Table of Content

21 June 2026, Volume 47 Issue 3

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Multidimensional breakthroughs in innovative drug development: from molecular design to clinical practice

Wang Yaoqi, Huo Ran, Zhang Shuang, Sun Qi, Zhang Xiaoyi, Cui Chunying, Zhang Qiang

2026, 47(3):  401.  doi:10.3969/j.issn.1006-7795.2026.03.001

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Conventional drug discovery and development is constrained by structural bottlenecks, including protracted timelines, high costs, low clinical success rates, and the rapid emergence of resistance associated with single-target strategies. With accelerating interdisciplinary convergence and continuous technological innovation, innovative drug R&D is undergoing a comprehensive, end-to-end transformation spanning target discovery, drug design, and clinical translation. This review systematically summarizes three major frontiers: (i) multi-omics integration and artificial intelligence (AI)-enabled precision target identification; (ii) intelligent drug design coupled with innovations in advanced drug delivery and controlled-release systems; and (iii) precision-medicine-driven individualized therapy. By integrating advances from nanotechnology, materials science, synthetic biology, and related disciplines, we elucidate a closed-loop pathway that translates molecular mechanisms into actionable clinical value, thereby further catalyzing drug innovation and supporting transformative progress in biomedicine. In alignment with national strategic priorities for the biopharmaceutical sector, we propose a new R&D paradigm centered on clinical value, supported by technological innovation, and advanced through multidisciplinary integration, providing both theoretical insights and practical reference for achieving high-level scientific and technological self-reliance and strengthening the foundation of biopharmaceutical industry development.

Association of ITGA2 dual site variants with recurrent ischemic events in patients undergoing stenting for symptomatic intracranial atherosclerotic stenosis

Dong Yiwen, Ye Jiadan, Cheng Sheng, Yang Hongge, Li Ze, Di Xuan, Lou Xin, Li Xingang, Ma Ning

2026, 47(3):  408-416.  doi:10.3969/j.issn.1006-7795.2026.03.002

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Objective  To investigate the correlation between gene polymorphisms and the occurrence of adverse clinical events following dual antiplatelet therapy in patients with symptomatic intracranial atherosclerotic stenosis. Methods  A total of 195 patients were enrolled and categorized into 32 cases (those with clinical adverse events) and 163 controls (without events). Genotyping of 20 single nucleotide polymorphism (SNP) from 17 genes was executed. To address the imbalance in sample size between cases (n=32) and controls (n=163), weighted Logistic regression analysis was performed using frequency weights based on the reciprocal of group proportions. Weights were calculated to account for the unequal case-control ratio and improve the stability and reliability of regression estimates. Results  The ITGA2 rs1126643 (C807T) and rs1062535 (G873A) polymorphisms were significantly correlated with adverse clinical events. Specifically, the mutant frequency of allele C (ITGA2 rs1126643) and allele G (ITGA2 rs1062535) was significantly higher in cases compared to controls (OR=2.97, 95%CI: 1.702-5.172, P=0.000 1; OR=3.27, 95%CI:1.762-6.066, P=0.000 2, respectively). Other genotypes showed no significant differences between the groups. Conclusion  The ITGA2 C807T and G873A polymorphisms are associated with an increased risk of recurrent ischemic events in Chinese patients with symptomatic intracranial atherosclerotic stenosis after stenting. Detection of these variants may help identify individuals at high risk of recurrent ischemic events in this specific population.

A reduction-gated pH transition-switchable delivery system for precise tumor imaging

Xia Heming, Zhou Bushu, Wang Yiguang, Chen Binlong

2026, 47(3):  417-427.  doi:10.3969/j.issn.1006-7795.2026.03.003

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Objective  To investigate the efficiency and mechanism of the reduction-gated pH transition-switchable delivery system (RPS) in tumor imaging. Methods  Reduction-sensitive monomers (HEMA-SS-C3 and AMA-SS-C3) were synthesized, and polymers with different monomer ratios were prepared via atom transfer radical polymerization (ATRP) to construct RPS polymers. The physicochemical properties of polymers and micelles were characterized by using dynamic light scattering (DLS), fluorescence spectroscopy, and nuclear magnetic resonance hydrogen spectroscopy (1H-NMR). Cellular uptake and in vivo tumor imaging effects were evaluated through flow cytometry and living imaging system. Results  The RPS micelles exhibited a particle size of 30-50 nm. After reduction response, the pH transition point increased from approximately 5.5 to 6.5, and in vitro cellular uptake was significantly enhanced. In vivo imaging revealed that RPS micelles exhibited favorable tumor-imaging effects. Conclusion  RPS possesses a reduction-gated pH transition-tunable property, providing a novel design concept and research basis for precise tumor imaging and drug delivery.

