Radiotherapy is a crucial treatment modality for head and neck tumors. However, while effectively killing tumor cells, it significantly disrupts the homeostasis of the oral microecology, which is closely associated with various complications such as radiation-induced oral mucositis. Literature review indicates that as radiotherapy doses accumulate and treatment durations extend, the richness and diversity of the oral microbiota show a declining trend, with the genus Streptococcus decreasing most markedly. In contrast, radiotherapy selectively promotes the proliferation of bacterial phyla such as Proteobacteria and Bacteroidetes, which are rich in opportunistic pathogens. Mechanistically, radiotherapy activates the nuclear factor-kappa B pathway, triggering chronic inflammation and oxidative stress, damaging the epithelial barrier, suppressing local immunity, and causing damage to organs such as the salivary glands. It can also induce systemic diseases via the oral-gut axis, forming a multi-level, interconnected pathogenic network. In terms of interventions, treatment strategies including probiotics and prebiotics have shown promising efficacy against side effects such as radiation-induced oral mucositis. Saliva-based oral microbiota transplantation is an emerging strategy that is expected to become widely utilized for restoring oral microecological balance. Existing interventions provide preliminary pathways for clinical practice, but this field still faces several key scientific questions. The association between oral microecology and systemic diseases remains largely correlative, lacking causal evidence. Furthermore, critical parameters for oral microbiota transplantation, such as donor screening criteria, transplantation protocols, and long-term safety, are not yet well-defined. Therefore, future research should focus on conducting large-scale clinical trials to establish standardized protocols and safety evaluation systems for oral microecological interventions, and explore combined treatment therapies such as probiotics, prebiotics, and microbiota transplantation to advance the development of personalized precision modulation. These will enable more effective management of radiotherapy-induced oral microecological dysbiosis and improve treatment outcomes and quality of life for patients with head and neck tumors.

In recent years, the global prevalence of myopia has continued to rise. In China, myopia shows a trend toward widespread prevalence, earlier onset, and greater severity, and high myopia poses a serious threat to adolescent ocular health. Orthokeratology is currently one of the most effective clinical interventions for slowing myopia progression, yet its exact mechanisms of action have not been fully elucidated. Focusing on the various hypotheses proposed in the literature, this review summarizes the role of peripheral retinal defocus, choroidal thickness and blood flow, higher-order aberrations, accommodation, and biomechanics in myopia control with orthokeratology lenses. Specifically, the induction of peripheral myopic defocus through the reverse-geometry design of orthokeratology lenses constitutes the core mechanism by which axial elongation is slowed. After lens wear, choroidal thickening and increased blood perfusion improve the nutritional supply to the outer retina and inhibit scleral remodeling. Increases in higher-order aberrations, such as spherical aberration and coma, expand the depth of focus and reduce accommodative lag. Improvements in accommodative function and alterations in corneal biomechanics also act synergistically. These mechanisms are interrelated and act in a cascading manner to jointly inhibit axial elongation. This review aims to provide a theoretical basis for a deeper understanding of the mechanisms of orthokeratology lenses and to offer clinical references for individualized lens fitting, optimized lens design, and future research on myopia prevention and control.

