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.

ObjectiveTo review the application of the International Classification of Functioning, Disability and Health (ICF) in the field of visual impairment (VI) rehabilitation. MethodsLiterature related to ICF and VI rehabilitation was retrieved from PubMed, Web of Science, CNKI, Wanfang Data, and VIP from inception to May, 2026. Standards and policy documents related to VI published before May, 2026 were retrieved from the National Standards Full-text Disclosure System of the Standardization Administration of China, the China Disabled Persons' Federation and the Chinese Government Portal. Following PRISMA-ScR, based on the three-dimensional ICF framework, an integrated analysis was conducted from the dimensions of theory, practice and policy. ResultsA total of 17 articles involving 2 648 participants, and four domestic VI assessment standards and one guideline were included. At the theoretical level, domestic VI standards showed the highest alignment with the ICF dimension of body functions, while the coverage of the activities and participation dimension was uneven, and the coverage of the environmental factors dimension was the weakest. At the practical level, the ICF was primarily used for developing assessment tools, conducting clinical evaluations, implementing interventions and exploring service models. At the policy level, the overall orientation of domestic special education and medical insurance payment aligned with the ICF concept of whole person rehabilitation, yet specific implementation rules remained to be formulated. ConclusionICF provides a comprehensive and systematic approach for integrating the VI rehabilitation system in China, demonstrating significant application value in standard construction, clinical practice optimization and policy refinement.

Objective:To establish a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products,screen critical quality markers,and provide methodological support for their intelligent quality control.Methods:Ultra-performance liquid chromatography coupled with quadrupole-orbitrap mass spectrometry(UPLC-Q-Orbitrap-MS)was employed to quantitatively analyze 34 bioactive components(e.g.,tanshinone Ⅱ A and alvianol-ic acid B)in 20 batches of fermentation products.The key markers were screened through hierarchical cluster anal-ysis and partial least squares discriminant analysis,and an intelligent discriminant model was constructed with sup-port vector machine machine learning algorithm to digitally analyze the characteristics of quality differences between batches.Results:Thirty-four common peaks were calibrated across all batches.Combined with partial least squares analysis,six key difference markers were further screened,including terpenoids such as isotanshinone Ⅱ A and tan-shinone Ⅱ A and phenolic acids such as salvianolic acid G.The support vector machine model can achieve 100％accuracy of origin discrimination by optimizing parameters jointly with genetic algorithm and grid search.Conclusion:This study developed a digital quality evaluation system for Salvia miltiorrhiza-Monascus fermentation products through a three-step analytical strategy("chemical feature exploration-marker screening-model valida-tion"),providing a transferable technical pathway for the intelligent transformation of traditional Chinese medicine quality control.

Objective:To investigate the potential of praeruptorin A (PA) in alleviating inflammatory damage in sepsis through the inhibition of ferritin expression.Methods:C57BL/6 mice were intraperitoneally injected with lipopolysaccharide (LPS) to establish the model of sepsis. After 6 and 12 h of PA intervention, serum levels of inflammatory cytokines IL-6 and TNF-α were measured by ELISA. Kidney tissues were collected at 72 h for HE staining to assess inflammatory cell infiltration and tissue damage. Human neutrophils were divided into four groups: control, LPS, ferritin, and LPS+ ferritin groups. After 12 h of intervention, qRT-PCR was used to detect the expression of IL-6 and TNF-α mRNA. In order to observe the effect of PA on the expression of inflammatory cytokines and ferritin, human neutrophils were grouped into control, LPS, and LPS+ PA (2/3/4 μmol/L) groups. After 12 h of intervention, qRT-PCR was performed to measure the expression of IL-1β, IL-6, TNF-α, and ferritin mRNA; ELISA was used to quantify the levels of IL-1β, IL-6, and TNF-α in culture supernatants; Western blot was used to analyze the expression of ferritin. Molecular docking was conducted to verify interactions between PA and ferritin.Results:Significant inflammatory cell recruitment, tissue damage, and elevated serum levels of IL-6 and TNF-α ( P<0.01) were observed in mice with LPS-induced sepsis. PA significantly inhibited cytokine secretion ( P<0.01) and alleviated tissue injury in sepsis mice. In human neutrophil models, ferritin upregulated the expression of IL-6 and TNF-α mRNA ( P<0.01); LPS stimulation alone increased the expression of IL-1β, IL-6, TNF-α, and ferritin at both mRNA and protein levels ( P<0.01), while co-stimulation with PA (3/4 μmol/L) significantly reversed the aforementioned results ( P<0.01). Molecular docking confirmed there were interaction sites between PA and ferritin. Conclusion:PA inhibits the release of inflammatory cytokines and alleviates tissue damage in sepsis, and the potential mechanism may involve modulating ferritin expression to suppress inflammatory responses.

