Depression is a common mental disorder that falls under the category of "stagnation syndrome" in traditional Chinese medicine （TCM）. Its complex pathogenesis poses challenges for the development of novel therapeutic agents. Currently， clinically used antidepressants are often accompanied by significant side effects， and statistics show that about one-third of patients do not respond to these medications. TCM demonstrates advantages in the treatment of depression through multi-target， multi-pathway and multi-mechanistic approaches. Pinelliae Rhizoma， a phlegm-resolving herb， exhibits effects such as drying dampness and resolving phlegm， as well as eliminating stuffiness and reducing masses. The characteristics of harmonizing Yin and Yang and resolving stagnation in the middle energizer align precisely with the pathogenesis of depression syndrome， demonstrating therapeutic efficacy in affected patients. Literature studies have found that the active ingredients of Pinelliae Rhizoma， such as cavidine， baicalein， β-sitosterol， as well as Pinelliae Rhizoma herb pairs， such as Pinelliae Rhizoma-Magnoliae Officinalis Cortex， Pinelliae Rhizoma-husked sorghum， Pinelliae Rhizoma-Prunellae Spica， exhibit significant antidepressant effects. Furthermore， TCM formulas containing Pinelliae Rhizoma as the principal therapeutic agent， such as Banxia Xiexin Tang， Banxia Houpo Tang， and Wendan Tang， as well as formulas incorporating Pinelliae Rhizoma like compound Xiaochaihu Tang， Chaihu Jia Longgu Muli Tang， and Erchen Tang， have also demonstrated favorable antidepressant efficacy. The antidepressant mechanism of these agents may involve modulation of 5-hydroxytryptamine （5-HT） and dopamine （DA） levels， up-regulation of brain-derived neurotrophic factor （BDNF） expression， regulation of the hypothalamus-pituitary-adrenal （HPA） axis， reduction of oxidative stress， modulation of nuclear transcription factor-κB （NF-κB） signaling pathway， and inhibition of microglia-mediated inflammatory responses. This review summarized the antidepressant mechanisms and clinical applications of the active components， herb pairs， and TCM formulas containing Pinelliae Rhizoma， aiming to provide a reference for modern research on the use of Pinelliae Rhizoma in antidepressant therapy.

ObjectiveTo investigate the mechanism of Yijing decoction to inhibit oxidative stress induced by chronic iron overload and improve ovarian reserve hypofunction in mice. MethodsSeventy-two female C57BL/6J mice with normal estrous cycles were randomly divided into six groups （n=12 per group）：blank group，model group，Yijing decoction（YJD） low-dose group，medium-dose group，high-dose group，and dehydroepiandrosterone （DHEA） group. Mice in the blank group received intraperitoneal injections of normal saline，while those in all other groups were administered iron dextran （Sigma-Aldrich） at a dose of 0.5 g·kg^-1 once weekly for 8 weeks to establish a chronic iron overload model. Following the final injection，interventions were initiated and continued for 4 weeks. The low，medium，and high dose groups of YJD received oral gavage of Yijing decoction aqueous solution at doses of 18.165， 36.33，and 72.66 g·kg^-1·d^-1，respectively. The DHEA group received DHEA aqueous solution at 10.812 5 mg·kg^-1·d^-1. The blank and model groups received an equivalent volume of distilled water by gavage once daily. Body weight was recorded weekly，and food intake was monitored throughout the treatment period. Vaginal smears were collected daily and stained with hematoxylin-eosin （HE） to assess estrous cycle regularity. At the end of the experiment，mice were euthanized，and bilateral ovaries and uteri were rapidly excised and weighed to calculate ovarian and uterine indices （mg·g^-1）. Ovarian tissues were fixed，embedded，and sectioned for hematoxylin and eosin （HE） staining to evaluate histopathological changes. Iron deposition in ovarian tissue was visualized using Prussian blue staining. Serum levels of follicle-stimulating hormone （FSH），luteinizing hormone （LH），estradiol （E₂），and anti-Müllerian hormone （AMH） were measured by enzyme-linked immunosorbent assay （ELISA）. Malondialdehyde （MDA） content and superoxide dismutase （SOD） activity in ovarian homogenates were determined using commercial biochemical assay kits. Reactive oxygen species （ROS） levels in ovarian tissue were assessed by ROS