Construction of a Pd/Cu-TCPP-based photoresponsive nanosystem and preliminary investigation of its synergistic antitumor mechanism

Ren Yihan, Jiang Yuyan, Sun Qi

2026, 47(3):  428-436.  doi:10.3969/j.issn.1006-7795.2026.03.004

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Objective  To construct a Pd/Cu-TCPP (PCT)-based photoresponsive nanodelivery system (PCT@PDA/siPKM2), investigate the feasibility of synergistic photothermal therapy, hydrogen therapy, and gene therapy, and preliminarily evaluate its in vitro antitumor mechanism.Methods  PCT nanoparticles were synthesized via a solvothermal method and subsequently coated with polydopamine (PDA) to form a core-shell structure. Polyethylenimine (PEI) was further employed to load siRNA targeting the PKM2 gene (siPKM2), yielding PCT@PDA/siPKM2 nanoparticles. The physicochemical properties, siRNA loading and protection capacity, photothermal performance, and hydrogen release behavior were systematically characterized. Cellular uptake and antitumor efficacy were evaluated in 4T1 mouse breast cancer cell line.Results  Uniform and stable PCT@PDA/siPKM2 nanoparticles were prepared, exhibiting excellent siRNA loading and protection capabilities, as well as prominent photothermal conversion efficiency and controllable hydrogen release under 808 nm near-infrared laser irradiation. In vitro studies demonstrated effective lysosomal escape and significant inhibition of 4T1 cell viability upon laser irradiation.Conclusion  This study confirmed the feasibility of PCT@PDA/siPKM2 in combining photothermal effects, hydrogen release and genetic intervention, providing an experimental basis for further research into synergistic tumour control.

Optimization of a dual-targeting biomimetic nano-delivery system and in vitro evaluation of its targeting efficacy in glioblastoma

Na Chang, Tian Yang, Luo Shuxin, Zhang Shuang, Wang Yaoqi

2026, 47(3):  437-448.  doi:10.3969/j.issn.1006-7795.2026.03.005

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Objective  To construct a dual-targeting nano-delivery system (ANG-2-CMLNPs) based on an epigallocatechin gallate (EGCG)-Zn supramolecular nanocarrier coated with a fusion membrane comprising angiopep-2-modified liposomes and glioma cell membranes for efficient loading and brain delivery of si-Survivin. Methods  Dynamic light scattering, transmission electron microscopy(TEM), agarose gel electrophoresis, fluorescence spectrophotometry, and flow cytometry were used to systematically characterize the particle size, Zeta potential, morphology, encapsulation efficiency, stability, and cellular targeting, uptake behavior of the nano-system. Models of U87 MG glioma cells and HCMEC/D3 endothelial cells were used to evaluate the system's blood-brain barrier（BBB） penetration capability, tumor cell targeting efficiency, and in vitro anti-proliferative activity. Results  ANG-2-CMLNPs with an average particle size of approximately (89.33±13.25) nm and a Zeta potential of(-11.17±0.70) mV were prepared. The optimal encapsulation efficiency［(98.98±1.01)%］ was attained at an EZ NP/siRNA mass ratio of 125∶1.  TEM confirmed a spherical shape with an intact membrane structure. Flow cytometry results indicated significant uptake of ANG-2-CMLNPs by HCMEC/D3 cells, demonstrating potential for BBB penetration; its uptake efficiency in U87 MG cells was significantly higher than in the control groups (P<0.001). When the mass ratio of liposomes to cell membrane was 1∶5, the system achieved optimal uptake balance. MTT results showed that ANG-2-CMLNPs inhibited U87 MG cell proliferation in a concentration-dependent manner, with cell viability decreasing to 28.4% at an siRNA concentration of 100 nmol/L. Conclusion  This study constructed a nano-drug delivery system with BBB-crossing and tumor-targeting capabilities, exhibiting good stability, high encapsulation efficiency, and significant targeting ability. The optimized membrane fusion ratio (1∶5) provided a key parameter for the synergistic realization of dual-targeting functions, offering a new strategy for RNAi therapy of glioma.

