Andrological diseases have become an important public health problem threatening men's health worldwide， which significantly affects the quality of life of patients and brings a heavy disease burden. Western medicine often faces the dilemma of obvious side effects and limited efficacy. Traditional Chinese medicine has unique advantages in the prevention and treatment of andrological diseases and has accumulated rich clinical experience. Epimedii Folium， as a traditional Chinese medicine for strengthening kidney and Yang， exerts a key therapeutic effect on andrology diseases through multi-component synergy， multi-target regulation， and multi-pathway intervention. Recent studies have found that the main active components of Epimedii Folium， such as icariin， icariside， and icaritin， are the key material basis for the treatment of andrological diseases. The active components of Epimedii Folium can play a role in common andrological diseases such as erectile dysfunction， male infertility， and prostate cancer by regulating the activity of the nitric oxide/cyclic guanosine monophosphate （NO/cGMP） pathway， participating in oxidative stress response， regulating the secretion of hypothalamic-pituitary-gonadal axis hormones， improving spermatogenic dysfunction， and inhibiting the proliferation of cancer cells. However， the systematic action network and molecular mechanisms of the active components of Epimedii Folium have not been fully elucidated， thereby limiting its potential for clinical translation and application. In the future， it is necessary to combine cutting-edge technologies such as metabolomics， single-cell sequencing， and targeted nanoscale drug delivery systems， strengthening the research on the compatibility rules of active components and organ-specific delivery， providing a scientific basis for the development of innovative andrology traditional Chinese medicine formulas with international competitiveness， and promoting the innovation and breakthrough of andrology disease treatment modes.

Chronic heart failure （CHF） is a clinical syndrome characterized by impaired ventricular ejection function due to cardiac abnormalities， representing the terminal stage of most cardiovascular diseases. With its rising prevalence and significant impact on patients' quality of life， CHF has emerged as a major global public health concern. Current Western medicine treatments mainly involve the oral administration of the "new quadruple therapy" drugs and diuretics. Despite substantial progress in pathological research and clinical treatment， challenges persist， including considerable side effects， drug resistance， and marked interindividual variability in therapeutic response. Therefore， exploring and leveraging the advantages of traditional Chinese medicine （TCM） in treating CHF has become an urgent research priority. TCM has a millennia-long history in the prevention and treatment of heart failure， accumulating extensive clinical experience. Characterized by its multi-component and multi-target properties， TCM enables holistic regulation of multiple systemic functions and intervention in the progression of heart failure， demonstrating significant clinical relevance in its management. By employing therapeutic strategies such as warming Yang， promoting diuresis， replenishing Qi， nourishing Yin， and activating blood circulation， TCM effectively improves myocardial fibrosis， inhibits oxidative stress responses， enhances myocardial contractility， and ameliorates ventricular remodeling. Modern proprietary Chinese medicines derived from classic formulas， based on the theoretical foundation of traditional prescriptions， not only exhibit favorable clinical efficacy but also offer notable advantages in convenience， stability， and safety. This review systematically examined the significant therapeutic effects and underlying mechanisms of classical TCM formulas in the treatment of CHF， and provided an overview of the clinical application of modern proprietary Chinese medicines. It aims to provide new strategies for the clinical diagnosis and treatment of CHF.

OBJECTIVE To assess the bleeding risk signals associated with the concomitant use of direct oral anticoagulants （DOACs） and triazole antifungals， and to provide pharmacovigilance evidence for the safety evaluation and monitoring of combined clinical use. METHODS Adverse event reports involving the concomitant use of DOACs and triazole antifungals were extracted from the US FDA Adverse Event Reporting System （FAERS） from the first quarter of 2004 to the third quarter of 2025. Nine bleeding-related preferred terms （PTs） were selected. The Ω shrinkage measure， additive model， multiplicative model， and combined risk ratio method were employed to detect drug-drug interaction signals. The strength of positive signals was further analyzed based on the Ω shrinkage measure. RESULTS A total of 790 adverse event reports involving the concomitant use of DOACs and triazole antifungals were included， among which 229 reports involved nine bleeding-related PTs. A total of 13 signals were consistently identified as posit ive by all four methods. These signals involved six drug combinations： apixaban-fluconazole， apixaban-posaconazole， rivaroxaban-itraconazole， dabigatran etexilate-fluconazole， apixaban-voriconazole， and dabigatran etexilate-itraconazole. The Ω shrinkage measure showed that the apixaban-posaconazole combination exhibited stronger signals for bleeding （ Ω ＝2.73， Ω 025 ＝2.05） and hemoptysis （ Ω ＝2.17， Ω 025 ＝0.83）； the apixaban-fluconazole combination exhibited stronger signals for hematoma （ Ω ＝2.30， Ω 025 ＝1.47） and hematuria （ Ω ＝1.71， Ω 025 ＝0.74）； the rivaroxaban-itraconazole combination exhibited stronger signals for epistaxis （ Ω ＝2.01， Ω 025 ＝0.90） and hematoma （ Ω ＝1.93， Ω 025 ＝0.42）； no positive Ω signals were observed for intracranial hemorrhage or upper gastrointestinal hemorrhage. CONCLUSION S This study suggests that the concomitant use of DOACs and triazole antifungals may increase the risk of bleeding-related events， with differences in signal strength and signal distribution across various drug combinations. In clinical practice， particular attention should be paid to the concomitant use of apixaban or rivaroxaban with strong cytochrome P450 3A4 or P-glycoprotein inhibitors such as posaconazole and itraconazole. For other DOAC-triazole antifungal combinations， close monitoring for bleeding-related manifestations and timely adjustment of anticoagulation or antifungal regimens are also warranted.