fluorescence staining on frozen sections. Mitochondrial ultrastructure in ovarian tissue was examined by transmission electron microscopy （TEM）. Total RNA was extracted from ovarian tissue for real-time quantitative polymerase chain reaction （Real-time PCR） to quantify mRNA expression of ferritin heavy chain 1 （Fth1），ferritin light chain （Ftl），transferrin （Tf），transferrin receptor 1 （Tfr1），catalase （Cat），and glutathione peroxidase 1 （GPX1）. Protein expression levels of Fth1，Ftl，Tf，Tfr1，and glutathione peroxidase 4 （GPX4） were analyzed by Western blot. ResultsCompared with the blank group，mice in the model group exhibited significantly reduced body weight and severe estrous cycle disruption （P<0.01），a markedly increased uterine index （P<0.01），and a significantly decreased ovarian index （P<0.01）. The number of antral follicles was significantly reduced，while atretic follicles were markedly increased，accompanied by pronounced iron deposition in the ovarian stroma. Serum levels of AMH and E₂，as well as ovarian SOD activity，protein and mRNA expression of Tf and Tfr1，and mRNA levels of GPX1 and Cat were all significantly downregulated （P<0.05，P<0.01）. Conversely，serum FSH and LH levels，MDA content，protein and mRNA expression of Fth1 and Ftl，and ROS fluorescence intensity were significantly elevated （P<0.05，P<0.01），along with a marked decrease in GPX4 protein expression （P<0.01）. TEM revealed an increased number of damaged mitochondria in ovarian tissue，characterized by loss or disappearance of mitochondrial cristae. Compared with the model group，treatment with low，medium，and high doses of YJD and DHEA significantly improved body weight and ameliorated estrous cycle irregularities （P<0.05，P<0.01），decreased the uterine index （P<0.05），and increased the ovarian index （P<0.05，P<0.01）. These groups also showed increased numbers of antral follicles，reduced atretic follicles，and significantly diminished iron deposition in the ovarian stroma. Serum AMH and E₂ levels，ovarian SOD activity，protein and mRNA expression of Tf and Tfr1，and mRNA levels of GPX1 and Cat were all significantly upregulated （P<0.05，P<0.01）. In contrast，serum FSH and LH levels，MDA content，protein and mRNA expression of Fth1 and Ftl，and ROS fluorescence intensity were significantly reduced （P<0.05，P<0.01），while GPX4 protein expression was markedly increased （P<0.01）. Moreover，mitochondrial damage was alleviated，and mitochondrial ultrastructure was notably restored in ovarian tissue. ConclusionYijing decoction ameliorates ovarian reserve function in mice with chronic iron overload by upregulating the expression of Tf，Tfr1，and GPX4，downregulating the expression of Ft，Fth1，and Ftl，thereby alleviating systemic iron metabolism disorders，reducing oxidative stress in ovarian tissue，and restoring mitochondrial morphology and structure.

Ischemic stroke accounts for approximately 80% of all stroke cases worldwide and remains a leading cause of long‑term neurological disability and mortality. Intravenous thrombolysis and endovascular thrombectomy constitute the mainstay of acute reperfusion therapies, yet their clinical utility is severely constrained by narrow therapeutic time windows. Even when large‑vessel recanalization is successfully achieved, a considerable proportion of patients still suffer poor functional outcomes due to futile reperfusion and ischemia‑reperfusion injury. Historically, preclinical studies have largely focused on direct neuronal protection against calcium overload, oxidative stress and ferroptosis. Unfortunately, most promising neuroprotective agents that exhibited robust benefits in rodent models have failed to demonstrate satisfactory efficacy in phase‑Ⅱ and phase‑Ⅲ clinical trials. One critical contributor to such translational failure is the disregard for the pathological disturbance within the cerebral vascular microenvironment. Instead of merely regarding neuronal death as an autonomous cellular event, accumulating evidence indicates that sequential biochemical disruption of perivascular microenvironment acts as an initiating amplifier that propagates damage toward brain parenchyma after ischemic insult. The cerebral vascular microenvironment centers on brain microvessels and comprises endothelial cells, endothelial glycocalyx, basement membrane, pericytes, astrocytic end‑feet, perivascular microglia, as well as interstitial