-one" Talent Training Systems for Laboratory Animal Professionals in Medical Colleges
Xiuran WANG ; Hao LI ; Zhengtao CHEN ; Yang YU ; Suying ZHANG ; Ru TAO ; Kezhou WANG
Laboratory Animal and Comparative Medicine 2026;46(3):446-455
Laboratory animal science is an emerging interdisciplinary field supporting life science and medical research, and a key component of talent cultivation and technological innovation in medical colleges. Currently, this field faces challenges such as a significant imbalance between talent supply and demand and a weak systematic training system. To respond to national strategies and societal needs, Shandong First Medical University established the School of Laboratory Animal through industry-education integration during the 14th Five-Year Plan period. The school is based on The Medical Laboratory Technology major, cultivates application-oriented, interdisciplinary professionals in laboratory animal science, and has constructed a three-in-one training system integrating "course learning–scientific research–industry practice". Specific measures for talent cultivation include: optimizing the general education, professional courses, and intensive practical modules in the talent training program, and establishing the "Yellow River Class" integrating industry and education; implementing an undergraduate mentor system, and conducting scientific research training based on The Model Animal Research and Development Engineering Laboratory; collaborating with bases across the entire industrial chain of laboratory animal production, research, application, and quality control, appointing industry mentors, and strengthening practical teaching. Practice has shown that this system has been remarkably effective: a total of 320 undergraduate students have been enrolled since 2020; the employment rate of undergraduate graduates for two consecutive cohorts has reached 100%, and the postgraduate enrollment rate has exceeded 50%; undergraduate students have won numerous national and provincial awards in academic competitions, and have obtained multiple patents and published papers. In the future, the school will further integrate the advantages of medicine, agriculture, and science, optimize the depth and breadth of courses, strengthen the construction of faculty and teaching materials, and improve the undergraduate-master's integrated training mechanism. This article can provide a reference for the training of professionals in laboratory animal science and related biomedical fields in medical colleges.
5.Timing of endoscopic treatment for acute esophagogastric variceal bleeding in liver cirrhosis: Controversies and challenges
Xinhui LI ; Xingshun QI ; Xiaofeng LIU ; Daiming FAN ; Jing WANG
Journal of Clinical Hepatology 2026;42(5):1178-1184
Acute esophagogastric variceal bleeding (AEGVB) is one of the life-threatening complications of decompensated cirrhosis. Endoscopy is the main method for the diagnosis and treatment of AEGVB, and endoscopic treatment can effectively control acute bleeding and alleviate or eliminate varices. However, there is still a lack of consistent recommendations for the timing of endoscopic examination and intervention for AEGVB in related guidelines in China and globally. Existing studies in China and globally have low quality of evidence, with significant variations in the definition of “early endoscopy” and inconsistent conclusions. This article reviews the research advances in the timing of endoscopic treatment for AEGVB in liver cirrhosis, points out the controversies over the optimal timing of treatment, and discusses future research directions in this field.
6.Clinical and Neuroelectrophysiological Characteristics of Split Face Phenomenon in Patients with Amyotrophic Lateral Sclerosis
Dong ZHANG ; Wenqing WANG ; Jingwen XU ; Xiaoqing LYU ; Yuying ZHAO ; Chuanzhu YAN
JOURNAL OF RARE DISEASES 2026;5(2):184-190
Amyotrophic lateral sclerosis (ALS) is a chronic, progressive degenerative disease affecting both upper and lower motor neurons, primarily characterized by skeletal muscle weakness and atrophy. Notably, the same muscle group may exhibit asynchronous involvement. This study aims to investigate the involvement patterns of the orbicularis oculi (OOc) and orbicularis oris (OOr) in ALS patients, compare the findings with healthy controls (HCs) and myasthenia gravis (MG) patients, and explore the characteristics and clinical significance of facial muscle involvement in ALS. Clinical and neuroelectrophysiological data were collected and analyzed in ALS patients (ALS group), HCs (HCs group) and MG patients (MG group). Clinical data included age, gender, clinical symptoms and signs, and the revised ALS Functional Rating Scale (ALSFRS-R) score. Split-face (SF) phenomenon was defined as OOc muscle strength being greater than OOr muscle strength. The negative peak amplitudes of compound motor action potential (CMAP) recorded from OOc and OOr, namely CMAPOOc and CMAPOOr, were collected for electrophysiological evaluation. Number of patients enrolled in each group: 137 in the ALS group, 42 in the HCS group, and 33 in the MG group.Of the 137 ALS patients, 74 presented clinical SF manifestation. The CMAPOOc amplitude in the ALS group was 2.00 (1.66, 2.40) mV, showing no significant difference compared with 2.20 (1.86, 2.58) mV in the HCs group ( More than half of ALS patients have SF phenomenon, and neuroelectrophysiological indicators can provide objective evidence for SF. SF is correlated with bulbar onset, severe bulbar symptoms and rapid disease progression, and can serve as a potential indicator for the differential diagnosis between ALS-BO and MG.
