1.Ionizing Radiation-induced Lens Injury: Epidemiology, Dose-effect Relationship, and Molecular Mechanisms
Cheng-Hao HU ; Shao-Han REN ; Hai-Tao ZHANG ; Jing-Ming ZHAN
Progress in Biochemistry and Biophysics 2026;53(3):688-696
The crystalline lens of the eye is recognized as one of the most radiosensitive tissues in the human body. While the International Commission on Radiological Protection (ICRP) has classified ionizing radiation (IR)-induced cataracts as a tissue reaction (deterministic effect) and subsequently reduced the occupational equivalent dose limit for the lens, significant uncertainties remain regarding the precise dose threshold and the complex biological pathways driving lens opacification. This review provides a comprehensive synthesis of current knowledge concerning radiation-induced lens damage, integrating epidemiological exposure characteristics with dose-response modeling and mechanistic molecular insights. First, we analyze exposure characteristics through four epidemiological dimensions: dose, time, space, and population. Clinical evidence suggests that radiation cataracts—particularly posterior subcapsular opacities—exhibit a distinct latency period that is inversely correlated with dose. We highlight that risk is not confined to acute high-dose scenarios (such as in atomic bomb survivors) but is increasingly relevant in chronic low-dose occupational settings (e.g., interventional radiology) and medical diagnostics (e.g., CT scans). Crucially, individual susceptibility is modified by genetic background, age, and environmental co-factors, complicating risk assessment. Second, we critically examine the dose-effect relationship. Although the ICRP suggests a threshold of 0.5 Gy, emerging data challenge the traditional threshold model, with some studies advocating for a linear non-threshold (LNT) relationship. We further discuss the critical roles of radiation quality and dose rate. High linear energy transfer (LET) radiation demonstrates a significantly higher relative biological effectiveness (RBE) for cataractogenesis compared to low-LET radiation. Paradoxically, and unlike many other tissues, the lens may exhibit an “inverse dose-rate effect,” where fractionated or protracted exposures potentially enhance biological damage—a finding that challenges classical radiobiological paradigms. Third, drawing upon the “cataractogenic load” hypothesis and the unique physiological constraints of the lens, this review elucidates the multidimensional molecular mechanisms driving radiation-induced opacification. Key mechanisms include four aspects. (1) DNA damage and repair: IR induces DNA double-strand breaks (DSBs) that, due to the lens’ limited repair capacity (modulated by genes such as ATM, Ptch1, and Ercc2), lead to the accumulation of damage. (2) Antioxidant defense system: dysfunction of the Nrf2/HO-1 antioxidant axis results in redox imbalances, triggering NF-κB-mediated inflammation and protein aggregation. (3) Cell proliferation and senescence: IR disrupts cell cycle regulation, causing a dichotomy of effects—driving premature senescence in some cell populations (evidenced by ATM nuclear foci) while inducing aberrant proliferation via growth factor upregulation (FGF2, TGFβ) in others. (4) Cell migration and adhesion: activation of the Wnt/β‑catenin pathway and alterations in the E-cadherin complex promote the abnormal migration of epithelial cells to the posterior capsule, a hallmark of radiation-induced cataracts. In conclusion, radiation-induced cataractogenesis is a multifactorial process in which genetic susceptibility and environmental stressors converge to overwhelm the lens’ homeostatic thresholds. Future research must prioritize longitudinal cohort studies to refine dose thresholds and employ multi-omics approaches to map the crosstalk between DNA damage responses and matrix remodeling. Establishing a robust mechanistic model is essential for developing targeted radioprotective strategies and optimizing radiation protection standards for occupational and medical safety.