ions, inflammatory mediators, reactive oxygen species and extracellular matrix components. Distinct from the concept of neurovascular unit which emphasizes functional coupling between neurons, glia and vessels, the vascular microenvironment highlights dynamic biochemical homeostasis in perivascular interstitial space. Following cerebral ischemia, injured brain tissue can be spatially divided into the irreversibly damaged infarct core, metabolically‑stressed ischemic penumbra and mildly‑affected peripheral regions. These three zones lack rigid anatomical boundaries and evolve dynamically depending on reperfusion timing, presenting divergent features in blood perfusion, blood‑brain barrier integrity, cellular viability and immune‑inflammatory profiles. Four interrelated pathological cascades jointly disrupt microenvironmental homeostasis: calcium‑overload‑triggered cytotoxic cascades; blood‑brain barrier breakdown resulting from glycocalyx shedding, tight‑junction dissociation and matrix metalloproteinase‑driven basement‑membrane degradation; inflammatory‑immune dysregulation dominated by microglial phenotypic reprogramming; and mutual crosstalk between coagulation disturbance and neuroinflammation that exacerbates secondary brain injury. Multiple molecular layers orchestrate these pathological alterations. Excessive activation of HIF‑1α, NF‑κB and MAPK/ERK signaling pathways promotes barrier leakage, pro‑inflammatory factor secretion and extracellular‑matrix remodeling. Epigenetic modulation mediated by non‑coding RNAs including miRNAs and lncRNAs reshapes vascular microenvironment via three major patterns: modulating endothelial‑pericyte barrier integrity, switching microglia‑astrocyte inflammatory phenotypes, and driving metabolic reprogramming among multiple cell populations within microdomains. In addition, metabolic shift toward glycolysis among endothelial cells, microglia, astrocytes and compromised neurons establishes self‑amplifying vicious cycles of energy depletion and oxidative stress in perivascular niches. Targeted theranostic approaches oriented toward vascular microenvironment bring new opportunities for precision medicine of ischemic stroke. Magnetic nanoprobes and near‑infrared fluorescent probes respond to elevated reactive oxygen species, pH shift and inflammatory signals, enabling in situ visualization of pathological signatures of microenvironment and risk evaluation of hemorrhagic transformation. Function‑tailored nanodelivery systems exert multi‑modal protective effects: reactive oxygen species‑responsive polymeric micelles deliver calcium chelators to block calcium‑overload‑initiated injury cascades; nanozymes scavenge reactive oxygen/nitrogen species and revert microglial pro‑inflammatory polarization; biomimetic membrane‑coated nanoparticles accumulate at micro‑thrombosis sites to break thrombo‑inflammatory loops and mitigate no‑reflow phenomenon; ferroptosis‑inhibitor‑loaded nanocarriers eliminate excessive labile iron within perivascular toxic microdomains. During subacute and recovery phases, spatiotemporally controlled release of angiogenic factors by nanocarriers facilitates maturation of newly‑formed microvessels rather than blind vascular sprouting, which helps reconstruct intact blood‑brain barrier and restore microenvironmental homeostasis. Nevertheless, substantial translational bottlenecks still impede clinical transformation of these nanomedicines, including potential biosafety risks caused by in vivo material accumulation, protein‑corona‑induced impairment of targeting capacity, intrinsic blood brain barrier transport obstacles, lack of unified quality‑control criteria for large‑scale manufacture, reliance on high‑end clinical imaging instruments, and prominent interspecies discrepancies between experimental animals and human patients. On the basis of summarizing spatiotemporal pathological characteristics, multi‑level regulatory mechanisms and cutting‑edge microenvironment‑oriented diagnostic and interventional strategies, the present review advocates a conceptual shift from isolated neuronal protection to comprehensive reconstruction of perivascular vascular microenvironment homeostasis. Such perspective provides theoretical foundations for expanding therapeutic time windows and inspires future development of novel therapeutic modalities for ischemic stroke.