Combined vaccines can simplify the vaccination process, improve coverage rates, reduce the risk of adverse events following immunization, lower social costs, and improve the timeliness of childhood vaccination. This article focuses on multi-component vaccines based on the diphtheria-tetanus-pertussis containing vaccine. Globally, multiple combined vaccines have been developed and marketed, but the development of combined vaccine is still in its infancy stage in China, with limited vaccine types and doses available. The research, development, and application of combined vaccines still face numerous challenges in China, including technical challenges in research and development, as well as insufficient motivation for research and development. Additionally, the high cost of existing combined vaccines, coupled with low public awareness and weak vaccination intentions, significantly hinders their widespread application, China should continue to rigorously implement the Vaccine Administration Law of the People's Republic of China, promote innovative development of combined vaccines, increase public awareness, strengthen child guardians' confidence in vaccination, and improve the accessibility and affordability of combined vaccines to protect public health across all life stages.

Objective:To explore the risk factors of fungal infection in patients with upper urinary tract calculi after surgery and construct a risk prediction nomograph model.Methods:The clinical data of 2 329 patients who had undergone upper urinary calculus surgery in the Second Affiliated Hospital of Zhengzhou University from January 2019 to December 2023 were retrospectively analyzed. According to the presence or absence of fungal infection within 3 months after surgery, the patients were divided into fungal infection group (n=97) and non-fungal infection group (n=2 232). Univariate logistic regression analysis and LASSO regression were used to screen the potential influencing factors. The enrolled patients were randomly divided into a training set (n=1 630) and a validation set (n=699) at a ratio of 7∶3. Based on the training set, multivariate logistic stepwise regression was used to screen independent risk factors and to construct a nomogram. Based on the validation set, ROC curve, calibration curve and decision curve were drawn to evaluate the model's differentiation, accuracy and clinical applicability.Results:Univariate logistic regression analysis showed that female gender, age, diabetes mellitus, history of malignant tumor, long-term bedridden disease, long-term use of immunosuppressants, hemoglobin on admission, serum creatinine, uric acid, white blood cell count on admission, neutrophil count on admission, degree of hydronephrosis, preoperative indwelling ureteral stent, duration of surgery, postoperative fever within 48 hours, white blood cell count, neutrophil count, CRP, urinary catheter indwelling time, length of hospital stay, use of carbapenem antibiotics, the duration of antibiotic use and the duration of postoperative ureteral stent indwelling were related to fungal infection. screening after upper urinary calculi surgery ( P<0.05). Univariate logistic regression results were screened after LASSO regression. Multivariate logistic stepwise regression analysis for the training set showed that age ( OR=1.041, 95% CI 1.017-1.066, P=0.001), diabetes( OR=3.138, 95% CI 1.517-6.492, P=0.002), long-term bed-rest ( OR=10.627, 95% CI 3.671-30.767, P<0.001), history of malignant tumor( OR=11.934, 95% CI 5.473-26.022, P<0.001), white blood cell count on admission( OR=1.276, 95% CI 1.134-1.436, P<0.001), postoperative fever within 48 hours ( OR=3.940, 95% CI 1.956-7.937, P<0.001), use of carbapenem antibiotics( OR=5.826, 95% CI 2.783-12.196, P<0.001), length of hospital stay( OR=1.201, 95% CI 1.131-1.277, P<0.001), and postoperative retention time of ureteral stent( OR=1.205, 95% CI 1.104-1.315, P<0.001) were independent risk factors for fungal infection after upper urinary calculi surgery.The nomogram model was constructed based on independent risk factors. The results of ROC curve analysis showed that the AUC of the nomogram model in the prediction validation set was 0.955(95% CI 0.926-0.984). The calibration curve of the model was well fitted to the ideal curve. The results of decision curve analysis proved that the net benefit rate of the prediction model within the threshold range was higher than the two extreme lines when the threshold probability was <86%, indicating that the model was of good clinical applicability. Conclusions:Age, diabetes, history of malignant tumor, long-term bed-rest disease, white blood cell count on admission, postoperative fever within 48 hours, use of carbapenem antibiotics, length of hospital stay, and postoperative retention time of ureteral stent are independent risk factors for fungal infection in patients with upper urinary calculi after surgery. The model constructed in this study has good predictive ability and clinical applicability for the risk of fungal infection in patients with upper urinary calculi after surgery.

