OBJECTIVE To analyze the prototype components absorbed into blood and brain of Lithocarpus litseifolius leaves， so as to provide a reference for clarifying the pharmacological material basis of its prevention and treatment of central nervous system dis eases. METHODS The ethanol extract of L. litseifolius leaves， as well as the gastric lavage fluid and perfusion solution were prepared. Using rats as subjects， plasma samples of intestinal wall metabolism， intestinal flora metabolism and hepatic metabolism were prepared via in situ intestinal perfusion and closed intestinal loop method； while comprehensive metabolic plasma samples， brain tissue samples， and cerebrospinal fluid samples were collected after intragastric administration. UPLC-HRMS technology was utilized to analyze and identify chemical components and prototype components absorbed into blood and brain of L. litseifolius leaves. RESULTS A total of 66 chemical constituents were identified in L. litseifolius leaves， primarily consisting of flavonoids， organic acids， and others. A total of 16， 13， 11， and 5 prototype components were identified in intestinal wall metabolism， intestinal flora metabolism， hepatic metabolism， and comprehensive metabolic plasma samples， respectively. Additionally， 4 prototype components were detected in brain tissue and 9 in cerebrospinal fluid. Phloridzin， trilobatin， phloretin-2- O -malonyl hexoside， and phloretin were identified as common components across all sample types. CONCLUSIONS Prototype components absorbed into blood and brain of L. litseifolius leaves， such as phloridzin， trilobatin， phloretin， and other components may serve as the pharmacological material basis for their therapeutic effects on central nervous system diseases.

ObjectiveTo explore the mechanism by which aerobic exercise improves hippocampal neuroinflammation and learning and memory ability in brain-aged mice via interferon regulatory factor 7 (IRF7). MethodsA total of 60 male specific pathogen-free (SPF) C57BL/6J mice were enrolled in the experiment, including 30 young mice (2 months old) and 30 naturally aging mice (12 months old). Young mice and old mice were respectively randomly assigned to four groups: young control group (group C, n=15), young exercise group (group CE, n=15), and aging control group (group A, n=15), aging exercise group (group AE, n=15). Mice in the exercise groups received an 8-week continuous treadmill aerobic exercise intervention, while control mice were kept under routine feeding without exercise intervention. After the intervention, Barnes maze and Y-maze behavioral tests were performed to comprehensively assess the learning and memory abilities of each group of mice. Transmission electron microscopy was used to observe the ultrastructural morphological changes of hippocampal synapses. Western blot assay was utilized to detect the protein expression and phosphorylation levels of Janus kinase 1 (JAK1), signal transducer and activator of transcription 1 (STAT1), as well as the expression of postsynaptic density protein 95 (PSD95). Immunofluorescence staining was applied to quantify the fluorescence intensity of ionized calcium-binding adapter molecule 1 (IBA1) in hippocampal tissues. The expression levels of inflammatory cytokines including interferon-α (IFN-α), interferon-β (IFN-β), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were measured by enzyme-linked immunosorbent assay (ELISA). Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to detect the mRNA expression level of IRF7, and DNA methylation assay was further conducted to analyze the methylation level of the IRF7 gene in mouse hippocampus. ResultsAt the molecular level, compared with group C, the protein expression levels of JAK1, STAT1, p‑JAK1, and p‑STAT1 in group A were significantly increased (P<0.05), whereas PSD95 expression was decreased (P<0.05). ELISA assays showed that the levels of IFN‑α, IFN‑β, TNF‑α, and IL‑1β were significantly elevated in group A (P<0.001). RT‑PCR analysis revealed that, compared with group C, the mRNA expression of IRF7 in group A was markedly upregulated (P<0.000 1), while the CpG methylation rate of the IRF7 promoter was significantly reduced (P<0.05). In contrast, all the above parameters in the AE group showed improvements relative to those in group A. Immunofluorescence staining indicated positive IBA1 expression in the brain tissues of group A mice. Exercise intervention reversed these abnormal changes. ConclusionIn aged mice, aerobic exercise induces hypermethylation of the IRF7 promoter region, suppresses IRF7 expression and activation of the downstream IFN‑I/JAK1/STAT1 signaling pathway, accompanied by alleviated neuroinflammation, improved learning and memory, and ameliorated brain aging-related phenotypes.

