BackgroundSchizophrenia， as a common chronic mental disorder， although second-generation antipsychotic drugs have shown significant efficacy in alleviating positive symptoms， the widespread cognitive dysfunction among patients remains a challenge in clinical treatment. Traditional Chinese medicine has unique advantages in the treatment of mental disorders. However， the current clinical research on the combination of Wendan Decoction and antipsychotic drugs for schizophrenia varies in quality， and there is a lack of systematic reviews evaluating its effects on cognitive improvement and safety. ObjectiveTo systematically evaluate the effects of modified Wendan Decoction combined with antipsychotic drugs on schizophrenia symptoms and cognitive improvement， providing evidence-based support for the clinical application of Wendan Decoction. MethodsLiterature searches were conducted in China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP Information， China Biomedical Literature Service System， China Clinical Trial Registry， PubMed， Web of Science， the Cochrane Library， and Embase to collect randomized controlled trials （RCTs） of modified Wendan Decoction combined with antipsychotic drugs for the treatment of schizophrenia. The search period was from the establishment of the databases to March 19， 2026. The quality of the included literature was evaluated using the Cochrane 6.3. Meta-analysis was performed using RevMan 5.3 software. ResultsA total of 11 studies were included， involving 1 130 patients with schizophrenia. Among them， 566 cases were in the study group （receiving modified Wendan Decoction combined with antipsychotic drugs）， and 564 cases were in the control group （receiving antipsychotic drugs only）. Meta-analysis showed that the effective rate of improvement in psychotic symptoms in the study group was higher than that in the control group （RR=1.21，95% CI： 1.15–1.27， P<0.01）. In terms of psychotic symptoms， the Positive and Negative Symptom Scale （PANSS） positive symptom score （MD=-3.69， 95% CI： -5.87–-1.51， P<0.01） and PANSS total score （MD=-9.20， 95% CI： -11.80–-6.59， P<0.01） of the study group were lower than those of the control group. In cognitive function assessments， the Mini-Mental State Examination （MMSE） score （MD=2.51， 95% CI： 1.33–3.68， P<0.01） and the Loewenstein Occupational Therapy Cognitive Assessment （LOTCA） score （MD=11.85， 95% CI： 2.55–21.15， P=0.010） of the study group were higher than those of the control group， and the Wisconsin Card Sorting Test （WCST） score was lower than that of the control group （MD=-9.34， 95% CI： -12.57–-6.11， P<0.01）. The levels of brain-derived neurotrophic factor （BDNF） （SMD=1.34， 95% CI： 0.63–2.05， P<0.01） and nerve growth factor （NGF） （MD=6.94， 95% CI： 4.00–9.89， P<0.01） of the study group were higher than those of the control group. In terms of safety， there was no statistically significant difference in the incidence of adverse reactions between the two groups （RR=0.60， 95% CI： 0.31–1.18， P=0.14）. ConclusionThe modified Wendan Decoction combined with antipsychotic drugs may be more effective than antipsychotic drugs alone in improving positive symptoms and cognitive function in patients with schizophrenia， and it also exerts a favorable neurotrophic regulatory effect. ［Funded by Postgraduate Education Reform and Quality Improvement Project of Henan Province （number， YJS2023AL060）； Key Scientific Research Projects of Higher Education Institutions in Henan Province （number， 24B320018， 25B310004）］