Objective:To explore the application value of three-dimensional visualization reconstruction technology in robot-assisted laparoscopic partial nephrectomy（RAPN）for the treatment of highly complex（R.E.N.A.L. score≥10）renal hilar tumors.Methods:The clinical data of 87 patients with highly complex renal hilar tumors with R.E.N.A.L. scores ≥10 who were treated in First Affiliated Hospital of Nanchang University from January 2021 to December 2024 were retrospectively analyzed，of which 36 underwent 3D visualization reconstruction and 51 underwent conventional CT. The 3D visualization reconstruction method was to import the patient’s enhanced CT images in DICOM format into the 3D reconstruction image data processing software to produce a 3D visualization model. There were 22 males and 14 females in the 3D visualization group，with an average age of（54.2 ± 9.5）years，a body mass index of（24.8 ± 4.5）kg/m 2，and a tumor size of（4.3 ± 1.0）cm. Tumors were located on the left side in 16 cases and on the right side in 20 cases. Tumor stages were classified as T 1a in 11 cases，T 1b in 21 cases，and T 2a in 4 cases. The R.E.N.A.L. scores were distributed as follows：10 points in 21 cases，11 points in 12 cases，and 12 points in 3 cases. The estimated glomerular filtration rate（eGFR）before operation was（78.2±9.6）ml/（min·1.73 m 2）. There were 35 males and 16 females in the conventional CT group，with an average age of（51.3±8.9）years，a body mass index of（25.4 ± 3.9）kg/m 2，and a tumor size of（4.1 ± 1.2）cm. Tumors were located on the left side in 25 cases and on the right side in 26 cases. Tumor stages were classified as T 1a in 12 cases，T 1b in 33 cases，and T 2a in 6 cases. The R.E.N.A.L. scores were distributed as follows：10 points in 31 cases，11 points in 18 cases，and 12 points in 2 cases . The preoperative eGFR was（80.6 ± 8.8）ml/（min·1.73 m 2）. There was no statistical difference in general data and preoperative renal function between the two groups（ P > 0.05）. Both groups underwent RAPN. The two groups were analyzed and compared in terms of operation time，warm ischemia time，intraoperative blood loss，postoperative hospital stay，postoperative complications，and changes in renal function 3 months after surgery. Results:There were no cases of conversion to radical treatment or open surgery in both the 3D visualization group and the conventional CT group. The 3D visualization group had shorter operation time［（94.6 ± 18.5）min vs.（110.2 ± 17.2）min， P < 0.001］，shorter renal artery occlusion time［（23.3 ± 4.0）min vs.（27.2 ± 3.3）min， P < 0.001］，less intraoperative blood loss［120（100，250）ml vs. 150（120，300）ml， P = 0.018］，and a lower proportion of intraoperative collecting system incision（19/36 vs. 38/51， P = 0.042）than the conventional CT group. There was no significant statistical difference in the time of postoperative drainage tube removal and postoperative hospital stay between the two groups（ P > 0.05）. One case in the 3D visualization group had postoperative fever，and two cases in the conventional CT group had postoperative obvious macroscopic hematuria. Postoperative pathological diagnosis of the patients was clear cell carcinoma in 78 cases，papillary cell carcinoma in 6 cases，chromophobe cell carcinoma in 2 cases，and oncocytoma in 1 case. No positive resection margin was found in both groups. Three months after surgery，there was no significant statistical difference in eGFR between the two groups［（70.6 ± 8.5）ml/（min·1.73 m 2）vs.（71.4 ± 9.2）ml/（min·1.73 m 2）， P = 0.681］. During the median follow-up of 17.8 months，no tumor recurrence or metastasis was observed in either group. Conclusions:RAPN has good safety and feasibility in the treatment of highly complex（R.E.N.A.L. score ≥10）renal hilar tumors. Preoperative three-dimensional visualization reconstruction technology helps to reduce RAPN operation time，renal artery occlusion time and intraoperative blood loss，and has good clinical application value.