Objective To summarize the clinical characteristics and analyze prognostic factors of neuroblastoma (NB) in infants (≤12 months) at a single center. Methods A retrospective analysis was conducted on the clinical data of infant patients (≤12 months) diagnosed with NB and treated between January 2014 and December 2022. Clinical features were analyzed, and comparisons between two sample rates were performed using the χ² test. Univariate prognostic analysis was conducted using the log-rank test, and survival outcomes were analyzed using the Kaplan-Meier method. Results A total of 42 infants (≤12 months) with NB were enrolled. Low-risk patients underwent surgical resection alone; intermediate-risk patients received surgery combined with chemotherapy with or without maintenance therapy; high-risk patients were treated with surgery and chemotherapy with or without maintenance therapy or radiotherapy. The 5-year event-free survival (EFS) rate was (92.7±4.9)%, and the 5-year overall survival rate was (95.2±3.6)%. Only two patients died because of tumor recurrence or progression. Univariate analysis identified MYCN amplification and the initial lactate dehydrogenase (LDH) level ≥ five times the upper limit of the normal were significantly associated with poor prognosis (5-year EFS: 33.3% vs. 97.4% and 60.0% vs. 97.3%, P<0.0001 and P=0.0035). Conclusion Infant NB has a favorable overall prognosis. MYCN amplification and markedly elevated initial LDH are associated with poor outcomes.

ObjectiveTo observe the clinical efficacy and safety of Huatan Quyu formula in treating cerebral small vessel disease （CSVD） with phlegm and blood stasis blocking collateral pattern via randomized controlled trial， and explore its mechanism of improving CSVD by regulating glymphatic system （GS） circulation. MethodsSixty-eight CSVD patients with phlegm and blood stasis blocking collateral pattern in the Department of Encephalopathy， Affiliated Hospital of Shaanxi University of Chinese Medicine from April to December 2024 were selected and randomly divided into an experimental group （34 cases） and a control group， with 34 cases in each group. Both groups received basic Western medicine treatment， while the experimental group additionally received Huatan Quyu formula. After a course of 12 weeks， the following parameters were compared between the two groups before and after treatment. Clinical outcomes were assessed using the Tinetti performance-oriented mobility assessment （POMA）， Montreal Cognitive Assessment （MoCA）， Scales for Outcomes in Parkinson's Disease-Autonomic （SCOPA-AUT）， and traditional Chinese medicine （TCM） syndrome scores of phlegm and blood stasis blocking collateral pattern. Perivascular space （PVS） in the frontal lobe/basal ganglia and cerebrospinal fluid （CSF） flow parameters in the cerebral aqueduct were evaluated by 3.0T brain MRI， cerebrospinal fluid flow imaging， and phase-contrast magnetic resonance imaging （PC-MRI）. Then， safety indicators were monitored， and SPSS 25.0 was used for statistical analysis. ResultsSixty-four patients completed the study （32 in each group）. ①Baseline data： No statistically significant difference was found between the two group. ②Efficacy indicators： After treatment， the experimental group exhibited significantly improved total POMA， SCOPA-AUT， and TCM syndrome scores （P<0.01）， outperforming the control group （P<0.05）. No significant change was observed in MoCA scores between the two groups. ③Imaging indicators： The experimental group showed a reduced PVS area alongside significantly increased CSF flow parameters （including downward flow during the systolic period， and upward flow during the diastolic period） （P<0.01）， which were superior to the control group （P<0.01）. ④Safety： The laboratory indicators were normal in both groups， with no drug-related adverse reactions. ConclusionFor CSVD patients with phlegm and blood stasis blocking collateral pattern， Huatan Quyu formula can safely and effectively improve motor function， autonomic nerve function， and TCM syndromes， with potential mechanisms related to pulsatile CSF flow enhancement and GS circulation efficiency improvement.