ObjectiveTo observe the effect of modified Shenling Baizhu Powder （参苓白术散， SBP） on peripheral blood counts and immune function in breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 102 breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome were randomly divided into a treatment group and a control group， with 51 cases in each group. Both groups received granulocyte colony-stimulating factor （G-CSF） support therapy and blood component transfusion therapy after chemotherapy. The treatment group additionally took modified SBP orally at one dose per day， while the control group was administered with placebo orally at the same dosage. Each chemotherapy cycle lasted 21 days and was defined as one treatment course. A total of four treatment courses were administered， with either herbal medicine or placebo taken orally for three weeks during each course. The primary outcome measures were peripheral blood para-meters including white blood cell count （WBC）， red blood cell count （RBC）， platelet count （PLT）， and hemoglobin （Hb） levels； secondary outcome measures were comprised of immune function parameters including CD3⁺ lymphocyte percentage， CD4⁺ lymphocyte percentage， CD8⁺ lymphocyte percentage， immunoglobulin A （IgA）， immunoglobulin G （IgG）， and immunoglobulin M （IgM）， traditional Chinese medicine （TCM） syndrome scores， chemotherapy completion rate， and incidence of adverse reactions. ResultsDuring the study， 2 cases in the treatment group and 3 cases in the control group were lost， resulting in a final analysis of 49 cases in the treatment group and 48 cases in the control group. Compared with baseline values， WBC， RBC， PLT， Hb， CD3⁺， CD4⁺， CD4⁺/CD8⁺ ratio， IgA， IgG and IgM levels increased in both groups， while CD8⁺ lymphocyte percentage and TCM syndrome scores decreased （P＜0.05）. Compared to the control group after treatment， the treatment group had higher levels of WBC， PLT， Hb， CD3⁺， CD4⁺， IgA， IgG and IgM， and lower levels of CD8⁺ lymphocyte percentage and TCM syndrome scores （P＜0.05）. The chemotherapy completion rate in the treatment group was 91.84% （45/49）， which was higher than 77.08% （37/48） in the control group （P＜0.05）. The overall incidence of adverse reactions in the treatment group was 30.61% （15/49）， significantly lower than 56.25% （26/48） in the control group （P＜0.05）. ConclusionModified SBP as an adjuvant therapy can effectively improve the peripheral blood counts， enhance the body's immune function， and demonstrate favorable safety in breast cancer patients with myelosuppression and spleen-kidney insufficiency syndrome during chemotherapy.

ObjectiveTo observe the effect of modified Shenling Baizhu Powder （参苓白术散， SBP） on peripheral blood counts and immune function in breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 102 breast cancer patients with chemotherapy-induced myelosuppression and spleen-kidney insufficiency syndrome were randomly divided into a treatment group and a control group， with 51 cases in each group. Both groups received granulocyte colony-stimulating factor （G-CSF） support therapy and blood component transfusion therapy after chemotherapy. The treatment group additionally took modified SBP orally at one dose per day， while the control group was administered with placebo orally at the same dosage. Each chemotherapy cycle lasted 21 days and was defined as one treatment course. A total of four treatment courses were administered， with either herbal medicine or placebo taken orally for three weeks during each course. The primary outcome measures were peripheral blood para-meters including white blood cell count （WBC）， red blood cell count （RBC）， platelet count （PLT）， and hemoglobin （Hb） levels； secondary outcome measures were comprised of immune function parameters including CD3⁺ lymphocyte percentage， CD4⁺ lymphocyte percentage， CD8⁺ lymphocyte percentage， immunoglobulin A （IgA）， immunoglobulin G （IgG）， and immunoglobulin M （IgM）， traditional Chinese medicine （TCM） syndrome scores， chemotherapy completion rate， and incidence of adverse reactions. ResultsDuring the study， 2 cases in the treatment group and 3 cases in the control group were lost， resulting in a final analysis of 49 cases in the treatment group and 48 cases in the control group. Compared with baseline values， WBC， RBC， PLT， Hb， CD3⁺， CD4⁺， CD4⁺/CD8⁺ ratio， IgA， IgG and IgM levels increased in both groups， while CD8⁺ lymphocyte percentage and TCM syndrome scores decreased （P＜0.05）. Compared to the control group after treatment， the treatment group had higher levels of WBC， PLT， Hb， CD3⁺， CD4⁺， IgA， IgG and IgM， and lower levels of CD8⁺ lymphocyte percentage and TCM syndrome scores （P＜0.05）. The chemotherapy completion rate in the treatment group was 91.84% （45/49）， which was higher than 77.08% （37/48） in the control group （P＜0.05）. The overall incidence of adverse reactions in the treatment group was 30.61% （15/49）， significantly lower than 56.25% （26/48） in the control group （P＜0.05）. ConclusionModified SBP as an adjuvant therapy can effectively improve the peripheral blood counts， enhance the body's immune function， and demonstrate favorable safety in breast cancer patients with myelosuppression and spleen-kidney insufficiency syndrome during chemotherapy.

