Objective: To investigate the effects of clinical routine X-ray irradiation dose (average irradiation dose: 29.7±0.54 Gy) on the function, apoptosis, activation state and mitochondrial function of platelets during in vitro storage, so as to provide experimental evidence for optimizing platelet irradiation strategies. Methods: A paired experimental design was adopted. Platelets were collected from 12 healthy donors, and each sample was equally divided into the irradiated group and the control group (non-irradiated). All samples were stored for 5 days under standard platelet preservation conditions (22±2℃, continuous oscillation). Flow cytometry was used to detect platelet count, apoptosis rate (Annexin V+ positive rate), activation markers (CD62P, PAC-1, CD42b) and reactive oxygen species (ROS) level. Meanwhile, mitochondrial-specific probes were used to evaluate changes in mitochondrial count, membrane potential and adenosine triphosphate (ATP) content. Additionally, transmission electron microscopy (TEM) was employed to observe the ultrastructure of platelets, with a focus on mitochondrial morphology, platelet membrane integrity and granule distribution. Results: Within 5 days of storage, the platelet count was (841±89.16)×10 /L in the irradiated group and (824.5±92.88)×10 /L in the control group, with no statistically significant difference between the two groups (P=0.54). The apoptosis rate was (4.94±1.39) % in the irradiated group and (5.50±0.83) % in the control group, showing no significant difference (P=0.31). For activation indicators, the CD62P expression rate was (24.32±7.57) % in the irradiated group versus (25.21±8.13) % in the control group (P=0.43). The PAC-1 positive rates were (12.15±4.43) % and (11.75±3.40) % in the irradiated group and control group, respectively (P=0.44). The CD42b expression rates were (12.14±4.43) % and (11.75±3.4) % in the two groups, respectively (P=0.47). The ROS levels were (31.98±8.1) % and (30.64±5.89) % in the two groups, respectively (P=0.45). No significant differences were found in the above indicators. For mitochondrial function indicators, the mitochondrial count was (55.88±11.49) % in the irradiated group and (53.5±7.24) % in the control group (P=0.57). The ATP contents were (42.45±5.29) % and (41.58±9.50) % in the irradiated group and control group, respectively (P=0.77). The relative membrane potential values were (59.53±10.89) % and (57.49±6.54) % in the two groups, respectively (P=0.47). No significant difference were observed on the mitochondrial function-related indicators. TEM further confirmed that the ultrastructure of platelets in the irradiation group was intact, the mitochondrial morphology was normal, and no pathological changes such as swelling or vacuolization were observed. Conclusion: This study evaluated the impact of conventional-dose X-ray irradiation on platelet storage quality, confirming that this dose does not significant impair platelet count, apoptosis rate, activation status, or mitochondrial function. This finding provides important experimental evidence for the clinical promotion of X-ray irradiation technology and suggests its potential as a safe alternative to γ irradiation. Future studies could further expand the sample size and extend the observation period to verify the effects of X-ray irradiation on long-term platelet storage and post-transfusion in vivo survival rate.

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 explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

Testicular radiation injury is a structural and functional abnormality of the testes caused directly or indirectly by radiation, which disrupts spermatogenesis and compromises male fertility. The development of effective preventive and therapeutic interventions is essential because of the high prevalence of this condition in clinical settings and its profound effect on patients′ reproductive health and overall well-being. The concept of "the struggle between vital qi and pathogen" is first seen in the Treatise on Cold Pathogenic Diseases. It denotes the dynamic struggle between vital and pathogenic qi. The occurrence, development, and sequelae of all diseases reflect this ongoing conflict. In this context, this study defines the "vital qi" of the testis as its capacity to generate and preserve the essence of reproduction and to resist damage. The pathogenic qi associated with testicular radiation injury is categorized into two types: ionizing poison and retaining evil. The pathogenesis of testicular radiation damage is delineated into three stages by integrating the characteristics of vital and pathogenic qi: the injury, adhesion, and recovery phases. Based on the theoretical framework advanced by this study, the therapeutic approach for testicular radiation injury should adhere to the fundamental principle of strengthening vital qi and eliminating pathogenic factors. Although the primary focus of treatment should be on strengthening vital qi, it should also be complemented by strategies to eliminate pathogenic influences. This paper aims to provide a novel perspective and strategic approach to the traditional Chinese medicine diagnosis, prevention, and treatment of testicular radiation injury. By elucidating the process of testicular radiation injury and its corresponding treatment principles, it seeks to offer valuable insights for clinical practice.