Quality attribute evaluation of drug-vehicle systems in extemporaneous compounding oral pharmaceutical vehicles

Ta Na, Yang Mei, Yu Feng, Huang Min, Wang Xiaoling, Mei Dong

2026, 47(3):  449-456.  doi:10.3969/j.issn.1006-7795.2026.03.006

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Objective  To evaluate the feasibility of an extemporaneous compounding oral pharmaceutical vehicle for dose-splitting administration in children and special populations, and to investigate the content uniformity and stability of drugs with different Biopharmaceutics Classification System (BCS) classes in this system. Methods  Four representative drugs were selected, including fluconazole (BCS class Ⅰ), dipyridamole (BCS class Ⅱ), propranolol hydrochloride (BCS class Ⅲ), and furosemide (BCS class Ⅳ). After processing with a routine clinical grinding procedure, the drugs were added to the oral pharmaceutical vehicle for extemporaneous compounding. The content uniformity at different spatial sampling positions of the suspension and the content changes at different time points under 5 ℃ and 25 ℃ storage conditions were evaluated and followed by statistical analysis. Results  The content uniformity of all four drugs in the oral pharmaceutical vehicle met the acceptance criteria of the Chinese Pharmacopoeia ［relative standard deviation (RSD) < 15%］. Differences in RSD values were observed among drugs of different BCS classes. Stability studies showed that drug contents exhibited only minor changes during the evaluated storage periods of 30-90. Conclusion  The oral pharmaceutical vehicle can support the extemporaneous compounding of drugs with different physicochemical properties and demonstrates acceptable content uniformity and stability in dose-splitting administration scenarios, indicating its potential as a feasible technical option for medication use in children and special populations.

Establishment and performance evaluation of a candidate reference method for 4 anti-tuberculosis drugs in human plasma

Miao Wenxuan , Chen Qi , Mei Shenghui

2026, 47(3):  457-469.  doi:10.3969/j.issn.1006-7795.2026.03.007

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Objective  To establish a candidate reference method for the simultaneous, accurate and sensitive determination of four first-line anti-tuberculosis drugs (rifampicin, isoniazid, pyrazinamide and ethambutol) in human plasma, and to provide technical support for individualized and precise clinical diagnosis and treatment. Methods  An ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed. Rifampicin-d8, isoniazid-d4, ethambutol-d4 and pyrazinamide-d3 were used as internal standards, and acetonitrile was selected as the extraction solvent for the quantitative determination of the four drugs in human plasma. The blood samples were centrifuged, and the supernatant was directly injected for analysis. The mobile phase was composed of 0.1% formic acid aqueous solution (v/v) (A) and methanol (B). The flow rate was set as 0.3 mL/min, the column temperature was set at 40℃ and the injection volume was 1 μL. Methodological validation was performed according to General Chapter 9012 of the Chinese Pharmacopoeia, including specificity, linearity, precision, accuracy, matrix effect and stability. Results  All four drugs showed good linearity in their respective concentration ranges, with all the correlation coefficients (r2) of the calibration curves greater than 0.995. The intra-batch recoveries were in the range of 94.4% to 108.2% with the relative standard deviations (RSD) less than 6.34%, and the inter-batch recoveries were 92.4% to 104.8% with the RSD less than 4.44%. All the validation parameters met the requirements of methodological verification. Conclusion  The established UPLC-MS/MS method for the determination of four first-line anti-tuberculosis drugs in human plasma is accurate, rapid, simple, and highly sensitive, with a wide linear range. It provides a reliable technical basis for therapeutic drug monitoring (TDM) and individualized dosing regimens for anti-tuberculosis treatment.