[摘 要] 目的：探讨CD44变异剪接异构体9（CD44v9）对卵巢癌细胞迁移与侵袭能力的影响并初步分析其机制。方法：采用免疫组织化学法及Western blotting法检测卵巢癌组织及细胞中CD44v9的表达水平。将CD44v9-shRNA质粒转染至卵巢癌细胞OVCAR-3与SKOV3，敲低细胞中CD44v9的表达后，通过划痕愈合实验、Transwell细胞迁移、侵袭实验检测细胞迁移和侵袭能力的变化；免疫荧光和Western blotting实验检测OVCAR-3和SKOV3细胞中缺氧诱导因子-1α（HIF-1α）、Ras样无CAAX基序蛋白1（RIT1）的表达。转染HIF-1α过表达质粒（HIF-1α-OE）进行功能回复实验，检测HIF-1α过表达对CD44v9敲低所致细胞迁移和侵袭能力变化的影响。建立裸鼠异种移植模型与血行转移模型，评估敲低CD44v9对体内肿瘤生长及转移的影响，并采用免疫组织化学检测肿瘤组织中HIF-1α的表达。结果：CD44v9在卵巢癌组织与细胞中呈高表达（P < 0.01）。敲低CD44v9抑制卵巢癌细胞的迁移和侵袭（P < 0.01）并降低HIF-1α和RIT1的表达（P < 0.01）。过表达HIF-1α能部分逆转CD44v9敲低对卵巢癌细胞迁移与侵袭的抑制作用。体内实验显示，敲低CD44v9抑制小鼠体内卵巢癌移植瘤的生长和血行转移（P < 0.01）并降低肿瘤组织中HIF-1α的表达。结论：CD44v9在卵巢癌中表达上调，敲低CD44v9可抑制卵巢癌细胞迁移、侵袭及体内肿瘤生长和转移，其机制可能与HIF-1α/RIT1通路有关。

ObjectiveTo observe the clinical efficacy of modified Xiangsha Liujunzi Decoction （香砂六君子汤， XLD） in the treatment of abemaciclib-related diarrhea of spleen-stomach deficiency type， and its regulatory effect on immune function in patients with advanced hormone receptor-positive/human epidermal growth factor receptor 2-negative （HR+/HER2-） breast cancer. MethodsA prospective， randomized， open-label， blinded-endpoint （PROBE） study was conducted. A total of 70 patients with advanced HR+/HER2- breast cancer and abemaciclib-related diarrhea were randomly divided into two groups， with 35 cases in each group. In addition to abemaciclib， the control group was treated with oral loperamide， while the trial group was treated with oral modified XLD. Both groups received treatment for 7 days as one course. The efficacy for diarrhea after treatment was compared between groups. Traditional Chinese medicine （TCM） syndrome score， Karnofsky performance status （KPS） score， inflammatory markers including interleukin-6 （IL-6） and C-reactive protein （CRP）， and immune function indicators including CD4⁺， CD8⁺， and CD4⁺/CD8⁺ ratio were compared between groups before and after treatment. Adverse events during the study were recorded， and safety was assessed. ResultsDuring the study， 1 case in the trial group and 2 cases in the control group， were lost to follow-up leaving 34 cases in the trial group and 33 cases in the control group for final analysis. The total effective rate of diarrhea in the trial group was 94.12% （32/34）， higher than 72.73% （24/33） in the control group （P＜0.05）. After treatment， both groups showed decreased TCM syndrome scores， increased KPS scores， increased CD4⁺， CD8⁺， and CD4⁺/CD8⁺ ratio， and decreased IL-6 and CRP levels （all P＜0.05）. Compared to the control group， the trial group had higher KPS scores， CD4⁺ levels， and CD4⁺/CD8⁺ ratios， and lower TCM syndrome scores and IL-6， CRP， and CD8⁺ levels （P＜0.05）. The incidence of adverse events in the trial group was 20.59% （7/34）， with an incidence of adverse drug reactions of 14.71% （5/34） after causality assessment； in the control group， the corresponding rates were 45.45% （15/33） and 39.39% （13/33）， respectively. The incidence of adverse events in the trial group was significantly lower than that in the control group （P＜0.05）. ConclusionModified XLD can effectively alleviate abemaciclib-related diarrhea in patients with advanced HR+/HER2- breast cancer of the spleen-stomach deficiency type， reduce levels of inflammatory cytokines， and regulate immune function， with a favorable safety profile.