7.Neuroelectromagnetic Activities Across Temporal Scales
Zhuo-Qun SHEN ; Xiao-Fei XU ; Yan-Qing WANG ; Jing-Xin LI ; Lan TIAN ; Wei GUO ; Jing-Jing XU
Progress in Biochemistry and Biophysics 2026;53(6):1541-1560
Although global brain science research has progressed rapidly in recent decades, several fundamental questions in neuroscience remain unresolved. In particular, the physical mechanism underlying neural signal transmission remains controversial, and the carriers responsible for neural information storage and retrieval have not yet been fully clarified. These unresolved issues motivate us to re-examine the processes of neural information generation, transmission, integration, storage, and retrieval from multiple perspectives. A key observation is that neural electromagnetic activities are closely associated with time. Their duration, temporal structure, and dynamic evolution play crucial roles in neural information processing. In this work, we analyze neural electromagnetic activities from the perspective of temporal scales (referred to here as the “time course”). By reviewing and integrating findings from previous studies, we examine the characteristic time requirements and dynamic features of neural processes occurring at different stages of information processing. These stages include neural signal generation, signal transmission along axons, synaptic integration, synaptic plasticity, and memory formation and retrieval. Based on this temporal analysis, we outline a framework describing neural electromagnetic activities across a wide range of time scales, spanning from microseconds to minutes, hours, or even longer periods associated with long-term memory, which suggests that neural information processing involves multiple physical processes operating at different time levels. Rapid electromagnetic events may occur on microsecond scales, whereas electrophysiological phenomena such as action potentials typically last on the order of milliseconds. Longer time scales are associated with synaptic plasticity and memory-related processes. From this perspective, we propose that the physical carrier of neural information may be transient electromagnetic pulses with durations on the microsecond scale. In this framework, action potentials can be interpreted as the macroscopic electrophysiological manifestation of underlying electromagnetic processes triggered by ionic currents across neuronal membranes. Rather than being the fundamental neural signal itself, the action potential may represent a measurable membrane-level response associated with the successful activation of these electromagnetic events. Moreover, we discuss a possible mechanism for long-term memory storage. Considering the apparent temporal contradiction between the millisecond-scale excitation of neurons and the long-term persistence of memories, we believe that long-term memory information may be stored within neural network topologies formed by electrical synapse coupling. Such structures, referred to as electrically coupled memory networks (ECMNs), may enable neurons within the same network to respond rapidly and synchronously to stimuli, thereby facilitating efficient memory retrieval. Overall, this study emphasizes the importance of considering the temporal organization of neural electromagnetic activities when interpreting neural signaling mechanisms. It may provide new insights into the physical nature of neural information carriers and the mechanisms of memory storage and retrieval. Furthermore, highlighting the potential role of electromagnetic interactions in neural activity may contribute to the development of new theoretical frameworks and experimental approaches in neuroscience. Such perspectives may also offer valuable references for future research on neural coding, brain function mechanisms, and neuromodulation technologies.
8.Psychological Stress-induced Immune Dysregulation: The Key Factor Undermining Aerobic Exercise’s Antagonism Against Tumor Progression
Xin ZHOU ; Hua ZHANG ; Jing-Jing LIU ; Hui-Xin PAN ; Jing ZHANG ; Qing-Lu WANG
Progress in Biochemistry and Biophysics 2026;53(6):1656-1671
Cancer is one of the most lethal and burdensome diseases worldwide. Its progression not only causes irreversible damage to the body, but also imposes a substantial psychological burden on patients due to its complex prognosis. Immune imbalance, a hallmark of the tumor microenvironment (TME), accelerates tumor invasion and metastasis by impairing the function of effector immune cells, promoting the abnormal infiltration of immunosuppressive cells, and disrupting cytokine homeostasis, thereby constituting a major barrier to the efficacy of cancer immunotherapy. Compared with conventional chemotherapy and radiotherapy, aerobic exercise has shown considerable potential in antagonizing tumor progression through relatively mild but effective immunomodulatory mechanisms. On the one hand, regular aerobic exercise enhances the number and activity of key effector immune cells, such as CD8+ T cells, thereby strengthening their ability to recognize and eliminate tumor cells and alleviate immune imbalance. On the other hand, aerobic exercise promotes tumor vascular normalization, improves vascular maturity, and stimulates the secretion of irisin and other anti-inflammatory myokines, thereby remodeling the TME and relieving its immunosuppressive state to delay tumor progression. However, psychological stress following a cancer diagnosis can not only act as an independent disruptive factor that exacerbates immune imbalance within the TME, but also amplify the effects of other detrimental factors, such as reduced treatment adherence, thereby further weakening the antagonistic effect of aerobic exercise on tumor growth. Psychological stress, as a chronic stressor, promotes the excessive secretion of emotion-related hormones, including glucocorticoids (GCs) and norepinephrine (NE), which further suppress the activation and effector functions of antitumor immune cells such as CD8+ T cells and natural killer (NK) cells, while facilitating the recruitment of protumor immune cells such as regulatory T cells (Tregs). These changes ultimately disrupt immune homeostasis in the TME, promote tumor immune evasion, accelerate tumor invasion and metastasis, and offset the beneficial effects of aerobic exercise on tumor control. In addition, psychological stress induces hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis and abnormal excitation of the sympathetic nervous system (SNS), thereby maintaining elevated levels of GCs, NE, and related stress hormones, suppressing inflammatory chemokine expression and immune cell recruitment, and further disturbing immune homeostasis in the TME, which accelerates tumor progression. More importantly, prolonged psychological stress can also disrupt the homeostasis of central neurotransmitters, such as 5-hydroxytryptamine (5-HT) and glutamate (Glu). This not only directly inhibits the activation and effector functions of antitumor immune cells and promotes the establishment of an immunosuppressive microenvironment, but also impairs cellular energy metabolism and continuously provides energy for tumor cells through metabolic reprogramming, thereby sustaining rapid tumor growth and adaptation to a hostile TME. Ultimately, these alterations contribute to the dysregulation of “neuro-endocrine-immune” axis and weaken the protective effect of aerobic exercise against tumor progression. Therefore, this review focuses on the interaction between psychological stress and the “neuro-endocrine-immune” axis, with particular emphasis on the mechanisms by which psychological stress induces immune imbalance and weakens the antagonistic effect of aerobic exercise on tumor progression. We further highlight the important role of psychological stress in tumor progression and propose that combining psychotropic interventions, aerobic exercise, and clinical antitumor immunotherapy may help restore the tumor-killing capacity of the immune system. Such a multimodal strategy may exert synergistic effects at multiple levels, including psychological stress relief, neuroendocrine regulation, and reconstruction of immune homeostasis, thereby providing new perspectives for identifying therapeutic targets in solid tumors, enhancing the efficacy of cancer immunotherapy, and improving patient prognosis.
9.Analysis of the incidence and associated factors of cyclosporine-associated acute kidney injury in hospitalized patients based on real-world data
Yaqing DOU ; Jiahui LAO ; Xue WANG ; Yanying SUN ; Xin HUANG ; Hanbing LI ; Xiao LI
China Pharmacy 2026;37(12):1584-1589
OBJECTIVE To analyze the incidence of cyclosporine (CsA)-associated acute kidney injury (AKI) in hospitalized patients, identify influencing factors, and construct a risk prediction model. METHODS A single-center retrospective study was conducted, enrolling clinical data from hospitalized patients treated with CsA at the First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital from January 2018 to July 2024. The patients were classified into AKI group and non-AKI group based on the occurrence of CsA-related AKI. Univariate analysis and multivariate Logistic regression analysis were used to identify independent risk factors for CsA-related AKI, and a risk prediction model was constructed and its performance was evaluated. RESULTS A total of 439 patients were included, of whom 54 developed CsA-related AKI, with an incidence rate of 12.30%. The occurrence of CsA-associated AKI was positively correlated with concurrent bacterial pulmonary infection, cytomegalovirus viremia, respiratory failure, renal insufficiency, gastrointestinal bleeding, and peripheral central venous catheterization (odds ratios of 763.750, 16.944, 41.933, 236.806, 17.537 and 212.789, respectively; P <0.05); while uric acid, prealbumin, and calcium levels were negatively associated with it (odds ratios of 0.983, 0.967 and 0.058, respectively; P <0.05). The prediction model constructed based on the above factors yielded a χ 2 value of 10.254 ( P >0.05) in the Hosmer-Lemeshow test. The average area under the curve (AUC) from 10-fold cross-validation was 0.885. The AUC of the receiver operating characteristic curve was 0.883, with a sensitivity of 84.3% and a specificity of 80.4%, respectively, at the optimal cutoff value of 0.1. CONCLUSIONS Six factors, including concurrent bacterial pulmonary infection and cytomegalovirus viremia, are positively associated with the occurrence of CsA-related AKI; while uric acid, prealbumin, and calcium levels are negatively associated. The Logistic regression model constructed based on these factors demonstrates good predictive performance and can assist clinic in conducting early risk assessment and personalized interventions.
10.Diagnosis and treatment of hepatic vascular malformations
Mengyao WANG ; Guangchuan WANG
Journal of Clinical Hepatology 2026;42(4):765-770
Hepatic vascular malformations are a group of congenital or acquired disorders characterized by structural abnormalities of the intrahepatic arterial, venous, or portal venous systems, with the clinical manifestations of hyperdynamic circulation, portal hypertension, and complications of portosystemic shunting. Due to the low incidence rate and nonspecific clinical manifestations of such disorders, they are easily confused with cirrhotic portal hypertension, leading to the delay in diagnosis and treatment. This article introduces the common clinical manifestations and differential diagnosis of hepatic vascular malformations and elaborates on three typical types of hepatic vascular malformations, in order to provide ideas and references for clinical diagnosis and treatment.

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