Mechanism of Yangxue Antai granules in treating recurrent spontaneous abortion through ferroptosis regulation: a study integrating multi-omics and experimental

Zhao Wen, Yao Weijie, Gong Leilei, Gai Di, Feng Xin

2026, 47(3):  470-481.  doi:10.3969/j.issn.1006-7795.2026.03.008

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Objective  To investigate the molecular mechanism by which Yangxue Antai granules (YXATG) treat recurrent spontaneous abortion (RSA) through the regulation of ferroptosis. Methods  Network pharmacology was employed to screen the active ingredients and potential targets of YXATG by using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and other databases. The obtained targets were intersected with RSA-related and ferroptosis-related targets retrieved from databases such as GeneCards and FerrDb to identify core targets, followed by enrichment analysis. Molecular docking was performed to validate the binding affinity between core active ingredients and the targets. In vitro cell experiments were conducted for verification: drug-containing serum of YXATG was prepared from SD rats; the human choriocarcinoma cell line JEG-3 was used as a model, in which oxidative stress was induced by H²O² and intervened with the drug-containing serum; finally, Western blotting was used to detect the protein expression levels of the core targets TP53, PTGS2, and ICAM1.Results  A total of 88 active ingredients and 258 drug targets were screened. Twenty-two common targets among YXATG, RSA, and ferroptosis were identified, among which ICAM1, TP53, and PTGS2 emerged as the central targets. Enrichment analysis revealed that the targets were significantly enriched in pathways related to oxidative stress, inflammatory response, and lipid metabolism. Molecular docking confirmed that components such as diosgenin, stigmasterol, and quercetin exhibited good binding affinity to the core targets. In vitro experimental results showed that, compared with the control group, the protein expression levels of TP53, PTGS2, and ICAM1 were significantly increased in the H²O² model group (all P < 0.01); whereas, compared with the model group, intervention with YXATG-containing serum significantly inhibited the expression of all three proteins (all P < 0.01).Conclusion  YXATG may exert its therapeutic effect on RSA through the synergistic action of multiple components such as diosgenin and quercetin, targeting key molecules including TP53, PTGS2, and ICAM1, regulating their expression, thereby alleviating oxidative stress and inflammatory responses, inhibiting ferroptosis, and ultimately treating RSA.

Analysis of clinical and histopathological features of brucella spondylitis and diagnostic value of novel molecular pathological techniques

Du Juan, Che Jialu, Yan Guangxuan, Su Dan, Che Nanying

2026, 47(3):  482-489.  doi:10.3969/j.issn.1006-7795.2026.03.009

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Objective  To analyze the clinicopathological characteristics of Brucella spondylitis (BS) and compare the pathogen detection capabilities of special staining and molecular pathology techniques, thereby providing a novel technical approach for the pathological diagnosis of BS.Methods  A retrospective analysis was conducted on the clinical data, imaging findings and histopathological features of 86 BS patients were confirmed by etiological or serological tests, who were admitted to Beijing Chest Hospital Affiliated to Capital Medical University from October 2016 to October 2025. Paraffin-embedded pathological tissue samples of these patients were subjected to Giemsa staining, weak acid-fast staining and Brucella-specific quantitative real-time polymerase chain reaction (qRT-PCR) detection.Results  Histopathological examination revealed lymphocyte and plasma cell infiltration (54.7%), eosinophil infiltration (37.2%), neutrophil infiltration (44.2%), and inflammatory granulation tissue formation (22.1%), accompanied by varying degrees of bone destruction (41.9%). In some cases, focal necrosis (12.3%), fibrous connective tissue proliferative lesions (19.8%) and sheets of histiocytes and foam cells (11.6%) were also observed, while a minority of cases showed multinucleated giant cell infiltration with granulomatous lesion formation (8.1%). The positive rate of Giemsa staining was 33.7%, and that of weak acid-fast staining was 23.3%. The results of qRT-PCR showed that 54 out of 86 cases (62.79%) were positive for Brucella-specific targets. Notably, the positive rate of IS711 (62.79%) was significantly higher than that of bcsp31 (46.51%) (P < 0.01). The combined positive detection rate of IS711 qRT-PCR and Giemsa staining was 67.44%, which was slightly higher than that of IS711 qRT-PCR alone (62.79%), without statistically significant difference (P > 0.05).Conclusion  BS presents is characterized by clinical-imaging-pathological triad. Histopathological evaluation, supplemented by special staining and molecular pathological techniques, can effectively improve the accuracy of pathological diagnosis of BS.