ObjectiveTo establish an in vitro culture model of rat corpora cavernous smooth muscle cells （CCSMCs） using a modified tissue block adherence method. MethodsCorpus cavernosum smooth muscle tissue was digested with collagenase type I and subsequently cultured using an adherent method. Cells were purified via differential adhesion and identified through immunofluorescence and Western blotting. ResultsCCSMCs began to emerge from the tissue block after 3 days， increased significantly by day 7， and converged by day 12. Post-passage， CCSMCs exhibited strong proliferation and a “peak-to-valley” phenomenon. After purification， the cells tested positive for α-smooth muscle actin （α-SMA）， confirming the successful establishment of the in vitro culture model. ConclusionThe modified tissue block adherence method is a cost-effective and efficient way to obtain high-purity CCSMCs.

OBJECTIVE To construct a whole-process management system for the smart pharmacy based on the integration of drug batch numbers and traceability codes， aiming to solve the problems of low upload rates and traceability difficulties of drug traceability codes in the central pharmacy， and to enhance its level of refined management and medication safety. METHODS Following the FOCUS-PDCA framework（find，organize，clarify，understand，select-plan，do，check，act）， a drug batch number and traceability code management system was established by optimizing batch number management processes， introducing “pre-scan registration” technology， and establishing a dynamic “code pool” mechanism. Based on medical insurance upload data and operational performance indicators in our hospital from June to August 2025， the differences in management efficacy before and after the implementation of the system were compared and analyzed. RESULTS The drug batch number and traceability code management system was successfully established， achieving “one-object， one-code” whole-process association with batch numbers for inpatient drugs， especially split drugs. After the application of this system， the upload rate of inpatient drug traceability codes reached 100%， significantly higher than the average upload rate of inpatient drugs in other tertiary hospitals in our city （with the highest rate being only 23.22%， P ＜0.001）. The inventory stocktaking error rate dropped from 0.9% to 0.3% （a decrease of 66.7%）； the number of daily dispensing errors decreased from 1.43 to 0.37； the dispensing time （14.75 min） for temporary medical orders recovered to the routine level （14.42 min） prior to the system implementation. CONCLUSIONS By adopting the “pre-scan registration-code pool management-closed-loop traceability” model， this system enables traceability for individual drug products in their smallest packaging units， improves the upload rate of traceability codes， significantly reduces the medication dispensing error rate， and does not increase the time cost for temporary medical order dispensing， thereby balancing efficiency with closed-loop traceability.

High-altitude retinopathy(HAR)is a retinal vascular disorder induced by exposure to high-altitude environments. With the increasing popularity of high-altitude travel, mountaineering, and special occupational activities, worldwide, the incidence of HAR has risen, particularly among individuals with rapid or short-term exposure to elevated altitudes. Most cases of HAR are self-limiting and gradually resolve with descent to lower altitudes. However, severe cases may result in permanent visual function impairment if not recognized and managed promptly. This review systematically summarizes the epidemiology, diagnostic progress, pathogenesis, and prevention and treatment strategies of HAR, with particular emphasis on hypoxia-associated molecular pathways involved in retinal damage, and evaluates current evidence for clinical interventions. Deepened understanding of its pathological mechanisms and clinical management strategies facilitates early identification, targeted intervention, and ocular health protection for populations exposed to high altitudes.

