Idiopathic oligoasthenospermia （IO） has been increasingly emphasized in the diagnosis and treatment of male infertility. Oxidative stress damage directly affects sperm quality and spermatogenesis， constituting a major causative factor of IO. Firstly， due to its high content of polyunsaturated fatty acids， the sperm plasma membrane is highly sensitive to reactive oxygen species （ROS）， leading to lipid peroxidation accumulation and even inducing ferroptosis. Secondly， deficient downstream key proteins in the base excision repair pathway render sperm unable to repair extensive DNA oxidative damage under oxidative stress. Simultaneously， under oxidative stress， the apoptotic pathway of sperm is cascade-activated， causing rapid loss of motility. ROS further disrupts the hypothalamic-pituitary-gonadal axis， inhibiting testosterone production and ultimately affecting spermatogenesis. Wuzi Yanzongwan，in line with traditional Chinese medicine theory of treating IO through "nourishing kidney essence and harmonizing Yin and Yang"， clinically demonstrates its ability to improve sperm morphology， count， and motility， thereby enhancing male fertility. The research on the pharmacological constituents of Wuzi Yanzongwan primarily involves establishing a characteristic spectrum of Chinese medicine to achieve quality control and exploring the pharmacology of effective components. Studies have found that its main active ingredients consist of flavonoids and phenylpropanoids. Specifically， compounds such as hyperin， acteoside， kaempferol， and schisandrin A are identified as the primary active substances and quality control components. These compounds exhibit strong antioxidant activity and have been partly applied in research related to reproductive endocrine disorders. Tripterygium glycoside is primarily used for modeling of oxidative stress-induced IO. It leads to the accumulation of various lipid peroxides in testicular tissues and concurrently compromises the body's antioxidant capacity. Mechanistic studies have found that Wuzi Yanzongwan can inhibit elevated ROS levels in IO models and enhance the body's antioxidant capacity， thereby ameliorating inflammation， suppressing cell apoptosis， promoting testosterone production， and ultimately alleviating the decline in sperm quality and spermatogenesis caused by oxidative stress.

Objective:To perform FLASH irradiation experiments on cells and animals with carbon ion beams by updating the beam conditions and testing the performance of a clinical carbon ion therapy system.Methods:By using the vertical beam of the carbon ion therapy system and shortening the synchrotron beam extraction time to increase the current intensity, ultra-high dose rate beam could be achieved. Spreading the high current beam in the depth direction using a ridge filter and expanding it horizontally using point scanning technology could form the required field for cellular and animal experiments. The field flatness, penumbra, absorbed dose, average dose rate and other parameters were measured to verify whether the beam performance met the requirements.Results:The spread-out Bragg peak in the depth direction was consistent with the design, and the parameters such as field flatness and penumbra obtained by the measured lateral dose curve met the experimental requirements. After expansion, within a target volume of 20 mm×20 mm×10 mm, the absorbed dose in the field reaches 8 Gy, with the equivalent field dose rate of over 60 Gy/s and the maximum could reach 100 Gy/s. Within a target volume of 30 mm×30 mm×10 mm, the absorbed dose in the field is 4 Gy, and the equivalent filed dose rate of some energy in the field is greater than 40 Gy/s. In the experiment, the energy with a suitable dose rate can be selected for irradiation.Conclusion:After beam optimization, the carbon ion FLASH irradiation conditions for cytology and animal experiments can be realized on synchrotrons, and the beam performance parameters can meet the experimental requirements.

Ionizing radiation can induce the death of lymphatic endothelial cells, leading to structural damage, dysfunction, and reduction of lymphatic vessels, which poses a negative impact on radiotherapy. However, it can also induce tumor cells and tumor-infiltrated immune cells to secrete various cytokines and promote tumor-associated lymphangiogenesis, which favors anti-tumor therapy and improve anti-tumor immunity. Studying the changes in lymphatic vessels after ionizing radiation may be a way to explore the synergistic anti-tumor effects of radiotherapy and immunotherapy. This review summarized the morphological changes in lymphatics after ionizing radiation, the molecular mechanisms for the effects of ionizing radiation on lymphatic vessels, and the clinical value of lymphatic changes after ionizing radiation, aiming to provide ideas for the study of the effects of ionizing radiation on lymphatic vessels.

In recent years, heavy ion beams have received great attention in the field of malignant tumor radiotherapy due to their radiation physics and biological characteristics. The high rate of local tumor control is one of its advantages, but the control rate of metastatic lesions is still crucial in the treatment of most malignant tumors. Clinical studies on the combined conventional radiotherapy and immunotherapy suggest that the combination of the two can not only control the primary lesions, but may also reduce or completely eliminate distant metastatic lesions. High linear energy transfer radiation, especially heavy ion beams, may have stronger potential in combined immunotherapy. Therefore, this article focuses on the basic research progress of heavy ion beams regulating anti-tumor immune effects and their combined application with immunotherapy.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood.Radiation therapy has been integrated into the primary treatment of most patients with rhabdomyosarcoma, but which in turn potentially induces severe acute and late toxicities.Proton therapy in recent years has been more and more used in the treatment of rhabdomyosarcoma, which is safe and effective, with no serious adverse events.Compared with conventional photon therapy, proton therapy has distinct physical advantages and enables greater precision in the delivery of tumoricidal radiation doses with reduced irradiation of normal tissues, and improves quality of life for patients.Additional follow-up and prospectively studies are needed to determine whether proton therapy truly reduces the incidence and severity of late effects in comparison to patients treated with modern photon techniques.

