While cranial radiotherapy effectively kills tumor cells and significantly prolongs patient survival, it often leads to progressive cognitive decline. To date, the specific mechanisms underlying radiation-induced cognitive decline have not been fully elucidated, which greatly limits the development of related therapeutic strategies. Therefore, this article provides a comprehensive analysis of post-radiation changes in neurogenesis, neuronal synaptic plasticity, myelin injury plasticity, and parenchymal cells such as microglia in the brain, systematically elucidates the potential mechanisms of radiation-induced cognitive decline, and summarizes feasible therapeutic approaches. These findings provide a solid foundation for developing novel strategies to mitigate radiation-induced cognitive decline.

Objective To evaluate the long-term effects of orthokeratology(ortho-k)lenses with different back optical zone diameters(BOZD)on the quality of vision in myopic children.Methods We conducted an exploratory analysis based on a prospective,randomized,double-blind clinical trial,focusing on the parameters related to visual quality.A total of 66 myopic children aged 8 to 12 years were enrolled and randomly assigned to either a 6-mm BOZD ortho-k lens group(the 6 mm group)or a 5-mm BOZD ortho-k lens group(the 5 mm group).The participants were followed up at baseline,and at 1 day,1 week,and 1,3,6,9,and 12 months after lens wearing.Visual quality measurements included uncorrected visual acuity(VA),best corrected VA,contrast sensitivity(CS),high-order aberrations(HOA),modulation transfer function(MTF),Strayer ratio(SR),and visual quality questionnaire.Results A total of 63 children(33 children in the 6 mm group and 30 children in the 5 mm group)completed the study.There were no significant differences in baseline data between the two groups(P>0.05).There were no significant differences in subjective uncorrected VA or best corrected VA between the two groups at any follow-up visit(P>0.05).After wearing the lenses for 3 months,the CS at high spatial frequency(18 cpd)in the 5 mm group was lower than that in the 6 mm group(P=0.015).However,at 12 months,no significant differences in the CS were found between the two groups(P>0.05).The ocular and corneal total HOA,spherical aberration,and coma aberration in both groups increased after wearing the lenses,and the HOA in the 5 mm group was higher than that in the 6 mm group(all P<0.05).After wearing the lenses for 3 months,the MTF and SR values in the 5 mm group were lower than those in the 6 mm group(P<0.05).At 12 months,there was no significant difference between the two groups(P>0.05).The vision-quality-related questionnaire scores showed no significant differences between the two groups(P>0.05).Conclusion In myopic children,wearing ortho-k lenses with different BOZD results in improved subjective satisfaction,with no difference in subjective visual quality.However,objective visual quality declined in both groups,with a greater impact observed in the 5 mm group.

Vascular cognitive impairment is a group of disorders characterized by cognitive dysfunction caused by vascular factors. Disruption of the blood-brain barrier is an early pathophysiological mechanism of vascular cognitive impairment. Dynamic contrast-enhanced magnetic resonance imaging and arterial spin labeling-based blood-brain barrier imaging techniques can quantitatively assess the integrity of the blood-brain barrier. In recent years, these techniques have gradually been applied to detect the extent of blood-brain barrier dysfunction. This article provides a comprehensive review of the basic principles of relevant magnetic resonance techniques and the progress made in their application to the assessment of the blood-brain barrier in vascular cognitive impairment.

Iron is an essential trace element for brain development and cognitive function maintenance. Iron homeostasis disruption in the body, whether due to iron overload or deficiency, may lead to a series of adverse consequences to the brain. Vascular cognitive impairment is a neurodegenerative disease characterized by cognitive impairment such as mental decline and weak thinking, which seriously endangers people's health. At present, the relationship between iron metabolism and vascular cognitive impairment is receiving more and more attention. This paper summarizes the progress of iron metabolism and its role in vascular cognitive impairment, in order to provide new ideas and methods for prevention and treatment of vascular cognitive impairment.