2.Comparative Analysis of Clinical Efficacy of Traditional Chinese Medicine Manipulative Reduction Combined with Small Splint Fixation Versus Surgical Treatment for Type A Distal Radius Fracture
Yang SHAO ; Zihan WANG ; Jianwei WANG ; Guoda DAI ; Hengyan CUI ; Zhen HUA ; Tingchen ZHU ; Shaoshuo LI ; Jun MAO ; Fenghua CHEN ; Shuai TAO ; Mao WU
Journal of Traditional Chinese Medicine 2026;67(10):1078-1085
ObjectiveTo compare the clinical efficacy of traditional Chinese medicine (TCM) manipulative reduction combined with small splint fixation versus surgical treatment for type A distal radius fracture (DRF) and to explore the factors influencing the choice of treatment. MethodsA multi-center retrospective study was conducted, collecting data from 1237 type A DRF patients treated in 11 hospitals in Jiangsu province from September, 2023 to April, 2025. Among them, 851 patients in the TCM group received manipulative reduction combined with small splint fixation, and 386 patients in the surgical group underwent open reduction and internal fixation. Visual analog scale (VAS) scores for pain and radiographic indicators including palmar tilt, ulnar deviation, and radial height were compared before treatment, 5-7 days after treatment, and 4-6 weeks after treatment. The wrist joint function scores including Dienst and Gartland-Werley scores at 12 weeks after treatment were recorded. Subgroup analysis was conducted for the excellent rate of Dienst and Gartland-Werley scores, stratified by age (<50, 50-59, 60-69, ≥70 years old) and AO subtypes (A1, A2, A3). A multivariate logistic regression model was used to identify independent factors influencing treatment choice. ResultsOn 5-7 days after treatment, the surgical group had lower VAS scores than the TCM group, while 4-6 weeks after treatment, the TCM group showed lower VAS scores than the surgical group (P<0.01). In terms of radiographic indicators, except for the palmar tilt before treatment being higher in the surgical group than in the TCM group (P<0.01), there were no significant differences in palmar tilt, ulnar deviation, and radial height at other timepoints (P>0.05). Twelve weeks after treatment, the surgical group had a higher average Gartland-Werley score and the excellent rate than the TCM group (P<0.01). Subgroup analysis showed that in patients with A2 type DRF aged 50-59 and 60-69 years old, the excellent rates of Dienst and Gartland-Werley scores in the TCM group were higher than those in the surgical group (P<0.05). Multivariate logistic regression analysis revealed that age, palmar tilt, ulnar deviation, and the degree of swelling on the affected side were independent factors influencing the choice of treatment (P<0.05). ConclusionBoth TCM manipulative reduction combined with small splint fixation and surgical treatment for type A DRF can achieve good therapeutic effects. TCM manipulative reduction combined with small splint fixation has certain advantages in medium- and long-term pain relief, especially in elderly patients, where wrist joint function recovery is more stable. Age, palmar tilt, ulnar deviation, and swelling degree are the main factors influencing the treatment choice.
3.Mechanism of Ellagic Acid in Ameliorating Bleomycin-induced Lung Injury
Li SHAO ; Ke TAO ; Li WEI ; Juanli LI ; Zhizhi SHI ; Shugui QIAO ; Shaokang WANG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(3):496-508
ObjectiveTo investigate the protective effect of ellagic acid (EA) against bleomycin (BLM)-induced pulmonary fibrosis and associated pulmonary function impairment in mice, and to elucidate its relationship with the regulation of the interleukin(IL)-17/ nuclear factor (NF)-κB/ matrix metalloproteinase (MMP)9 signaling axis. MethodsA pulmonary fibrosis model was established in male C57BL/6J mice via intratracheal BLM injection. Interventions included IL-17 neutralizing antibody, Ixekizumab, SB-3CT, PDTC, or EA were used to modulate the IL-17/NF-κB/MMP9 signaling axis. Pathological changes in lung tissue were observed via HE, Masson, and Sirius red staining. Pulmonary function was assessed using a pulmonary function test (PFT). Western blot and qRT-PCR were employed to detect related protein and gene expression. Network pharmacology was utilized to predict the potential targets of EA. A protein-protein interaction (PPI) network was constructed using the STRING database and Cytoscape. Molecular docking was performed to validate the binding capability of EA to core targets. ResultsBLM successfully induced obvious pulmonary fibrosis and lung dysfunction in mice, significantly elevating the level of the pro-inflammatory cytokine IL-17. This was associated with the activation of the transcription factor NF-κB p65, leading to the upregulation of the pro-fibrotic factor MMP9. Inhibition of the IL-17/NF-κB/MMP9 signaling axis markedly alleviated the degree of pulmonary fibrosis. EA intervention significantly suppressed the BLM-induced increase in IL-17, blocked the activation of the NF-κB/MMP9 pathway, and consequently reduced lung fibrotic lesions and improved pulmonary function. ConclusionEA may effectively ameliorate BLM-induced pulmonary fibrosis and lung dysfunction in mice, likely by inhibiting the inflammatory and fibrotic responses mediated through the IL-17/NF-κB/MMP9 signaling pathway.
4.Recent advances in the application of three dimensional reconstruction techniques in surgical treatment of early lung cancer
Tao LONG ; Zhengbing REN ; Aizhong SHAO ; Zhicheng HE ; Weibing WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):121-128
Lung cancer is the leading cause of death worldwide. With the prevalence of CT screening and early diagnosis and treatment of lung cancer in China, more and more patients with early-stage lung cancer characterized with ground-glass opacity are discovered and urgently require treatment, which poses a significant challenge to surgeons. As an emerging technology, three dimensional reconstruction technology plays a crucial auxiliary role in clinical work. This review aims to briefly introduce this technology, focusing on its latest advances in surgical applications in early lung cancer screening, malignant risk assessment, and perioperative period application and medical education.