Research on establishing an artificial intelligence model to assist in the counting of eosinophils in nasal polyps

Lou Xiaoting, Rong Lulu, Wang Yuanhang, Wang Qing, Xu Mengke, Zhang Liang, Zhang Yungang

2026, 47(3):  490-496.  doi:10.3969/j.issn.1006-7795.2026.03.010

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Objective  To establish and validate an artificial intelligence (AI) model based on deep learning to automatically identify and quantitatively count eosinophils in nasal polyp tissue sections, thereby assisting in the pathological diagnosis of nasal polyps. Methods  A total of 220 surgical specimens from patients with chronic rhinosinusitis with nasal polyps in Beijing Chaoyang Hospital, Capital Medical University were retrospectively included to construct a comparative framework between manual  and AI  counting. Manual counting were performed by two senior pathologists and two beginners, who selected four hotspots under high magnification of a traditional microscope for counting. To achieve as much field-of-view matching as possible, the AI counting automatically identified the four hotspots with the highest eosinophil density on digital full-field images and calculated their average. The consistency between methods and among observers was systematically evaluated by using Pearson's correlation coefficient and intraclass correlation coefficient.  Results  The AI model demonstrated excellent recognition performance, with its counting results highly positively correlated with manual counting (r=0.925,P<0.001), and excellent consistency (ICC = 0.892, 95% CI: 0.859-0.917). In contrast, the consistency between the four counters was only moderate (ICC = 0.750).  Conclusion  The AI model developed in this study can achieve high-precision and high-consistency quantitative analysis of eosinophils in nasal polyps, significantly reducing the inter-observer variation inherent in traditional manual methods. This model provides objective and efficient technical support for the standardized pathological diagnosis of eosinophilic nasal polyps, and it is of great value in promoting the precise classification of this disease.

A study on the clinicopathological characteristics of gastrointestinal sexually transmitted diseases

Zhu Meiling, Qiu Mingxin, Hong Shan, Liu Feifei, Yue Wenhui, Chen Jiamin, Cheng Jun, Sun Lei

2026, 47(3):  497-506.  doi:10.3969/j.issn.1006-7795.2026.03.011

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Objective  To investigate the clinicopathological features of common sexually transmitted diseases (STD) in the gastrointestinal tract. Methods  We retrospectively collected patients with a clinical diagnosis of the common STD, presented with gastrointestinal symptoms, and had undergone a pathological biopsy, from Beijing Ditan Hospital, Capital Medical University, from December 2022 to December 2025. Clinical data and tissue specimens were collected from enrolled patients. To analyze the histopathological characteristics, gastrointestinal biopsy specimens were examined with a series of techniques, including HE staining, special staining, immunohistochemistry (IHC), in situ hybridization (ISH) and probe capture-based pathogen metagenomic testing of pathological specimens (MetaPath). Results  A total of 19 patients were enrolled in this study, including 18 male, with an age range of 23 to 56 years, predominantly young and middle-aged adults. Co-infection human immunodeficiency virus (HIV) was 14 cases (74%). Biopsy sites included rectum, 10 cases (53%); anal fistula, 8 cases (42%); gastric antrum, 1 case (5%). MetaPath testing revealed infections with Treponema pallidum (TP) in 6 cases (32%), Chlamydia trachomatis (CT) in 8 cases (42%), and other pathogens in 4 cases (21%). One case (5%) tested negative. Histopathologically, gastrointestinal TP infection showed active chronic inflammation with ulceration. The inflammatory infiltrate in the stroma was mixed, predominantly composed of lymphocytes, plasma cells, and neutrophils, accompanied by neutrophilic vasculitis. In anal fistula specimens, TP infection showed elongation of the rete ridges with neutrophilic infiltration. The dermis showed a dense infiltrate of plasma cells and lymphocytes. TP was predominantly located within the intercellular spaces of the epidermal basal layer. Gastrointestinal CT infection showed mucosal ulceration and necrosis. The area around the ulcer showed a prominent mixed inflammatory infiltrate, dominated by lymphocytes, plasma cells, and neutrophils. Conclusion  This study describes the histopathological features of gastrointestinal sexually transmitted diseases.  This differential diagnosis should be considered in patients with pathologically diagnosed inflammatory bowel disease who show a suboptimal response to treatment.