Electromagnetic fields can regulate the fundamental biological processes involved in bone remodeling. As a non-invasive physical therapy, electromagnetic fields with specific parameters have demonstrated therapeutic effects on bone remodeling diseases, such as fractures and osteoporosis. Electromagnetic fields can be generated by the movement of charged particles or induced by varying currents. Based on whether the strength and direction of the electric field change over time, electromagnetic fields can be classified into static and time-varying fields. The treatment of bone remodeling diseases with static magnetic fields primarily focuses on fractures, often using magnetic splints to immobilize the fracture site while studying the effects of static magnetic fields on bone healing. However, there has been relatively little research on the prevention and treatment of osteoporosis using static magnetic fields. Pulsed electromagnetic fields, a type of time-varying field, have been widely used in clinical studies for treating fractures, osteoporosis, and non-union. However, current clinical applications are limited to low-frequency, and research on the relationship between frequency and biological effects remains insufficient. We believe that different types of electromagnetic fields acting on bone can induce various “secondary physical quantities”, such as magnetism, force, electricity, acoustics, and thermal energy, which can stimulate bone cells either individually or simultaneously. Bone cells possess specific electromagnetic properties, and in a static magnetic field, the presence of a magnetic field gradient can exert a certain magnetism on the bone tissue, leading to observable effects. In a time-varying magnetic field, the charged particles within the bone experience varying Lorentz forces, causing vibrations and generating acoustic effects. Additionally, as the frequency of the time-varying field increases, induced currents or potentials can be generated within the bone, leading to electrical effects. When the frequency and power exceed a certain threshold, electromagnetic energy can be converted into thermal energy, producing thermal effects. In summary, external electromagnetic fields with different characteristics can generate multiple physical quantities within biological tissues, such as magnetic, electric, mechanical, acoustic, and thermal effects. These physical quantities may also interact and couple with each other, stimulating the biological tissues in a combined or composite manner, thereby producing biological effects. This understanding is key to elucidating the electromagnetic mechanisms of how electromagnetic fields influence biological tissues. In the study of electromagnetic fields for bone remodeling diseases, attention should be paid to the biological effects of bone remodeling under different electromagnetic wave characteristics. This includes exploring innovative electromagnetic source technologies applicable to bone remodeling, identifying safe and effective electromagnetic field parameters, and combining basic research with technological invention to develop scientifically grounded, advanced key technologies for innovative electromagnetic treatment devices targeting bone remodeling diseases. In conclusion, electromagnetic fields and multiple physical factors have the potential to prevent and treat bone remodeling diseases, and have significant application prospects.

Alcoholic liver disease(ALD), a major cause of chronic liver disease worldwide, poses a serious threat to human health. Despite the availability of various drugs for treating ALD, their efficacy is often uncertain, necessitating the search for new therapeutic approaches. Traditional Chinese medicine polysaccharides have garnered increasing attention in recent years due to their versatility, high efficiency, and low side effects, and they have demonstrated significant potential in preventing and treating ALD. Emerging studies have suggested that these polysaccharides exert their therapeutic effects through multiple mechanisms, including the inhibition of oxidative stress and the regulation of lipid metabolism, gut microbiota, and programmed cell death. This review summarizes the recent research progress in the pharmacological effects and regulatory mechanisms of traditional Chinese medicine polysaccharides in treating ALD, aiming to provide a scientific basis and theoretical support for their application in the prevention and treatment of ALD.
Humans ; Liver Diseases, Alcoholic/metabolism* ; Polysaccharides/administration & dosage* ; Drugs, Chinese Herbal/administration & dosage* ; Animals ; Oxidative Stress/drug effects* ; Medicine, Chinese Traditional ; Gastrointestinal Microbiome/drug effects* ; Lipid Metabolism/drug effects*

This study explored the drying kinetics of Salviae Miltiorrhizae Radix et Rhizoma(SM), established the suitable models simulating the drying kinetics, and then analyzed the dynamic changes of active components during the drying processes with different methods, aiming to provide a basis for the establishment of suitable drying methods and the quality control of SM. The drying kinetics were studied based on the drying curve, drying rate, moisture effective diffusion coefficient, and drying activation energy, and the appropriate drying kinetics model of SM was established. The drying performance of different methods, such as hot air drying, infrared drying, and microwave drying of SM was evaluated, and the changes in the content of 10 salvianolic acids and 6 tanshinones during drying were analyzed by UPLC-TQ-MS. The Technique for Order Preference by Similarity to an Ideal Solution(TOPSIS) was employed to evaluate the quality of SM dried with different methods. The results showed that the drying rate and moisture effective diffusion coefficient of SM increased with the rise in drying temperature, and the maximum drying rates of different methods were in the order of microwave drying > infrared drying > hot air drying, slice > whole root. The drying rate decreased with the rise in temperature and the extension of drying time. The activation energy of hot air drying was higher than that of infrared drying in SM. The most suitable model for simulating the drying process of SM was the Page model. The TOPSIS results suggested infrared drying at 50 ℃ was the optimal drying method for SM. During the drying process, the content of salvianolic acids increased in different degrees with the loss of moisture, among which salvianolic acid B showed the largest increase of 44 times compared with that in the fresh medicinal material. Tanshinones also existed in the fresh herb of SM, and the content of tanshinone Ⅱ_A increased by 3 times after drying. The results provided a basis for the establishment of suitable drying methods and the quality control of SM.