5.Application of tenecteplase combined with tirofiban in interventional treatment for acute myocardial infarction
Tao DI ; Kai SHAO ; Jie LIANG ; Xiaozhao WANG
Basic & Clinical Medicine 2025;45(9):1215-1219
Objective To analyze the therapeutic effect of the combination of tenecteplase and tirofiban in percuta-neous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods A total of 120 AMI patients who underwent PCI in Shijiazhuang People's Hospital from June 2023 to January 2024 were collected and randomly separated into a tenecteplase group(tenecteplase during surgery as control)and a test group(tenecteplase in combined with tirofiban during surgery)with 60 patients in each.Two groups were compared for thrombolysis in myocardial infarction(TIMI)blood flow grading,TIMI myocardial perfusion grade(TMPG),myocardial injury markers[creatine kinase isoenzyme MB(CK-MB),cardiac troponinⅠ(cTnⅠ)],peak time,incidence of related bleeding events,echocardiography results[left ventricular end systolic diameter(LVESD),left ventricularend diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)]and incidence of major adverse cardiac events(MACEs).Results The proportion of immediate TIMI blood flow grade 3 and TMPG grade 3 in the test group was higher than that in control group(P<0.05).The proportion of ST segment regression>50%in test group(93.33%vs.80.00%)was higher than that in the control group(P<0.05).The peak time of CK-MB and cTnⅠin test group was shorter than that in the control group(P<0.05).Three months after surgery,the LVESD and LVEDD of the test group were lower than those before surgery and those of control group(P<0.05),and the LVEF was higher than that before surgery and that of contemporaneous control group(P<0.05).The incidence of MACEs at 3 months after surgery was lower in the test group(6.67%compared to 21.67%,P<0.05).Conclusions The application of tenecteplase combined with tirofiban during PCI for AMI can effectively promote myocardial perfusion recovery and ST segment regression,significantly shorten the peak time of myocardial injury markers and improve heart function and reduce MACEs.
6.Creatine regulating neuronal ferroptosis by reducing STAT1-SOCS1 signaling activation in Alzheimer's disease model mice
Xiang-Qi SHAO ; Xue WANG ; Tao WANG ; Bo YUAN ; Wen-Ying QIU ; Fan LIU ; Chao MA
Acta Anatomica Sinica 2025;56(3):253-259
Objective To explore whether creatine therapy regulates neuronal ferroptosis by inhibiting the activation of STAT1 signaling pathway associated with suppressor of cytokine signaling 1(SOCS1)in Alzheimer's disease.Methods Immunohistochemical staining and counting of positive results using paraffin sections of human brain frontal lobes were employed to determine the trend of changes in the target proteins.Further validation was performed by immunofluorescence and Western blotting.STAT1 phosphorylation was inhibited by creatine injection using eleven FAD4T mice and by cerebellar medullary pool puncture,and the expression of target proteins was examined by immunohistochemistry and immunofluorescence after postmortem sampling.Results Compared with the age controls,interferon-γ(IFN-γ),an activating cytokine of the STAT1 signaling pathway,and SOCS1,a negative regulator of STAT1 activation,were both significantly up-regulated,STAT1 phosphorylation was enhanced,and the ferroptosis markers ferritin light chain(FTL)and cystine/glutamate transporter(xCT)increased markedly in the cortex of AD human brains;Creatine treatment of FAD4T mice resulted in a reduction of both IFN-γ and SOCS1,and a significant decrease in the ferroptosis markers FTL and xCT(SLC7A11).Conclusion Creatine ameliorates neuronal ferroptosis in AD model mice by reducing neuronal STAT1-SOCS1 signalling activation.