Objective:To explore the mechanism of Danxing Zhishuang Prescription in the treatment of Parkinson's disease (PD) by combining network pharmacology with animal models.Methods:TCMSP, BATMAN database, Genecards, and OMIM databases were retrieved to obtain the active components and action targets of Danxing Zhishuang Prescription. Venny 2.1.0 was used to intersect drug targets and PD related genes, and a protein interaction network of the intersection targets was constructed using the STRING 12.0 platform. Topology analysis was performed using Cytoscape 3.10.0 software to identify the key targets of Danxing Zhishuang Prescription on PD; GO functional and KEGG pathway enrichment analysis was performed on key targets using the WeChat platform, and molecular docking was validated through AutoDockTools 1.5.7. Using a random number table method, mice were divided into a blank control group, a model group, and a Danxing Zhishuang Prescription group, with 20 mice in each group; except for the blank group, all other groups of mice were orally administered fisetin to prepare PD models; Danxing Zhishuang Prescription group was orally administered with concentrated Danxing Zhishuang Prescription at a dosage of 10.5 g/kg, while the blank group and model group were orally administered with 0.2 ml of physiological saline for 21 days; Western blot was used to detect the expressions of Akt1, Bcl-2, Bax, and α-Syn proteins.Results:359 intersection targets, 69 core targets, and 185 active components were obtained the treatment of PD with Danxing Zhishuang Prescription. The main active components included quercetin, kaempferol, phenylalanine, etc., and the key targets were AKT1, TP53, TNF, ESR1, etc. KEGG analysis revealed several key signaling pathways, such as AGE-RAGE, PI3K-Akt, fluid shear stress and atherosclerosis signaling pathways. The validation experiment results showed that compared with the model group, the expression of Bcl-2 protein was up-regulated ( P<0.01), and the expressions of Bax, Akt1, and α-Syn proteins were down-regulated in the Danxing Zhishuang Prescription group ( P<0.01). Conclusions:Danxing Zhishuang Prescription has the advantages of multi target and multi pathway treatment for PD. Its mechanism may be related to down-regulating the expressions of Bax, Akt1, and α-Syn proteins, improving brain blood supply, regulating neurotransmitter balance, inhibiting oxidative stress response, and promoting nerve regeneration.

Objective To explore the clinical significance of miR-423-5p in ischemic stroke and its effects on SH-SY5Y cell apoptosis along with the underlying mechanisms.Methods Plasma samples were collected from three stroke-prone patients who subsequently developed acute ischemic stroke(AIS)within 24 hours.High-throughput sequencing was used to identify miR-423-5p as a key target.Venous blood samples were collected from 46 AIS pa-tients within 24 hours of onset and from 46 matched control cases.RT-qPCR was performed to measure the plasma expression of miR-423-5p in both groups.The diagnostic value of miR-423-5p for AIS was evaluated using receiver operating characteristic(ROC)curve.After overexpression and knockdown of miR-423-5p in SH-SY5Y cells,flow cytometry was performed to detect apoptosis in each group to analyze the potential relationship between miR-423-5p and SH-SY5Y cell apoptosis.Western blot was used to measure changes in the expression level of the ap-optotic protein cleaved caspase-3 and the anti-apoptotic proteins Bcl-2 and Bcl-xL.Results The expression of miR-423-5p in 3 AIS patients showed significant difference before and after onset.Plasma miR-423-5p expression was significantly elevated in AIS patients versus controls(P＜0.001).ROC analysis indicated its strong diagnostic potential for AIS.Overexpression of miR-423-5p increased the apoptosis rate and cleaved caspase-3 ex-pression of SH-SY5Y cells after OGD/R,and decreased the expression of Bcl-2 and Bcl-xL,while knocking down miR-423-5p had the opposite effect.Conclusions The expression of miR-423-5p is upregulated in the plasma of patients with ischemic stroke compared to healthy controls.Furthermore,miR-423-5p promotes OGD/R-induced apoptosis in SH-SY5Y cells by increasing the level of cleaved caspase-3 and suppressing the expression of Bcl-2 and Bcl-xL.

A case of maxillary sinus cyst removal via lateral wall fenestration combined with sinus floor elevation and implant placement was reported.A 52-year-old female presented with bilateral posterior maxillary tooth loss.Preoperative CBCT revealed two dome-shaped pseudocysts at the right maxillary sinus floor,with intact sinus walls.During surgery,lateral wall fenestration was performed,followed by cyst aspiration and removal.The sinus mucosa was repaired using an absorbable collagen barrier membrane(Bio-Gide?),and deprotein-ized bovine bone matrix(Bio-Oss?)was implanted for bone augmentation.Postoperative CBCT at 9 months showed ideal bone height and density at the sinus floor,with no cyst recurrence and successful osseointegration of implants.The results suggest that concurrent cyst re-moval during sinus floor elevation could achieve stable bone augmentation when large cysts compromise the procedure.