AIM: To investigate the changes in ocular surface-related indicators and tear matrix metalloproteinase-9(MMP-9)levels in diabetic patients complicated with meibomian gland dysfunction(MGD), analyze the effects of diabetes mellitus on ocular surface status and tear MMP-9 levels in patients with MGD, and provide evidence for clinical diagnosis and treatment.METHODS: Prospective observational study.Patients with type 2 diabetes mellitus complicated with MGD who visited the Department of Ophthalmology of the hospital from June 2024 to December 2024 were enrolled(diabetes mellitus+MGD group), and patients diagnosed solely with MGD without a history of diabetes mellitus during the same period were recruited as the non-diabetic MGD group. Patients in the diabetes mellitus+MGD group were further subdivided into aglycosylated hemoglobin(HbA1c)<7.5% subgroup and an HbA1c≥7.5% subgroup based on HbA1c levels, and into a diabetes duration<10 y subgroup and a diabetes duration ≥10 y subgroup according to the duration of diabetes mellitus. Multiple ocular surface parameters, including the Ocular Surface Disease Index(OSDI)score and eyelid margin alteration score, as well as tear MMP-9 concentration, were measured in all participants, followed by between-group comparative analyses.RESULTS:Total of 101 patients(202 eyes)with type 2 diabetes mellitus combined with MGD were enrolled, including 56 males and 45 females with a mean age of 60.2±8.5 y. The non-diabetic MGD group consisted of 151 patients(302 eyes), with 82 males and 69 females and a mean age of 57.5±7.8 y.The HbA1c <7.5% group comprised 55 patients(110 eyes)aged 59.6±8.2 y; 31 males and 24 females. The HbA1c ≥7.5% group included 46 patients(92 eyes)aged 60.9±8.7 y; 25 males and 21 females.The subgroup with diabetes duration <10 y had 50 patients(100 eyes)aged 58.7±8.1 y; 28 males and 22 females, and the subgroup with duration ≥10 y consisted of 51 patients(102 eyes)aged 61.6±8.4 y; 27 males and 24 females. Patients in diabetes mellitus+MGD group exhibited higher OSDI scores, meibomian gland orifice scores, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 levels compared with non-diabetic MGD patients(all P<0.01), while tear film breakup time(BUT)and Schirmer test values were lower(all P<0.01).Among diabetic patients with MGD, the HbA1c≥7.5% subgroup had significantly higher OSDI score, meibomian gland orifice score, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 concentration than the HbA1c<7.5% subgroup(all P<0.05), accompanied by significantly shorter BUT and lower Schirmer I test results(all P<0.05). Similarly, the diabetes duration≥10 y subgroup showed significantly higher OSDI score, meibomian gland orifice score, meibum expressibility scores, meibum quality scores, corneal fluorescein staining scores, and tear MMP-9 concentration compared with the diabetes duration<10 y subgroup(all P<0.05), whereas BUT and Schirmer I values were significantly lower(all P<0.05).CONCLUSION: Diabetes mellitus may be associated with aggravated ocular surface damage in patients with MGD, accompanied by elevated tear MMP-9 levels. Poor glycemic control and longer disease duration are related to more severe ocular surface injury and higher tear MMP-9 levels. Tear MMP-9 may serve as a potential indicator for evaluating ocular surface inflammation and damage in diabetic patients with MGD, providing certain evidence for clinical treatment decision-making.

Moyamoya disease (MMD) is characterized by progressive stenosis or occlusion of the distal internal carotid artery and its major branches, with secondary formation of abnormal collateral vessels at the skull base. Previous studies evaluated peripheral blood molecules to reflect vascular pathology and inflammation of MMD, but their limited specificity and susceptibility to confounding factors restricted clinical utility. With advances in high-throughput omics, blood-based biomarkers with improved specificity have been identified, and bioinformatics and machine learning have facilitated biomarker screening and diagnostic model development. Meanwhile, biomarkers for different clinical scenarios have emerged, promoting a shift from “diagnostic” to “decision-making” and “predictive” biomarkers. This review summarizes recent studies in blood-based biomarkers for MMD, aiming to provide references for future in-depth studies and clinical translation.