7.Efficacy of Physio Space Balance Board Motor Control Training in Rehabilitation of Ankle Injuries
Zhuoqian DONG ; Dun LIU ; Shuiyan SHAO ; Xingkang CHEN ; Jisheng SHAN ; Tao CHEN
Journal of Kunming Medical University 2025;46(6):133-139
Objective To analyze the effect of Physio Space balance board motor control training on rehabilitation of ankle joint injuries in a prospective randomized controlled study.Methods A total of 96 patients with ankle joint injuries treated at Yunnan Provincial Hospital of Traditional Chinese Medicine from May 2022 to May 2023 were selected and randomly divided into the study group(n=48)and the control group(n=48).Both groups received conventional physical therapy.The control group underwent standard rehabilitation training,while the study group added Physio Space balance board exercise control training on top of the control group's regimen.The therapeutic effect,ankle stability[Cumberland Ankle Instability Tool(CAIT)score],ankle joint range of motion(dorsoextension,plantar flexion),pain levels,balance ability of the affected limb[mean displacement on the X-axis(Mcd)and mean displacement on the Y-axis(Msd)scores],and serum inflammatory pain factor levels[Substance P(SP),Tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),Neuropeptide(NPY)]were compared between the two groups.Results The rate of excellent and good treatment in the study group(93.75%vs.79.17%)was higher than that in the control group(P<0.05).After 1,2,3 and 4 weeks of treatment,the CAIT score of the study group was higher than that of the control group,and the VAS score was lower than that of the control group(P<0.05).After 2 and 4 weeks of treatment,the dorsiflexion and plantarflexion range of motion in the study group were higher than those in the control group(P<0.05).The Mcd and Msd scores in the study group were lower than those in the control group after 2 and 4 weeks of treatment(P<0.05).After 2 and 4 weeks of treatment,the serum levels of TNF-α,IL-6,SP and NPY in the study group were lower than those in the control group(P<0.05).Conclusion Physio Space balance board motion control training shows significant efficacy in the rehabilitation treatment of ankle joint injuries and is worthy of promotion and application.
8.Expression and prognostic value of triggering receptor expressed on myeloid cells-1 in patients with cirrhotic ascites and intra-abdominal infection
Feng WEI ; Xinyan YUE ; Xiling LIU ; Huimin YAN ; Lin LIN ; Tao HUANG ; Yantao PEI ; Shixiang SHAO ; Erhei DAI ; Wenfang YUAN
Journal of Clinical Hepatology 2025;42(5):914-920
Objective To analyze the expression level of triggering receptor expressed on myeloid cells-1(TREM-1)in serum and ascites of patients with cirrhotic ascites,and to investigate its correlation with clinical features and inflammatory markers and its role in the diagnosis of infection and prognostic evaluation.Methods A total of 110 patients with cirrhotic ascites who were hospitalized in The Fifth Hospital of Shijiazhuang from January 2019 to December 2020 were enrolled,and according to the presence or absence of intra-abdominal infection,they were divided into infection group with 72 patients and non-infection group with 38 patients.The patients with infection were further divided into improvement group with 38 patients and non-improvement group with 34 patients.Clinical data and laboratory markers were collected from all patients.Serum and ascites samples were collected,and ELISA was used to measure the level of TREM-1.The independent-samples t test was used for comparison of normally distributed continuous data between two groups;the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups,and the Kruskal-Wallis H test was used for comparison between multiple groups;the chi-square test was used for comparison of categorical data between two groups.A Spearman correlation analysis was used to investigate the correlation between indicators.A multivariate Logistic regression analysis was used to identify the influencing factors for the prognosis of patients with cirrhotic ascites and infection.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic and prognostic efficacy of each indicator,and the Delong test was used for comparison of the area under the ROC curve(AUC).Results The level of TREM-1 in ascites was significantly positively correlated with that in serum(r=0.50,P<0.001).Compared with the improvement group,the non-improvement group had a significantly higher level of TREM-1 in ascites(Z=-2.391,P=0.017)and serum(Z=-2.544,P=0.011),and compared with the non-infection group,the infection group had a significantly higher level of TREM-1 in ascites(Z=-3.420,P<0.001),while there was no significant difference in the level of TREM-1 in serum between the two groups(P>0.05).The level of TREM-1 in serum and ascites were significantly positively correlated with C-reactive protein(CRP),procalcitonin(PCT),white blood cell count,and neutrophil-lymphocyte ratio(r=0.288,0.344,0.530,0.510,0.534,0.454,0.330,and 0.404,all P<0.05).The ROC curve analysis showed that when PCT,CRP,and serum or ascitic TREM-1 were used in combination for the diagnosis of cirrhotic ascites with infection,the AUCs were 0.715 and 0.740,respectively.The multivariate Logistic regression analysis showed that CRP(odds ratio[OR]=1.019,95%confidence interval[CI]:1.001-1.038,P=0.043)and serum TREM-1(OR=1.002,95%CI:1.000-1.003,P=0.016)were independent risk factors for the prognosis of patients with cirrhotic ascites and infection,and the combination of these two indicators had an AUC of 0.728 in predicting poor prognosis.Conclusion The level of TREM-1 is closely associated with the severity of infection and prognosis in patients with cirrhotic ascites,and combined measurement of TREM-1 and CRP/PCT can improve the diagnostic accuracy of infection and provide support for prognostic evaluation.