Salvia miltiorrhiza/chemistry* ; Desiccation/methods* ; Drugs, Chinese Herbal/chemistry* ; Rhizome/chemistry* ; Kinetics ; Quality Control ; Abietanes

In order to clarify the effects of drought stress training on the quality and drought resistance of Codonopsis pilosula, this study used PEG to simulate drought stress and employed potting with water control for the drought stress training of C. pilosula plants. The polysaccharide content, secondary metabolites, antioxidant system, and photosynthetic pigment system of C. pilosula after drought stress training were analyzed. The results showed that the content of fructans in the root of C. pilosula increased after two rounds of drought stress treatment, and it was significantly higher than that of the control group. The accumulation of fructans in the root of C. pilosula showed an upward trend during the rehydration treatment. The content of lobetyolin and tangshenoside Ⅰ increased after drought stress treatment compared with that of the control group. The rehydration treatment caused first increasing and then decreasing in the content of lobetyolin, while it had no significant effect on the tangshenoside Ⅰcontent. The content of photosynthetic pigments decreased after drought stress treatment, and it gradually increased during the first round of rehydration and the second round of rehydration. Moreover, the increase was faster in the second round of rehydration than in the first round of rehydration. The content of the peroxidation product malondialdehyde(MDA) and the activities of superoxide dismutase(SOD), peroxidase(POD), and catalase(CAT) increased after drought stress treatment compared with those of the control group, and they showed a tendency of decreasing during rehydration. Moreover, the decrease was faster in the second round of rehydration than in the first round of rehydration. When the plants of C. pilosula after drought stress training were again subjected to severe drought stress, the wilting rate decreased significantly, and the biomass increases significantly. This study showed that the drought stress training could promote the accumulation of polysaccharides and secondary metabolites in the root of C. pilosula. When encountering drought stress again, C. pilosula plants could quickly regulate the antioxidant system and delay the decomposition of chlorophyll to respond to drought stress. The findings provide a theoretical basis for the ecological cultivation of C. pilosula in arid and semi-arid areas.
Codonopsis/growth & development* ; Droughts ; Polysaccharides/metabolism* ; Stress, Physiological ; Water/metabolism* ; Antioxidants/metabolism* ; Photosynthesis ; Drought Resistance

The present study delves into the cellular mechanisms underlying the antiviral effects of dehydrodiisoeugenol(DEH) by focusing on the transcription factor EB(TFEB)/autophagy-lysosome pathway. The cell counting kit-8(CCK-8) was utilized to assess the impact of DEH on the viability of human non-small cell lung cancer cells(A549). The inhibitory effect of DEH on the replication of influenza A virus(H1N1) was determined by real-time quantitative polymerase chain reaction(RT-qPCR). Western blot was employed to evaluate the influence of DEH on the expression level of the H1N1 virus nucleoprotein(NP). The effect of DEH on the fluorescence intensity of NP was examined by the immunofluorescence assay. A mouse model of H1N1 virus infection was established via nasal inhalation to evaluate the therapeutic efficacy of 30 mg·kg~(-1) DEH on H1N1 virus infection. RNA sequencing(RNA-seq) was performed for the transcriptional profiling of mouse embryonic fibroblasts(MEFs) in response to DEH. The fluorescent protein-tagged microtubule-associated protein 1 light chain 3(LC3) was used to assess the autophagy induced by DEH. Western blot was employed to determine the effect of DEH on the autophagy flux of LC3Ⅱ/LC3Ⅰ under viral infection conditions. Lastly, the role of TFEB expression in the inhibition of DEH against H1N1 infection was evaluated in immortalized bone marrow-derived macrophage(iBMDM), both wild-type and TFEB knockout. The results revealed that the half-maximal inhibitory concentration(IC_(50)) of DEH for A549 cells was(87.17±0.247)μmol·L~(-1), and DEH inhibited H1N1 virus replication in a dose-dependent manner in vitro. Compared with the H1N1 virus-infected mouse model, the treatment with DEH significantly improved the body weights and survival time of mice. DEH induced LC3 aggregation, and the absence of TFEB expression in iBMDM markedly limited the ability of DEH to counteract H1N1 virus replication. In conclusion, DEH exerts its inhibitory activity against H1N1 infection by activating the TFEB/autophagy-lysosome pathway.