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

Objective To evaluate the efficacy of the carbon ion radiotherapy for prostate cancer by Meta-analysis.Methods We searched the Cochrane library,PubMed,EMBASE,China Journal Fulltext Database,Chinese Biomedical Database,and Wanfang Database from their inception to December 2015,in order to collect clinical trial data of carbon ion radiotherapy for prostate cancer.References included within these studies were also retrieved.Meta-analysis was performed using MetaAnalyst Beta 3.13 and STATA 12.0 software.Results Six studies (eight clinical trials) were included.The results of Meta-analysis show that,the overall survival rates of 3,4,5 and 8 years were 95.7％,90.9％,91.8％ and 83.9％,respectively.The cause specific survival rate of 4 and 5 years were 97.1％ and 97.6％.The bNED rate of 3,4,5 and 8 years were 88％,86.3％ and 79.1％,respectively.The local control rates of 3,4 and 5 years were 98.1％,97.1％ and 98.4％,respectively.The rate of total death,prostate cancer death and intercurrent death were 7％,2.4％ and 7％,respectively.Different T-stage may affect the fiveyear of overall survival rate,bNED rate and cause specific survival rate.Conclusions The current evidence shows that carbon ion radiotherapy in gcncral is a fcasiblc trcatmcnt for prostate cancer,whether carbon ion is better than other radiotherapy,prospective,randomized,controlled clinical trial to get more evidence is required for carbon ion radiotherapy versus standard treatment for prostate cancer patients.

Objective To assess the efficacy and safety of the carbon ion radiotherapy for stage Ⅰ non-small cell lung cancer (NSCLC).Methods We searched multiple electronic bibliographic databases,including the Cochrane library,PubMed,EMBASE,China Journal Full-text Database,Chinese Biomedical Database,and the Wanfang Database to assemble the available studies of carbon ion radiotherapy for stage Ⅰ non-small cell lung cancer.MetaAnalyst Beta 3.13 and STATA 12.0 software were used to combine the extracted data.Results Ten studies (seven trials) were included.The overall survival rates of 1,3 and 5 years were 95.1％,68.5％ and 45.9％,respectively.The local control rates of 1,3 and 5 years were 90.2％,76.7％ and 81.2％,respectively.The cause specific survival rate of 1,3 and 5 years were 82.9％,58.5％ and 57.3％,respectively.The rate of primary recurrence and total recurrence were 45.8％ and 11％,respectively.The rates of total death and death from lung cancer were 52.4％ and 28.3％,respectively.There were differences observed between T1 stage and T2 stage in regards to five year overall survival rate,total recurrence,lung cancer death,and grade 1 and grade 2 skin toxicities.Conclusions Available data demonstrate that carbon ion radiotherapy,in general,is a safe and feasible treatment modality for stage Ⅰ NSCLC.Although current results are promising,more evidence is required before carbon ion radiotherapy can become the international standard treatment for lung cancer patients.

Internal mammary nodes are part of the first stop of mammary gland lymphatic drainage.It plays an important role in the process of occurrence and development of breast cancer.Whether irradiation internal mammary nodes or not is still a larger controversy.At present,for the early stage patients,the efficacy of internal mammary lymph node irradiation is not clear.For the patients with positive axillary lymph nodes,inboard or central quadrant lesions,postoperative radiotherapy of internal mammary nodes has a certain value.

Objective To assess the efficacy and safety of intensity-modulated radiation therapy (IMRT) for nasopharyngeal neoplasm.Methods PubMed,EMBASE,Cochrane Library,CBM,CNKI,VIP and WanFang Data were fully searched up from creating database to June 15,2012.Randomized controlled trials (RCTs) of IMRT versus conventional radiotherapy (CRT) for nasopharyngeal neoplasm were included.The quality of included studies was evaluated by two individual researchers and data were analyzed by using RevMan 5.1 software.Results Fifteen RCTs were included.Meta-analyses suggested that patients treated by IMRT had a higher fractional stimulated parotid salivary flow rate and a higher stimulated whole salivary flow rate than CRT.IMRT can significantly reduce the acute xerostomia (RR =0.46,P ＜ 0.000 1),reaction of mucosa(RR =0.g6,P =0.04),reaction of skin (RR =0.33,P ＜ O.000 1),long-dated xerostomia (RR ＝0.28,P =0.01) and limitation of mouth opening (RR =0.42,P =0.008).And IMRT trended to improve short-term efficacy (RR =1.22,P =0.02) and long-term survival (RR =1.25,P =0.04).Moreover,IMRT trended to shorten the treatment time while increasing the costs.Conclusion Compared with CRT,IMRT trends to be superior for nasopharyngeal neoplasm.However,because of small sample size,the results need to be proved by more clinical trials.