AIM: To compare the effectiveness of foldable capsular body(FCB)with traditional scleral buckling(SB)in the treatment of experimental retinal detachment animal models.METHODS: After successfully establishing rhegmatogenous retinal detachment(RRD)animal models, 24 New Zealand white rabbits were randomly divided into three groups(RRD models group, SB group, and FCB group), with 8 rabbits in each group. The FCB and SB groups underwent SB and FCB surgeries for the RRD animal models, while the RRD models group only consists of RRD models without any surgical intervention during the follow-up period. The follow-up duration was 3 mo. Wide-field neonatal fundus imaging system and ophthalmic B-ultrasound were used to assess the fundus conditions before and after surgery. The Icare® TONOVET Plus tonometer was utilized to evaluate intraocular pressure changes before and after surgery. The Eaton and Draize scoring systems were selected to monitor postoperative inflammatory reactions.RESULTS: The retinal reattachment rates in the FCB and SB groups were 87.5% and 75.0%, respectively, with no statistically significant difference between the groups(P>0.05). The intraocular pressure in both the FCB and SB groups increased postoperatively compared to preoperative levels(P<0.01), and there were no significant differences in intraocular pressure at any time points during the follow-up period between the groups(P>0.05). The intraocular pressure in the RRD models group remained at a low level throughout the follow-up period. The average surgical time for the FCB group was 16.87±2.29 min, which was shorter than 46.25±4.74 min in the SB group(t=-15.166, P<0.001). According to the Eaton and Draize scoring systems, the FCB group had lower grades of conjunctival hyperemia and edema in the early postoperative period compared to the SB group, indicating milder inflammatory reactions(P<0.05).CONCLUSION: Both FCB and SB are effective in treating experimental RRD. Compared to SB, FCB is simpler to operate, and also has a shorter surgical time and milder postoperative inflammatory reactions.

Objective To investigate the sputum metabolic profiles of patients with occupational coal workers' pneumoconiosis (CWP) by an untargeted metabolomics method, and to identify relevant differential metabolic pathways and potential biomarkers. Methods A total of 12 male patients with stage Ⅰ CWP were selected as the CWP group, and 16 healthy male individuals were selected as the control group, using a judgmental sampling method. Sputum metabolites of individuals in both groups were detected to perform non-targeted metabolomic analysis using the ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Differential metabolites (DMs) and their pathways were screened using principal component analysis, partial least squares discriminant analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Potential biomarkers were analyzed and identified via the receiver operating characteristic curve (ROC). Results There were apparent metabolic alterations observed in sputum of CWP patients compared with healthy controls. In the positive ion mode, a total of 42 DMs were identified in sputum from CWP patients, including 19 downregulated and 23 upregulated metabolites. In the negative ion mode, a total of 25 DMs were identified in sputum from CWP patients, including 16 downregulated and 9 upregulated metabolites. KEGG enrichment analysis of sputum from CWP patients showed that seven DMs pathways were enriched in ABC transporters, histidine metabolism, phenylalanine metabolism, arachidonic acid metabolism, linoleic acid metabolism, purine metabolism, and oxidative phosphorylation, involving 26 DMs. ROC analysis indicated that 16(R)-hydroxyarachidonic acid, pyrophosphate, and 2-hydroxyphenylacetate of these 26 DMs may serve as potential biomarkers for CWP. Conclusion Sputum metabolomic profiles were altered in CWP patients compared with healthy controls. The potential biomarkers of CWP prevention and treatment are 16(R)-hydroxyarachidonic acid, pyrophosphate, and 2-hydroxyphenylacetate.

Thymocyte selection-associated high mobility group box (TOX), a member of the high mobility group protein super-family, plays an important role in T cell development, functional maintenance, and exhaustion. It has been recently found that TOX exerts critical immunoregulatory functions during pathogen infections, and TOX expression is strongly associated with the intensity and tolerance of host immune responses. This review systematically summarizes the structural and functional features of TOX and focuses on its expression dynamics, mechanisms of action, and immunomodulatory effects during viral, bacterial, and parasitic infections, which provides a theoretical support to better understanding of the role of TOX in infectious diseases and provides new insights into development of potential immunotherapeutic strategies targeting TOX.