Renal fibrosis is the common pathological endpoint of many forms of chronic kidney disease (CKD), yet the mechanisms determining effective repair versus persistent fibrotic remodeling remain incompletely understood. Peritubular capillaries (PTCs) are not merely passive targets of fibrotic injury, but form a dynamic vascular microenvironment linking regional perfusion, oxygen delivery, tubular metabolism, endothelial barrier integrity, pericyte support, immune-cell trafficking, and extracellular matrix (ECM) remodeling. We propose that PTC abnormalities should not be interpreted simply as reduced capillary density, but as a multidimensional disturbance of microvascular structure and function. Structural vascular preservation does not necessarily indicate effective microcirculation: anatomically detectable capillaries may still exhibit impaired perfusion, barrier dysfunction, abnormal endothelial-pericyte interactions, disturbed oxygen metabolism, or reduced network connectivity. Conversely, increased angiogenesis does not necessarily signify successful vascular repair if vessels remain immature, poorly perfused, or inadequately integrated into the existing network. To organize these abnormalities, we conceptualize PTC remodeling into four predominant but nonexclusive states: endothelial barrier disruption with inflammatory adhesion; endothelial-pericyte uncoupling with no-reflow; dysregulated angiogenesis with network simplification; and capillary rarefaction with fibrotic matrix locking. These states are not sequential stages of CKD. They may coexist within the same kidney, overlap within the same anatomical region, and vary with disease etiology, injury phase, vascular compartment, and treatment exposure. We further propose six dimensions for evaluating PTC status—structural presence, functional perfusion, barrier integrity, pericyte coupling, oxygen metabolism, and network connectivity—so that vascular quantity, function, and reparative capacity are assessed separately rather than inferred from a single endothelial marker or capillary-density measurement. Mechanistically, these states converge on a bidirectional microvascular-fibrotic feedback loop. Barrier disruption facilitates leukocyte recruitment and alters vascular paracrine signaling. Endothelial-pericyte uncoupling compromises capillary stability, whereas abnormal pericyte contraction may increase local vascular resistance and contribute to no-reflow before overt capillary loss. Dysregulated angiogenesis may generate vessels that fail to mature or connect to an effective perfusion network. Progressive capillary rarefaction compromises oxygen delivery, while sustained tubular transport demand and mitochondrial dysfunction may aggravate regional oxygen supply-demand mismatch. Injured tubules, immune cells, endothelial cells, pericytes, and fibroblasts communicate through soluble mediators, extracellular vesicles, direct cell contact, and cell-matrix signaling. Importantly, fibrosis is not merely a downstream consequence of microvascular injury. Altered ECM may increase diffusion distance, modify mechanotransduction, impair endothelial survival and migration, and restrict capillary reopening and regeneration. We use the term matrix locking to describe this sustained constraint on vascular repair, while emphasizing that current evidence does not establish irreversible disease in humans. This framework also has therapeutic implications. PTC-directed treatment should not be reduced to increasing vessel number or uniformly promoting angiogenesis. Instead, intervention should be matched to the dominant and potentially reversible abnormality: preserving endothelial barrier function; restoring endothelial-pericyte stability and reducing pathological microvascular resistance; normalizing angiogenesis so that vascular growth is accompanied by maturation, barrier competence, network integration, and effective perfusion; and, in advanced rarefaction, relieving matrix-related constraints while supporting vascular regeneration. The context- and time-dependent effects of signaling through VEGF, Tie2, PDGF-B/PDGFRβ, eNOS/NO, and related pathways indicate that the same molecular signal may exert different effects depending on disease context and timing. Therapeutic efficacy should therefore be evaluated by restoration of effective microcirculation and tissue function rather than by isolated molecular changes or capillary counts alone. Despite increasing mechanistic evidence, the translational basis for this framework remains limited. Most causal and interventional data derive from animal or cell models, whereas human evidence is largely limited to pathological observations, patient-sample associations, and prognostic studies. Currently available circulating and urinary candidate biomarkers generally lack sufficient specificity for PTC injury or state assignment, and no standardized quantitative thresholds have been externally validated. The four-state model should therefore be regarded as a hypothesis-generating analytical framework rather than a clinicopathological classification system. Future studies should integrate spatially resolved tissue phenotyping, blood and urine biomarkers, and dynamic microcirculatory assessment in longitudinal cohorts. They should test reproducibility, assess prognostic value beyond conventional pathology, estimated glomerular filtration rate, and proteinuria, and determine whether changes in PTC status precede or mediate therapeutic benefit. Linking reproducible microvascular phenotypes to defined mechanisms, treatment response, and long-term renal outcomes will be essential to determine whether state-directed assessment and restoration of the PTC microenvironment can ultimately inform patient stratification and therapeutic decision-making.

Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Meishan City, Sichuan Province from 2011 to 2024, so as to provide the evidence for optimizing regional PTB prevention and control strategies. Methods: Data on PTB cases in Meishan City from 2011 to 2024 were collected through the Tuberculosis Management Information System of China Disease Prevention and Control Information System. A descriptive epidemiological method was used to analyze the temporal, population, and regional distribution characteristics of PTB cases. The average annual percent change (AAPC) and annual percent change (APC) were used to analyze the trend in incidence of PTB in Meishan City from 2011 to 2024. Results: From 2011 to 2024, a total of 23 405 PTB cases were reported in Meishan City, with an average annual reported incidence of 58.21/105, showing an overall downward trend (AAPC=-3.132%, P<0.05). Specifically, a declining trend was observed from 2011 to 2014 (APC=-11.724%, P<0.05), no statistically significant change from 2014 to 2020 (APC=-1.773%, P>0.05), and an increasing trend from 2020 to 2024 (APC=7.493%, P<0.05). There were 16 881 male cases (72.13%) and 6 524 female cases (27.87%). The predominant group was aged 21-<60 years, with 12 527 cases (53.52%). The proportion of PTB cases in the ≥60 years group increased from 38.44% in 2011 to 63.26% in 2024, showing an upward trend (AAPC=4.672%, P<0.05). Farmers/migrant workers constituted the predominant occupational group, with 18 522 cases (79.14%). The proportion decreased from 81.80% in 2011 to 73.00% in 2024, showing a downward trend (AAPC=-0.745%, P<0.05). Renshou County and Dongpo District had the highest number of reported PTB cases, with 8 814 and 7 052 cases, accounting for 37.66% and 30.13%, respectively. The proportion of PTB cases in Renshou County decreased from 13.72% in 2011 to 5.27% in 2024, showing a downward trend (AAPC=-5.898%, P<0.05). Conclusions From 2011 to 2024, the overall incidence of PTB in Meishan City showed a downward trend. Males, the elderly, and farmers/migrant workers were high-risk population. Renshou County and Dongpo District were high-incidence areas.

Objective:To evaluate the efficacy of different surgical approaches in treating various types of small-volume benign prostatic hyperplasia (BPH).Methods:The data of 62 patients with small-volume BPH (≤30 ml) who were treated at Affiliated Jinhua Hospital, Zhejiang University School of Medicine from March 2018 to March 2023 were retrospective analyzed.The average age of the patients was (63.21 ± 5.38) years old.Among them, 9 patients had bladder calculi and 12 presented with urinary retention. Patients were stratified into two groups based on preoperative cystoscopy findings: 38 patients with hyperplasia of the middle or bilateral lobes underwent anterior lobe-sparing holmium laser enucleation of the prostate (HoLEP)(group A); 24 patients with bladder neck elevation and no significant hyperplasia received transurethral holmium laser incision of the prostate (group B). Preoperative baseline characteristics: international prostate symptom score(IPSS) were (23.68±4.89) and (22.59±3.62) respectively, quality of life (QOL) were (4.82±0.43) and (4.59±0.31) respectively, maximum flow rate (Q max)(7.89±1.83) ml/s and (7.26±1.72)ml/s respectively. The operative parameters (including procedure duration and catheterization time), postoperative complications (infection, urinary incontinence, and bladder neck contracture) were evaluated. Results:All 62 procedures were successfully completed. The mean operative time of group A was (32.36±6.17) minutes, postoperative catheterization duration was 1-3 days, and no cases of urinary incontinence or infection at 1-month follow-up. During the 12-month follow-up period, no cases of bladder neck contracture were observed in group A. The mean operative time of group B was (19.58 ± 3.87) minutes, and postoperative catheterization duration was 5-7 days. One case of fever with epididymitis was observed after operation, and there was no urinary incontinence at 1-month follow-up. During the 12-month follow-up period, no case of bladder neck contracture was observed in group B. Postoperative outcomes of group A and B at 1 month were as follows: IPSS (7.20±1.72) and (7.80±1.52) respectively, QOL (2.12±0.33) and (2.36±0.25) respectively, Q max(19.32±3.55)ml/s and (18.29±2.83)ml/s respectively.All postoperative parameters showed significant improvement compared with preoperative values ( P<0.05). Conclusions:For small-volume BPH, patients with middle or bilateral lobe hyperplasia can benefit from anterior lobe-sparing HoLEP, patients with bladder neck elevation and minimal hyperplasia can achieve optimal outcomes with transurethral holmium laser incision. Both approaches demonstrate significant symptom improvement with low rates of postoperative urinary incontinence and bladder neck contracture.