Autopsy and genetic analysis of fetal aberrant right subclavian artery with complex cardiovascular malformations

Yu Wei, Shang Jianfeng, Fang Wei, He Yihua, Teng Fei, Cui Yayan , Fu Wen , Chen Dong

2026, 47(3):  507-513.  doi:10.3969/j.issn.1006-7795.2026.03.012

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Objective  To investigate the clinicopathological features and associated genetic as well as chromosomal abnormalities in fetuses with aberrant right subclavian artery (ARSA) complicated by complex cardiovascular malformations. Methods  The retrospective analysis was conducted on 18 fetuses diagnosed with ARSA combined with complex cardiovascular malformations by fetal autopsy at Beijing Anzhen Hospital, Capital Medical University from 2011 to 2020. General data and autopsyproven malformations were collected and analyzed. Ten of these cases underwent copy number variation sequencing (CNVseq), and those with negative results were further examined by whole-exome sequencing (WES). Statistical analysis was performed on fetal gender, maternal age, autopsy malformations, and molecular testing results.  Results  Among the 18 fetuses, there were 4 male and 14 female fetuses. The proportion of female fetuses was higher than that of male fetuses (P< 0.05). The mean maternal age was (32.1±5.4) years, with 14 cases in the nonadvanced maternal age group (<35 years) and 4 cases in the advanced maternal age group (≥35 years). All cases were anatomically classified as the retroesophageal type of aberrant right subclavian artery. No Kommerell diverticulum (KD) was found in any cases at autopsy. Associated cardiovascular malformations included atrial/ventricular septal defects (10 cases), valvular malformations (10 cases), aortic dysplasia (8 cases), pulmonary atresia/stenosis (7 cases), and persistent left superior vena cava (6 cases), etc. Among them, 11 cases (61.1%) were classified as conotruncal anomalies. Seven fetuses had extracardiac malformations, mainly pulmonary dysplasia (4 cases), limb malformations (3 cases), and hepatic abnormalities (3 cases). Of the 10 fetuses with molecular testing, abnormalities were identified in 7 cases: CNVseq detected trisomy 18 in 2 cases, trisomy 21 in 1 case, and 22q11.2 microdeletion in 1 case; WES identified KMT2D gene mutations in 2 cases and ZIC3 gene mutation in 1 case. The proportion of conotruncal anomalies in cases with abnormal molecular testing results was higher than that in cases with normal results (P< 0.05).  Conclusion  Non-isolated ARSA may be more prevalent in female fetuses and it is frequently associated with intracardiac malformations, especially conotruncal anomalies. Extracardiac malformations may include pulmonary hypoplasia, hand and foot deformities, and other anomalies. Chromosomal and genetic abnormalities such as trisomy 18, trisomy 21, 22q11.2 microdeletion, as well as KMT2D and ZIC3 gene mutations may be present. When fetal ARSA is detected on prenatal ultrasound, further evaluation for associated intracardiac and extracardiac malformations as well as genetic abnormalities is warranted. In addition to routine genetic testing, whole-exome sequencing can be performed as a supplementary examination.