Objective:To investigate the epidemiological and clinical characteristics of patients with nontuberculous mycobacterial infections in Hunan Province using metagenomics next generation sequencing (mNGS) .Methods:Pathological data form 320 patients diagnosed with mycobacterial infections at the Department of Pathology of Hunan People′s Hospital from June 2019 to December 2023 were collected, including HE staining, acid-fast staring, and fungal fluorescence staining. mNGS was utilized for the classification of mycobacterial pathogens.Results:Among 320 patients with mycobacterial infections, 249 cases were positive for Mycobacterium tuberculosis and 71 cases were positive for nontuberculous mycobacteria. Thirteen genera of nontuberculous mycobacteria were identified from the mycobacterial samples, including Mycobacterium chelonae, Mycobacterium avium complex, Mycobacterium abscessus, Mycobacterium gordonae, Mycobacterium intracellulare, Mycobacterium xenopi, Mycobacterium kansasii, Mycobacterium paragordonae, Mycobacterium obuense, Mycobacterium marinum, Mycobacterium fortuitum, Mycobacterium smegmatis and Mycobacterium mageritense. Conclusions:Infections caused by nontuberculous mycobacteria are gradually increasing, transitioning from single-strain infections to multi-strain complex infections. The histopathological features of nontuberculous mycobacterial infections are difficult to distinguish form those of tuberculosis, posing significant challenges for clinical diagnosis and treatment.

This paper introduces the academic characteristics of Professor ZHANG Ren in treatment with acupuncture for refractory eye diseases in modern times, guided by "homotherapy for heteropathy" (same therapy for different diseases sharing the same pathogenesis). The refractory eye diseases in modern times include a variety of conditions such as glaucoma, macular degeneration, diabetic retinopathy, high myopia and its complications, dry eye, cortical visual impairment and genetic eye diseases. The same therapy is used because these diseases share the similar location and pathogenesis. Professor ZHANG optimizes the methods of acupoint selection and provides the comprehensive prescriptions, "basic prescription, prescription based on disease differentiation, and supplementary prescription". A variety of acupuncture manipulation techniques are operated in clinical practice, such as compound needling methods, penetration needling, manipulations for promoting qi movement and conducting qi flow. "Early, regular and persistent" treatment is the common requirement with "the same acupoints, the same prescription and the same acupuncture method" as well as at "the same time". It is also proposed that the treatment should be provided flexibly according to the different symptoms, "identifying the differences within similarities".
Acupuncture Therapy/methods* ; Humans ; Eye Diseases/history* ; Acupuncture Points ; History, 20th Century ; China ; History, 21st Century

Objective To observe the clinical efficacy of Ruanjian Sanjie Pills in the treatment of patients with hepatitis B-related cirrhosis in compensatory stage differentiated as blood stasis blocking collaterals syndrome.Methods A total of 80 cases of patients with hepatitis B-related cirrhosis in compensatory stage admitted to Bao'an Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from January 2023 to April 2024 were randomly divided into the trial group and the control group,40 cases in each group.The control group was treated with oral administration of Entecavir for hepatitis B virus(HBV),and the trial group was treated with Ruanjian Sanjie Pills on the basis of treatment for the control group,the course of treatment covering one year.Before and after treatment,the two groups were observed in the changes of routine blood test indicators of white blood cell count(WBC)and platelet count(PLT),liver function indicators[albumin(ALB),total bilirubin(TBIL),alanine transaminase(ALT)and aspartate transaminase(AST)],prothrombin time(PT),liver stiffness measurement(LSM),and traditional Chinese medicine(TCM)syndrome scores.After treatment,the clinical efficacy and safety were evaluated.Results(1)There were three cases in the control group and four cases in the trial group fell off,and eventually 37 cases in the control group and 36 cases in the trial group were enrolled in the efficacy statistics.(2)After one year of treatment,the total effective rate of the trial group was 91.67%(33/36)and that of the control group was 67.57%(25/37),and the intergroup comparison(tested by chi-square test)showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group(P<0.05).(3)After treatment,the routine blood test indicators of WBC and PLT in the trial group were increased compared with those before treatment(P<0.05),while the WBC and PLT in the control group did not change significantly(P>0.05).The post-treatment WBC and PLT in the trial group were significantly higher than those of the control group(P<0.05).(4)After treatment,the ALB of patients in the two groups was increased compared with that before treatment(P<0.05),and the PT value of patients in the two groups and the ALT of the trial group were decreased compared with those before treatment(P<0.05),but TBIL and AST of the two groups and ALT of the control group did not differ from those before treatment(P>0.05).The comparison between the two groups showed that the decrease of PT value in the trial group was significantly superior to that of the control group(P>0.05),but no statistically significant differences of ALT,AST,TBIL and ALB were shown between the two groups(P>0.05).(5)After treatment,the LSM of patients in the two groups was decreased compared with that before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(6)After treatment,the TCM syndrome scores of the two groups of patients were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.05).(7)There were no significant adverse reactions or adverse events occurring in the two groups during the treatment.Conclusion Ruanjian Sanjie Pills can improve the clinical symptoms of patients with hepatitis B-related cirrhosis in the compensatory stage,improve the coagulation function,reduce the hardness of the liver,and slow down the process of cirrhosis,with satisfactory efficacy and good safety.