ObjectiveTo investigate the effect of proprioceptive stimulation combined with shoulder strength training on cervical muscle morphology, vertebral artery hemodynamics, proprioception and motor function in healthy young men. MethodsThirty healthy young men recruited from Beijing Bo'ai Hospital between January, 2022 and June, 2024 were randomly divided into a proprioceptive stimulation (PS) group, a strength training (ST) group and a combined training (CT) group, with ten participants in each group. PS group received proprioceptive stimulation using suspension vibration, ST group received isometric contraction of the right shoulder joint in six directions, and CT group received both interventions concurrently, for four weeks. Before and after intervention, the cross-sectional area (CSA) of the right cervical multifidus, the end diastolic velocity (EDV) and peak systolic velocity (PSV) of the vertebral artery, cervical range of motion (ROM), isometric peak torque (IPT) and cervical joint position error (CJPE) were measured. ResultsAll 30 subjects completed the study, and no serious adverse events were reported. The time-by-group interaction in CSA was significant (F = 10.183, P = 0.001, partial η² = 0.430); CSA was higher in CT group than in PS group and ST group (P < 0.05). The time-by-group interactions in EDV and PSV were significant (F > 4.036, P < 0.05, partial η² > 0.230); PSV was significantly higher in CT group than in PS group and ST group (P < 0.001). The time-by-group interaction in extension ROM was significant (F = 54.277, P < 0.001, partial η² = 0.801); extension ROM was significantly higher in CT group than in PS group and ST group (P < 0.001). The time-by-group interactions in flexion, extension and lateral flexion IPT were significant (F > 14.251, P < 0.001; partial η² > 0.514); flexion IPT was higher in CT group than in PS group and ST group (P < 0.05). ConclusionIn healthy young men, proprioceptive stimulation combined with shoulder strength training can improve neck muscle strength, blood flow and motor function.

ObjectiveTo investigate the clinical efficacy of Qihuang Jianpi Zishen granules in the treatment of systemic lupus erythematosus （SLE），observe their effects on renal podocyte injury，and decipher related mechanisms. MethodsSixty-two SLE patients with renal damage who met the inclusion criteria and treated in the First Affiliated Hospital of Anhui University of Chinese Medicine between November 2022 and July 2024 were selected. They were randomly allocated into a control group and an observation group （31 patients in each group）. The control group was treated with oral hydroxychloroquine sulfate，prednisone acetate，and mycophenolate mofetil. The observation group received Qihuang Jianpi Zishen granules orally in addition to the regimen in the control group. After 12 weeks of continuous treatment，the SLE Responder Index-4 （SRI-4） response rate was evaluated for both groups. Comparisons were made between the two groups before and after treatment regarding disease activity scores，traditional Chinese medicine （TCM） symptom scores，kidney-related indicators ［serum creatinine （SCr），cystatin C （Cys C），24-hour urine protein quantitation （24 h Pro），urine protein/creatinine ratio （UPCR），and urine albumin/creatinine ratio （UACR）］，immune and inflammatory markers ［anti-double-stranded DNA antibody，interferon-γ （IFN-γ），and monocyte chemoattractant protein-1 （MCP-1）］，urinary podocyte injury markers （Nephrin，Podocin，and WT-1），and mRNA levels of apoptosis-related factors （Bax，Bcl-2，and Caspase-3） in peripheral blood mononuclear cells. Adverse reactions were recorded. ResultsAfter 12 weeks of treatment，the SRI-4 response rate in the observation group was 48.38%（15/31），which was higher than that in the control group 36.66%（11/30）. Within-group comparisons showed that after treatment，both groups exhibited decreases in TCM symptom scores，kidney-related indicators （UACR，UPCR，24 h Pro，SCr，and CysC），inflammatory markers （IFN-γ and MCP-1），podocyte injury markers （Nephrin，Podocin，and WT-1），and the mRNA levels of Bax and Caspase-3 （P<0.05，P<0.01） and an increase in the mRNA level of Bcl-2 （P<0.01）. After treatment，the observation group showed lower disease activity score，TCM symptom scores，levels of UACR，UPCR，24 h Pro，SCr，IFN-γ，MCP-1，and podocyte injury markers （Nephrin，Podocin，WT-1），and mRNA level of Bax （P<0.05，P<0.01） and higher mRNA level of Bcl-2 （P<0.05） than the control group. No serious adverse reactions occurred during the treatment period. ConclusionQihuang Jianpi Zishen granules can effectively reduce the disease activity，TCM symptoms，proteinuria，podocyte injury，and renal damage in patients with SLE by regulating the immune-inflammatory state，mitigating podocyte injury，and inhibiting cell apoptosis.