Objective To systematically evaluate the effect of virtual shopping on cognitive function of patients with mild cognitive impairment. Methods PubMed,EMBASE,Cochrane Library,Web of Science,and CNKI were searched for literatures on virtual shopping,mild cognitive impairment,and cognitive function published from database inception to Sep. 2023. The literatures were screened and the data were extracted in strict accordance with the inclusion criteria,and the Review Manager 5.3 was used for meta-analysis. Results A total of 12 randomized controlled trials involving 382 patients with mild cognitive impairment were included. Meta analysis showed that compared with traditional cognitive rehabilitation training,virtual shopping could improve the comprehensive cognitive function,executive function,attention and abilities of daily living of patients with mild cognitive impairment (all P<0.05),but had no significant effects on the memory,language,or visuospatial ability (all P>0.05). Conclusion Virtual shopping is beneficial for improving the comprehensive cognitive function,executive function,attention and abilities of daily living of patients with mild cognitive impairment.

Objective To explore the difference in myopia control efficacy between spectacle lenses with highly aspherical lenslets(HAL)combined with 0.01％atropine eye drops and spectacle lenses with HAL alone or single vision spectacle lenses(SVL)in children and adolescents.Methods A retrospective cohort study was conducted with a total of 105 myopic children aged 6-15 years.According to the specific myopia correction and control methods of each subject,they were evenly divided into the HAL+0.01％atropine(HAL+AT)group,the HAL group,and the SVL group,with 35 subjects in each group.Relevant data,such as cycloplegic refraction and axial length(AL)at baseline and 12 months after wearing spectacles,were retrieved.One-way analysis of variance,or the Kruskal-Wallis test,was used to analyze the changes in AL and spherical equivalent refraction(SER)after wearing spectacles for 12 months in comparison to those at baseline in the three groups.Results There was no statistically significant difference in the baseline parameters and duration of wearing spectacles among the three groups(P＞0.05).After wearing spectacles for 12 months,the changes in SER were-0.13(-0.25,0.00)D,-0.25(-0.63,-0.25)D,and-0.63(-1.00,-0.25)D in the HAL+AT group,HAL group,and SVL group,respectively;AL elongation in the three groups was(0.09±0.11)mm,(0.19±0.16)mm,and(0.34±0.16)mm,respectively.The HAL+AT group exhibited slower SER changes(PHAL+AT vs.HAL=0.00 1,PHAL+AT vs.SVL=0.002)and AL elongation(PHAL+AT vs.HAL=0.009,PHAL+AT vs.SVL=0.001)than those of the HAL and the SVL groups.Compared with those of the SVL group,myopia progression was reduced by 79.4％and AL elongation was slowed down by 73.5％in the HAL+AT group,while in the HAL group,myopia progression and AL elongation were reduced by 60.3％and 44.1％,respectively.According to stratified analysis based on age and myopia progression rate,among younger children aged 6 to 8 years and older children aged 9 to 15 years,the HAL+AT group had a significantly lower proportion of subjects experiencing fast AL elongation(AL＞0.36 mm/year)and a significantly higher proportion of subjects experiencing slow AL elongation(AL≤0.18 mm/year)compared to the SVL group(P＜0.017).Conclusion The combination intervention of spectacle lenses with HAL and 0.01％atropine eye drops is effective in controlling myopia progression in children and adolescents,with better myopia control effect achieved using this combination intervention in myopic children of all ages.

With rapid global growth of the older population, it has been increasingly important for screening, early diagnosis, treatment and daily monitoring of cognitive function in the elderly population. Given the limited effects of pharmacological treatments, cognitive rehabilitation has the potential to improve meaningful outcomes for older people and thus comes into sight. Traditional cognitive assessment and rehabilitation require face-to-face interview, while patients with cognitive impairment are mostly elderly with difficulties in access to medical care, usually needed to be accompanied by caregivers and having other co-morbidities with limited mobility. This contradiction is especially prominent in the context of COVID-19 pandemic, which may even exacerbate cognitive decline of patients. Therefore, remote cognitive assessment and rehabilitation based on information and communication technologies have become new options. This paper introduces the widely used and validated means of remote assessment and its guiding use in cognitive rehabilitation, which can be implemented through the Internet, applications, video and telephone. The advantages of being fast, convenient and geographically agnostic lead to a wider use in large community and safeguard the health of patients with cognitive impairment.