Objective With the continuous advancement of China's deep space exploration and space station construction missions,the issues of radiation protection and health security for astronauts in special space environments have become increasingly prominent,gradually emerging as a core research topic in the field of special medicine.To investigate the protective effect and mechanism of Fuping decoction against ionizing radiation-induced inflammatory damage to the immune system in mice,and to verify whether it relieves radiation-induced inflammatory injury by regulating macrophage M1/M2 polarization balance.Methods An in vivo radiation injury model was established using Balb/c mice.The expression levels of pro-inflammatory factors TNF-α and IL-6 in the spleen and thymus,and the phagocytic rate of peritoneal macrophages were detected.Mouse-derived macrophages were cultured in vitro to establish an in vitro radiation injury model.The secretion levels of inflammatory factors TNF-α,IL-6,and IL-10 were measured,macrophage polarization was observed by immunofluorescence,and the protein expression of the TLR4/MyD88/NF-κB signaling pathway was analyzed by Western blot.Results In vivo experiments showed that Fuping significantly reduced the phagocytic rate of peritoneal macrophages and the contents of TNF-α and IL-6 in the spleen and thymus of irradiated mice.In vitro experiments demonstrated that Fuping restored the M1/M2 polarization balance of macrophages,decreased the expression levels of TNF-α and IL-6,increased the expression of IL-10,and inhibited the protein expression of TLR4,MyD88,and NF-κB in irradiated macrophages.Conclusion Fuping alleviates radiation-induced inflammatory injury by inhibiting the TLR4/MyD88/NF-κB signaling pathway and regulating macrophage polarization balance,providing an experimental basis for the development of natural radioprotective drugs.

Objective:To investigate the level of urinary serine protease(Corin) in early diabetic kidney disease(DKD) and its correlation with clinical stage.Methods:One hundred and seventy-three patients with type 2 diabetes mellitus(DM) from two tertiary A hospitals in Henan, diagnosed between April 2023 and December 2023 were selected as the research group, and 120 healthy subjects were selected as the control group. Basic clinical information and laboratory data were collected, and urinary Corin level was detected. DM patients were classified into G1-G5 stages based on estimated glomerular filtration rate(eGFR), and those in the early DKD stages(G1-G3) were further divided into A1-A3 subgroups based on urinary albumin/creatinine ratio(ACR). Spearman correlation analysis was performed to assess relationships between urinary Corin and other indicators, linear regression analysis identified factors influencing urinary Corin in early DKD patients, logistic regression analysis evaluated the risk factors for early DKD, and receiver operating characteristic(ROC) curve analysis determined the diagnostic value of urinary Corin in early DKD. Results:Urinary Corin levels were significantly higher in early DKD patients compared to healthy controls, with levels increasing as ACR rose( P<0.05). Urinary Corin was positively associated with serum creatinine( r=0.570), urea( r=0.458), cystatin C( r=0.693), ACR( r=0.616), urinary transferrin( r=0.448), urinary α1 microglobulin( r=0.507), urinary n-acetyl-β-D-glucosaminase( r=0.388) and A subgroup( r=0.692) while was negatively correlated with eGFR( r=-0.647), albumin( r=-0.312)(all P<0.05). eGFR was the only independent factor affecting urinary Corin. After adjusting for confounding factors in logistic regression analysis, urinary Corin was still an independent influencing factor for early DKD. ROC curve analysis indicated that urinary Corin had a diagnostic AUC of 0.842(95% CI 0.791-0.892, P<0.001), with a cut-off value of 2 226.04 pg/mL, sensitivity of 0.712, and specificity of 0.858 for early DKD diagnosis. Conclusions:Urinary Corin was elevated in early DKD patients and correlated with clinical stage. Urinary Corin is an independent factor of early DKD, and a reliable predictor of early DKD diagnosis.