ObjectiveTo investigate the mechanism by which Haizao Yuhu Tang regulates the nuclear receptor subfamily 4 group A member 1 （NR4A1）signaling pathway to modulate CD8-positive T lymphocyte （CD8⁺T） cell exhaustion-mediated immune escape in transgenic mice with papillary thyroid carcinoma （PTC）. MethodsSixty C57BL/6J mice carrying the conditional BRAF^V600E point mutation were randomly assigned to five groups （n=12）： Model， low-dose （7.28 g·kg^-1·d^-1） Haizao Yuhu Tang， medium-dose （14.56 g·kg^-1·d^-1） Haizao Yuhu Tang， high-dose （29.12 g·kg^-1·d^-1） Haizao Yuhu Tang， and vemurafenib （PLX4032， 0.02 g·kg^-1·d^-1）. In addition， 12 BRAF^V600E-negative mice were selected as the control group. All the groups received continuous intervention for 8 weeks. After treatment， the thyroid tumor weight and volume of mice in each group were measured. Hematoxylin and eosin （HE） staining was performed to observe the morphological characteristics of thyroid tumors. Enzyme-linked immunosorbent assay （ELISA） was adopted to quantify the serum levels of interferon-γ （IFN-γ）， interleukin-2 （IL-2）， tumor necrosis factor-α （TNF-α）， C-X-C motif chemokine ligand 9 （CXCL9）， and C-X-C motif chemokine ligand 10 （CXCL10）. Flow cytometry was employed to determine the proportion of cytotoxic CD8⁺T cells in the tumor tissue. Western blot and real-time PCR were employed to determine the protein and mRNA levels， respectively， of molecules related to the NR4A1 signaling pathway. ResultsCompared with the control group， the model group showed significantly increased thyroid tumor volume and weight （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups and the vemurafenib group exhibited varying degrees of reduction in thyroid tumor volume and weight （P<0.05， P<0.01）， with the medium-dose Haizao Yuhu Tang group and the vemurafenib group showing the most pronounced therapeutic effects （P<0.01）. Compared with the model group， the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups and the vemurafenib group showed increased serum levels of IFN-γ， IL-2， TNF-α， CXCL9， and CXCL10， decreased mRNA and protein levels of NR4A1， Programmed cell death-1 （PD-1）， and Programmed cell death-ligand 1 （PD-L1）， and enhanced cytotoxic activity of CD8⁺T cells （P<0.05， P<0.01） Among these groups， the medium-dose Haizao Yuhu Tang group exhibited the optimal therapeutic effects. In addition， compared with that in the model group， T-cell factor-1 （TCF-1） expression was increased in the low-dose， medium-dose， and high-dose Haizao Yuhu Tang groups （P<0.01）， whereas no significant change in TCF-1 expression was observed in the vemurafenib group. ConclusionHaizao Yuhu Tang may restore the cytotoxic function of CD8⁺T cells by inhibiting the NR4A1 signaling pathway， thereby suppressing immune evasion in PTC and delaying PTC growth.

Objective:To investigate the incidence of visual fatigue among military pilots during flights or simulated flights and analyze the correlations among the multidimensional evaluation indicators of visual fatigue.Methods:A total of 172 pilots from an Air Force unit were selected between March 2022 and August 2023. A self-made pilot visual fatigue scale [involving the basic information, visual fatigue status scale (VFSS), and visual quality scale (VQS) was used. The visual fatigue among pilots of different types was compared. Pearson correlation analysis was used to explore the correlations between the cumulative duration of visual display terminal (VDT) and the dimensions of the VFSS, as well as between dimensions of the VFSS and the VQS. Multiple linear regression was used to identify the determinants of the score of the VQS.Results:A total of 172 questionnaires were issued, 146 of which were valid, with an effective rate of 84.88%. Among the 146 military pilots, 73 were fighter pilots and 73 were pilots of other aircraft types (20 bombers, 5 helicopters, 36 transporters, 8 trainers, and 4 fighter-bombers). There were significant differences in the scores of various dimensions and the total score of the VFSS between pilots who were different in age, aircraft types, maximum single-sortie flight durations, and in the proportion of time spent viewing cockpit displays during flight missions ( F=4.93-14.41, t=2.37-4.86, all P<0.01 or <0.05). Significant differences in visual disturbance, systemic symptoms, environmental factors, and the total visual fatigue score were observed between pilots whose total flying hours were different ( F=14.18, 4.90, 4.66, 8.12, P<0.001, =0.009,0.011, <0.001). However, there were no significant differences in the scores of any dimension or in the total score of the VFSS between pilots with a history of ocular trauma or disease and those without (all P>0.05). The cumulative duration of VDT use was positively correlated with the scores of all dimensions and the total score of the VFSS ( r=0.353, 0.303, 0.312, 0.250, 0.356, P<0.001, <0.001, <0.001, =0.002, <0.001), the dimensions of which were positively correlated with those of the VQS ( r=0.448-0.781, all P<0.01). Age ( B=1.524, 95% CI: 0.503-2.545), proportions of time spent viewing cockpit displays during flight missions ( B=3.721, 95% CI: 1.683-5.759), starburst ( B=2.346, 95% CI: 0.516-4.176), blurred vision ( B=3.517, 95% CI: 1.168-5.866), visual fluctuation ( B=2.997, 95% CI: 1.036-4.957) and halo ( B=2.415, 95% CI: 0.469-4.362) were contributors to the total visual fatigue score. Conclusions:The scores of various dimensions and the total score of visual fatigue status in military pilots can increase with age, peak in the group ages 40 to 49, and then decline. Fighter pilots experience lower levels of visual fatigue than those of other aircraft types. The visual quality scale can serve as a reference for assessing pilots′ visual fatigue status. Cumulative durations of VDT use are positively correlated with the degree of visual fatigue. Age, proportions of time spent viewing cockpit displays during flight missions, starburst, blurred vision, visual fluctuation and halo can be used to quickly assess the risk level of visual fatigue among pilots.