Depression is one of the most common psychiatric disorders. Depression increases the risk of stroke，cardiovascular disease，and dementia. Certain types of depression may be a harbinger of cognitive impairment. Chronic stress and inflammation jointly compromise vascular and brain functions. The resulting microglial activation and increases in proinflammatory cytokines lead to depression and cognitive impairment，which may progress to dementia. Anti-inflammatory treatments can improve depressive symptoms，and anti-inflammatory and antidepressant treatments may prevent cognitive impairment in patients with inflammatory depression. This paper reviews the relationship between inflammation， depression，and cognition，aiming to provide a reference for the clinical research of inflammatory depression and dementia.

Cognitive impairment is one of the important clinical manifestations in depression. The particularly vulnerable cognition domains included executive function, attention, memory, and processing speed. Depression with cognitive impairment is not only a predictor of poor efficacy, but also closely related to dementia. Previous studies have suggested that multiple physiological mechanisms may be altered between depression and cognitive impairment. With the rapid development of neuroimaging technology, resting state functional magnetic resonance imaging has been widely used to explore the neurobiological mechanisms of depression and cognitive impairment. After reviewing the resting-state functional MRI manifestations of the comorbidity, it was found that the default mode network, cognitive control network, and salience network were activated or weakened in the brain. In addition, the inter-network functional connectivity was altered with the co-existence of impairment and compensation. The aforementioned changes of brain function are expected to be the therapeutic targets for depression with cognitive dysfunction.

Objective:To investigate the factors associated with delay in anticoagulant therapy in patients with cerebral venous sinus thrombosis (CVST) and its effect on outcome.Methods:Patients with CVST admitted to Changhai Hospital, Naval Medical University from January 2010 to August 2021 were retrospectively enrolled. Patients were divided into early anticoagulation group and late anticoagulation group by the median time interval from first symptom to initiation of anticoagulation. The modified Rankin Scale was used for outcome assessment at 90 d after onset. 0-2 scores were defined as good outcome and 3-6 were defined as poor outcome. Demographic and clinical data were compared for the early versus late anticoagulation group and for the good versus poor outcome groups. Multivariable logistic regression was used to identify independent influencing factors of delay in anticoagulation and the correlation of delay in anticoagulation with poor outcome. Results:A total of 131 patients were included, their age was 40.07±15.11 years old, and 68 (51.91%) were male. Of these, 65 patients (49.62%) were in the early anticoagulation group and 14 (10.69%) were in the poor outcome group. Compared with the late anticoagulation group, the early anticoagulation group had a significantly higher proportion of patients with seizures and brain parenchymal damage as well as higher D-dimer levels on admission, while the proportion of patients with visual impairment/papilloedema was significantly lower (all P<0.05). Compared with the good outcome group, the poor outcome group had significantly higher proportions of patients with seizures, dyskinesia, impaired consciousness, low Glasgow Coma Scale score, and brain parenchymal damage as well as higher D-dimer, total cholesterol and low density lipoprotein cholesterol levels, sites of thrombus involvement were more common in the superior sagittal and straight sinuses, and significantly lower proportions of patients with headache and lower albumin levels on admission (all P<0.05). Multivariate logistic regression analysis showed that visual impairment/papilloedema (odds ratio [ OR] 0.119, 95% confidence interval [ CI] 0.030-0.473; P=0.002) and brain parenchymal damage ( OR 1.341, 95% CI 1.042-1.727; P=0.023) were independently associated with a delay in anticoagulation treatment, and a delay in anticoagulation treatment ( OR 6.102, 95% CI 1.185-30.504; P=0.030) and D-dimer level on admission ( OR 1.299, 95% CI 1.141-1.480; P<0.001) were the independent predictors of poor outcome in patients with CVST. Conclusions:Visual impairment/papilloedema and absence of brain parenchymal damage on cranial imaging are the independent risk factors for delay in anticoagulation in patients with CVST. The delay in anticoagulation is strongly associated with the poor outcome in patients with CVST.