9.Effect of omalizumab on patients with allergic rhinitis
Linda ZHU ; Jiannan SHAO ; Yongming TAO
China Modern Doctor 2025;63(21):71-74,132
Objective To investigate the effect of omalizumab on serum helper T lymphocytes,the balance of T-helper cell type 1(Th1)/T-helper cell type 2(Th2),cellular inflammatory factors and disease control in patients with allergic rhinitis.Methods A total of 86 patients with allergic rhinitis admitted to Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine from March 2021 to January 2022 were selected and randomly divided into observation group and control group by single-blind random number table method,with 43 cases in each group.Patients in control group received conventional drug treatment,while those in observation group were treated with omalizumab in addition to the treatment of control group.The nasal symptom scores,clinical efficacy,disease control effect,related symptom scores,Th1/Th2,serological indicators and adverse reactions of two groups were compared.The patients were followed up for 2 years to record the recurrence situation.Results After treatment,the symptom scores of sneezing,nasal congestion,runny nose,and nasal itching,visual analogue scale(VAS),rhinoconjunctivitis quality of life questionnaire(RQLQ),serum immunoglobulin E(IgE),interleukin-4,Th2 levels and recurrence rates of both groups were all lower than those before treatment,and those of observation group were lower than those of control group(P<0.05).After treatment,the asthma control test(ACT)scores,Th1,Th1/Th2,and gamma interferon(IFN-γ)levels of both groups were all higher than those before treatment,and those of observation group were higher than those of control group(P<0.05).The total effective rate of observation group was higher than that of control group after treatment(P<0.05).Conclusion Omalizumab can improve the nasal symptoms and quality of life of patients with allergic rhinitis,regulate the Th1/Th2 balance,reduce the inflammatory response,lower the serum IgE level,and has a definite disease control effect,is safe and reliable,and has a good long-term prognosis.
10.Comparison of arthroscopic Y-shaped suture suspension fixation versus open reduction and internal fixation for tibial insertion avulsion fractures of the posterior cruciate ligament
Zijiang YANG ; Tao HE ; Huai SHAO ; Ming ZOU ; Yun GU ; Min YU
Chinese Journal of Orthopaedic Trauma 2025;27(8):674-680
Objective:To compare the clinical outcomes of arthroscopic Y-shaped suture suspension fixation and those of open reduction and internal fixation in the treatment of tibial insertion avulsion fractures of the posterior cruciate ligament (PCL).Methods:A retrospective study was conducted to analyze the clinical data from the 23 patients with PCL tibial avulsion fracture who had been admitted to Department of Sports Medicine, The Affiliated Changsha Central Hospital, University of South China, from May 2018 to May 2024. There were 15 males and 8 females with an age of (39.0±15.6) years. By the Meyers-McKeever classification, there were 20 cases of type Ⅱ and 3 cases of type Ⅲ. All patients were divided into 2 groups based on their different surgical schemes: an arthroscopic group of 11 cases treated with Y-shaped suture suspension fixation under arthroscopy and an open group of 12 cases treated with open reduction and internal fixation. The surgical time, intraoperative blood loss, and visual analog scale (VAS) pain scores, Lysholm knee function scores, and International Knee Documentation Committee (IKDC) subjective scores at 1 month after surgery and the last follow-up were recorded and compared between the 2 groups.Results:There was no statistically significant difference in the preoperative general information between the 2 groups, indicating comparability ( P>0.05). The 23 patients were followed up for (13.7±3.8) months after surgery. None of the patients experienced complications like incision infection, neurovascular damage, nonunion or delayed union of fracture. In the arthroscopic group, the surgical time was (97.1±11.1) min, significantly shorter than that in the open group [(64.7±9.0) min], and the intraoperative blood loss (14.9±6.6) mL, significantly less than that in the open group [(29.4±13.2) mL] ( P<0.05). At 1 month after surgery, the VAS pain score, Lysholm knee function score, and IKDC subjective score in the arthroscopic group were, respectively, 3.0 (2.0, 3.0) points, (72.0±4.8) points, and (67.3±2.9) points, all significantly better than those in the open group [5.0 (4.0, 5.0) points, (66.9±4.0) points, and (63.1±2.4) points] ( P<0.05). There was no statistically significant difference in the VAS pain score, Lysholm knee function score, or IKDC subjective score at the last follow-up between the 2 groups ( P>0.05). Conclusions:Both arthroscopic Y-shaped suture suspension fixation and open reduction and internal fixation can achieve satisfactory treatment outcomes for PCL tibial avulsion fractures. The latter shows an advantage in shorter surgical time, but the former advantages in less bleeding volume and better early efficacy.

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