Objective:To analyze the relationship between 24-hour urinary calcium (24 h UCa) level and the risk of end-stage kidney disease (ESKD), cardiovascular disease (CVD), and all-cause mortality.Methods:In the Chinese Cohort Study of Chronic Kidney Disease, we examined 3 375 patients aged 18-74 years with CKD stages 1-4. Kaplan-Meier survival and Cox proportional hazard regression models were used to test a time-to-event association between levels of 24 h UCa and incidence of ESKD, CVD, and all-cause mortality.Results:During a follow-up of 4.17 (3.37, 5.20) years, 179, 145, 104 and 38 ESKD events occurred in <0.60, 0.60-, 1.20-, ≥2.32 mmol 24 h UCa groups. Higher levels of 24 h UCa (1.20-,≥2.32 mmol) were independently associated with a lower incidence of ESKD events in patients with CKD, with HR (95% CI) of 0.71 (0.54-0.93) and 0.43 (0.29-0.64), respectively. No significant associations with CVD and all-cause mortality endpoints were detected. Conclusion:Among patients with CKD, levels of 24 h UCa displayed an association with the risk of ESKD among patients with CKD stages 1-4.

With the change of infectious disease incidence pattern and the development of related technologies, progresses have been made in the research of infectious disease epidemiology. In recent years, due to the change in the requirements of infectious disease prevention and control, the research focus has expanded from common infectious diseases to diseases which have been eliminated or might be eliminated, as well as emerging and re-emerging infectious diseases. Infectious disease data has been characterized by multiple sources and modalities. Along with the rapid development of pathogen detection methods, infectious disease surveillance has shifted from a single disease-targted one to a comprehensive one. Moreover, novel technologies such as multi-omics and artificial intelligence have been applied in infectious disease epidemiology research. The international cooperation in this field has become increasingly crucial, and the revision of the International Health Regulations and the negotiation of pandemic agreement will have a profound impact. In the future, infectious disease epidemiology research will develop with more powerful tools to improve its capabilities.

Objective:To understand the epidemiological characteristics of injury deaths in local residents in Nanjing from 2009 to 2023, and provide evidence for the development of injury prevention and control strategies.Methods:The injury mortality data in Nanjing from 2009 to 2023 were analyzed based on the death cause surveillance system. In the recorded 33 542 injury death cases, 19 906 (59.35%) were men, and 13 636 (40.65%) were women. The crude mortality rate, age-standardized mortality rate, age-specific mortality rate, cause-eliminated life expectancy (CELE), potential gains in life expectancy (PGLEs) and life loss rate, were calculated. Joinpoint 5.0 software was used to estimate the average annual percentage change (AAPC) and its 95% CI to assess temporal trends of injury deaths. Results:In Nanjing, the crude injury mortality rate showed an upward trend (AAPC=2.11%), while the age-standardized mortality rate exhibited a downward trend (AAPC=-1.27%) from 2009 to 2023. The ranking of injury deaths in all causes of death declined from the 4 th in 2009 to the 6 th in 2023. The crude and age-standardized injury mortality rates in men were consistently higher than those in women. The primary cause of injury deaths was fall (31.42%). Drowning was the primary cause of injury deaths in age group 0-14 years (35.94%), while traffic accident was the primary cause in age group 15-64 years. For residents aged ≥65 years, fall was the primary cause of injury deaths. From 2009 to 2023, the CELE (AAPC=0.61%, 95% CI: 0.34%-0.89%, P<0.05) and the PGLEs (AAPC=1.73%, 95% CI: 0.21%-3.29%, P<0.05) showed increasing trends. The PGLEs and life loss rate due to injury were consistently higher in men than in women, but the AAPC of PGLEs and life loss rate was higher in women. Conclusions:From 2009 to 2023, the age-standardized injury mortality rate decreased, but the life loss due to injury deaths showed an upward trend in Nanjing, indicating that injury still has non-negligible negative impact on life expectancy.