[Purpose]To analyze the incidence and mortality of gastric cancer in Zhejiang cancer registration areas in 2021,and trends from 2000 to 2021.[Methods]The data of gastric cancer were obtained from Zhejiang cancer registration areas.The crude incidence/mortality rates,age-specific rates,and age-standardized incidence/mortality rates by Chinese standard population(ASRC)and the world standard population(ASRW)were calculated.The temporal trends were ana-lyzed by calculating annual percentage change(APC)and average annual percentage change(AAPC).[Results]A total of 7 602 new cases and 4 178 deaths of gastric cancer were reported in 2021.The incidence and mortality rates of gastric cancer in men were significantly higher than those in women;the incidence rate in urban areas was significantly higher than that in rural areas,while the mortality was slightly lower than that in rural areas.From 2000 to 2021,the ASRC of inci-dence rate decreased from 16.80/105 to 16.08/105(without statistical significance):an upward trend was observed from 2000 to 2009,whereas a downward trend became apparent from 2009 to 2021.From 2000 to 2021 the ASRC of mortality rate decreased from 13.59/105 to 8.02/105 with an AAPC of-2.62％(P＜0.001).The decline rate of female mortality rate(AAPC=-2.68％,95％CI:-3.61％～-1.68％,P＜0.001)was slightly higher than that of male(AAPC=-2.44％,95％CI:-3.06％～-1.61％,P＜0.001).[Conclusion]In 2021,both the incidence and mortality rates of gastric can-cer in Zhejiang Province were lower than the national average in China,which ranked 6th and 4th among all types of cancer.From 2000 to 2021,the overall burden of gastric cancer in Zhejiang Province showed a downward trend.

OBJECTIVE To observe the epidemiological characteristics,virulence and drug resistance genes in Kleb-siella oxytoca complex(KOX)strains isolated from the children in Suzhou so as to provide theoretical bases for clinical prevention and control.METHODS The clinical distribution and drug resistance of 101 strains of KOX that were isolated from Children's Hospital of Soochow University from Jan.2021 to Mar.2024 were retrospectively analyzed.Fifty strains were randomly selected to detect the expressions of 18 types of virulence genes and 12 types of drug resistance genes.RESULTS Of the 97 strains of KOX isolated from hospitalized children,32.67％from i-solated from sputum,27.72％from stools and 24.74％from urine;45.54％were isolated from hematology de-partment,18.81％from neonatology department and 10.89％from ICU.The strains expressed a variety of viru-lence genes,among which the ironophore-related genes entB(82.00％),irp-1(64.00％),irp-2(64.00％),ybtS(64.00％)and fyuA(64.00％)were dominant.Carbapenem-sensitive KOX(CS-KOX)strains were susceptible to most of the antibiotics,while the drug resistance rates of the CR-KOX strains to most of the antibiotics were relatively high.The detection rates of extended-spectrum β-lactamase gene CTX(56.52％)and carbapenemase gene NDM(78.26％)were relatively high among the CR-KOX strains;38.89％(7/18)of the strains expressed NDM gene and meanwhile expressed other carbapenemase genes.CONCLUSIONS The KOX strains isolated from the hospitalized children in Suzhou carry a variety of virulence and drug resistance genes,and there is risk of trans-mission of CR-KOX in the hospital.Therefore,it is necessary to attach great importance to the surveillance of drug-resistant strains for the long-term hospitalized children and raise the awareness of infection control so as to prevent the transmission of such bacteria.