Influenza A Virus, H1N1 Subtype/genetics* ; Animals ; Autophagy/drug effects* ; Humans ; Mice ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics* ; Influenza, Human/metabolism* ; Lysosomes/metabolism* ; Orthomyxoviridae Infections/genetics* ; Eugenol/pharmacology* ; Antiviral Agents/pharmacology* ; Virus Replication/drug effects* ; A549 Cells ; Male

Objective To study a method for determining the cumulative dose of low-energy neutrons ( < 100 keV) independently based on a CR-39 detector. Methods According to the theory of track etching kinetics, the differences in the tracks formed by low-energy neutrons or fast neutrons in a BN + CR-39 detector under broad-spectrum neutron irradiation were analyzed. A method was proposed to identify the tracks produced by low-energy neutrons under specific etching conditions while avoiding interference from fast neutron tracks. Results Experimental results demonstrated that the BN + CR-39 detector using TASTRAK PADC CR-39 track-detecting plastic could independently detect the tracks of low-energy neutrons when etched in a 6.25 mol/L NaOH solution for 1 h. The track density showed a good linear relationship with the ambient dose equivalent of low-energy neutrons, and the calibration coefficient was 0.0366 μSv·tr⁻¹·cm². Conclusion The BN + CR-39 detector proposed in this study demonstrated high sensitivity to low-energy neutrons. The track identification method can be used for effective and independent determination of the cumulative dose equivalent of low-energy neutrons.

Objective To explore the predictive value of albumin,hemoglobin and multifactorial model for poor postoperative prognosis in elderly patients with meningioma.Methods A retrospective analysis was conducted on 253 elderly patients who underwent meningioma surgery and were transferred to the neurosurgical intensive care unit(NICU)at General Hospital of Northern Theater Command from January 2019 to September 2021,serving as the modeling cohort.Another 227 elderly patients who were treated in NICU after meningioma surgery from November 2021 to June 2023 were used as the validation cohort.Patients in the modeling cohort were categorized into good prognosis group[Glasgow Coma Scale(GCS)score>7,n=161]and poor prognosis group(GCS≤7,n=92)based on the GCS.Univariate and multifactorial logistic regression analyses were performed on the modeling cohort to identify independent risk factors,and a multifactorial model for predicting poor postoperative prognosis in elderly patients with meningioma was constructed based on these factors.The predictive efficacy and accuracy of the model were evaluated using the area under the receiver operating characteristic(ROC)curve(AUC),sensitivity,specificity,Hosmer-Lemeshow goodness-of-fit test,and calibration curves.The predictive value of postoperative albumin,hemoglobin,and the multifactorial models for postoperative prognosis in elderly meningioma patients was assessed using restricted cubic spline modeling(RCS),decision curves(DCA),and validated using an external validation cohort to assess the stability of the model.Results Meningioma WHO grade Ⅱand Ⅲ(OR=3.994,95％CI 1.963-8.126),postoperative hypoalbuminemia(OR=2.194,95％CI 1.079-4.462),and postoperative anemia(OR=2.117,95％CI 1.096-4.089)were identified as independent risk factors for poor postoperative prognosis in elderly meningioma patients(P<0.05),while the use of analgesic/sedative medications was a protective factor(OR=0.388,95％CI 0.201-0.748,P<0.05).The Hosmer-Lemeshow test indicated that the constructed multifactorial model had a good fit accuracy(P=0.161).The AUC for predicting poor postoperative prognosis in elderly meningioma patients for postoperative albumin and hemoglobin were 0.545(95％CI 0.472-0.617)and 0.632(95％CI 0.561-0.702),respectively,and showed a nonlinear dose-response relationship with prognosis(P<0.01).DCA analysis results showed that the net benefit rate of multifactorial model was higher than that of postoperative albumin and hemoglobin when the threshold probabilities were between 0.10 and 0.90.The AUC for predicting postoperative prognosis in the elderly meningioma patients in the modeling and validation cohorts were 0.810 and 0.819,respectively,and their calibration curves suggested good discrimination and accuracy.Conclusions Meningioma WHO grades Ⅱ and Ⅲ,postoperative anemia and hypoalbuminemia are independent risk factors for poor postoperative prognosis in elderly meningioma patients,while the use of analgesic/sedative drugs is a protective factor.The multifactorial model constructed based on these factors has a good predictive efficacy and credibility,and can be used as a reference for clinical decision-making.