OBJECTIVE To explore the clinical characteristics of patients with hematologic tumors combined with Fusarium infection and analyze the prevention and control measures.METHODS Six patients with hematologic neo-plasms combined with Fusarium infection diagnosed at the First Medical Center of the People's Liberation Army General Hospital from Apr.2019 to Dec.2023 were selected as research objects.Through retrospective analysis of patients' clinical data,the clinical manifestations,diagnosis,treatment and prevention strategies of Fusarium in-fection in hematologic neoplasms were analyzed.RESULTS All six patients with hematologic neoplasms combined with Fusarium infection were neutropenic or deficient patients,with main symptoms including moderate fever,painful skin nodules,rash,skin broken and crusted,and scrotal swelling and pain.Patients with severe neutrophil deficiency were susceptible to blood-borne Fusobacterium infections.Four patients had a markedly elevated G-test and Fusorium was first detected by microbiome metagenomic next-generation sequencing(mNGS)in blood,earli-er than traditional pathogenic culture methods.Five patients had Fusarium detected in urine or stool cultures.All six patients received empirical antibacterial and antifungal treatments,but the fungal infection treatment effects were poor.Treatment was adjusted according to the pathogenetic findings,mainly using a combination regimen based on liposomal amphotericin B or posaconazole tablets,with three patients cured and three death.Two pa-tients were from the same ward with a sixteen-day interval.Although no evidence of infection transmission was found,there was still a risk of cross-infection in patients with hematological malignancies and severe immunodefi-ciency.Measures for the prevention and control of hospital-acquired infections were implemented for patients with Fusarium infection and the ward.CONCLUSIONS The clinical manifestations of patients with hematological tumors combined with Fusarium infection are complex and varied with high mortality rates.MNGS testing is valuable in the early diagnosis of Fusarium infection,and it is necessary to explore new treatment options and hospital-ac-quired infectious disease prevention and control measures to improve the prognosis.

Depression, one of the most prevalent mental health disorders, has emerged as a critical focus in medical and neurobiological research, as well as a major challenge for global public health. The immune-inflammatory hypothesis has been confirmed to play a pivotal role in the pathogenesis and pathophysiology of depression, though its precise mechanisms remain to be fully elucidated. This article reviews the effects of key inflammatory factors, including tumor necrosis factor-α, interleukin-1β, interleukin-6, and Toll-like receptors on depression. Additionally, it summarizes the effects of immune-inflammatory pathway invovled in the pathogenesis of depression, along with scientific clues related to inflammatory factors in this pathway. Findings from this review will provide new insights for antidepressant development and serve as a reference for evaluating the clinical efficacy of antidepressants.

Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506～0.945)in the bowel damage group and 0.155(95%CI:0.093～0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.

Objective To explore the distribution characteristics and influencing factors of nasal colonized bacteria of healthcare workers(HCWs)in pediatric intensive care unit(PICU).Methods A cross-sectional study was con-ducted.Nasal swab specimens from 104 HCWs in the PICU of a hospital were collected for bacterial culture and an-timicrobial susceptibility testing.According to the identification and antimicrobial susceptibility testing results of strains,distribution characteristics of colonized bacteria was analyzed.Basic information of studied subjects were collected through questionnaire survey,and risk factors for colonized bacterial infection were conducted using logis-tic regression analysis.Results Among 104 specimens,colonized bacteria were detected from 66 specimens,with an overall detection rate of 63.46％.Gram-positive bacteria was mainly Staphylococcus aureus,with a detection rate of 34.62％(n=36),out of which methicillin-resistant Staphylococcus aureus(MRSA)accounted for 2.88％(n=3).Gram-negative bacteria was mainly Klebsiella spp.,with a detection rate of 21.15％(n=22).Multiva-riate logistic regression analysis showed that HCWs with junior professional titles(OR=11.400,95％CI:2.329-55.801,P=0.003)was an independent risk factor for Staphylococcus aureus colonization,and male(OR=4.260,95％CI:1.160-15.653,P=0.029)was an independent risk factor for Klebsiella spp.colonization.Conclusion Nasal cavity of HCWs in PICU has a high detection rate of colonized bacteria,with Staphylococcus aureus and Klebsiella spp.being the major colonized bacteria.