Distribution characteristics of germinal centers in thymoma and their correlation with myasthenia gravis

Li Zhong, Wang Conghui, Wang Shengnan, Fu Yongjuan, Zhao Lihong, Wang Yaye, Teng Lianghong

2026, 47(3):  514-519.  doi:10.3969/j.issn.1006-7795.2026.03.013

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Objective  To investigate the correlation between the number and distribution of germinal centers (GCs) in thymoma and clinicopathological parameters, and to explore its potential as a novel reference indicator for evaluating the clinical course and prognosis of patients with myasthenia gravis (MG). Methods  A retrospective analysis was conducted on thymoma cases diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University, between January 2019 and June 2025. The GCs were analyzed in relation to patients' clinical and pathological characteristic. Results  The number of GCs was significantly higher in thymoma cases complicated with MG compared to those without MG (P＜0.001). Among MG-complicated thymoma cases, a significant difference was observed in the gradient of GCs numbers between type Ⅰ (ocular) and type Ⅱ (generalized) MG (P=0.039). Additionally, the number of peritumoral GCs was significantly greater than that of intratumoral GCs (P=0.004). Conclusion  GCs show certain correlations with clinicopathological parameters in thymoma patients and are closely related to the pathogenesis and progression of MG. A higher number of GCs is associated with a increased risk of MG symptoms, These findings suggest that GCs may serve as a potential monitoring indicator for the occurrence and progression of MG.

Sinonasal spindle cell neoplasms easily misdiagnosed as inflammatory myofibroblastic tumor: a clinicopathological and molecular study of rare cases

Zhao Yihua, Gao Yige, Ma Donglin, Wan Hongfei, Piao Yingshi

2026, 47(3):  520-526.  doi:10.3969/j.issn.1006-7795.2026.03.014

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Objective  To investigate the clinicopathological and molecular characteristics of a group of rare sinonasal spindle cell neoplasms that are morphologically prone to be misdiagnosed as inflammatory myofibroblastic tumor (IMT), and to analyze the diagnostic pitfalls and the clinical application of molecular testing in such challenging cases. Methods  A retrospective analysis was conducted on all cases initially diagnosed as sinonasal IMT in the Department of Pathology, Beijing Tongren Hospital, from January 2007 to December 2021 (21 cases). From this cohort, three rare and challenging cases were selected. These cases were initially diagnosed as IMT with malignant transformation but were characterized as an aggressive clinical course leading to death within a short period. Next-generation sequencing (NGS) was performed on archived formalin-fixed, paraffin-embedded tissue from these three cases to analyze their genomic profiles. Pathological diagnoses were re-evaluated in conjunction with clinical data. Results  Morphologically, all three tumors overlapped with IMT, showing spindle cell proliferation with inflammatory infiltration. However, all lacked IMT-characteristic ALK expression and gene rearrangements. NGS precisely identified distinct molecular drivers in every case: Case 1 harbored a novel SLC9A3::TERT fusion, leading to a revised diagnosis of undifferentiated sarcoma; Case 2 showed homozygous deletion of CDKN2A/B and loss of H3K27me3 expression, supporting a diagnosis of malignant peripheral nerve sheath tumor (MPNST); Case 3 was positive for the NAB2::STAT6 fusion, resulting in a revised diagnosis of malignant solitary fibrous tumor (SFT). All three patients died of progressive disease (median survival: 21 months), confirming the highly aggressive biological behavior consistent with the revised diagnoses. Conclusion  There exits a rare subset of sinonasal spindle cell neoplasms that morphologically mimic IMT but harbor distinct molecular drivers, representing a significant diagnostic pitfall. This pitfall should be suspected in cases with IMT-like morphology that are ALK-negative or exhibit an aggressive clinical course (rapid progression, recurrence, or metastasis). In such clinicopathologically discordant and challenging cases, molecular testing plays an indispensable role: it not only enables a precise diagnosis by rectifying misdiagnosis but also provides direct evidence for prognostic assessment and therapeutic decision-making.

Research progress of HOX genes in spinal ependymal tumors

Wang Wanting, Wang Leiming, Teng Lianghong

2026, 47(3):  527-531.  doi:10.3969/j.issn.1006-7795.2026.03.015

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HOX genes constitute a highly conserved family of homeobox genes, which play a crucial role in embryonic development, cell differentiation, and tissue homeostasis. Abnormal expression of these genes is closely related to the occurrence, development, and prognosis of various tumors. Increasing evidence suggests that the dysregulation of HOX genes may play an important role in the occurrence, development, and invasiveness of spinal meningeal tumors. This article reviews the regulatory mechanisms of HOX genes, their expression patterns in spinal meningeal tumors, and their potential clinical value. Finally, this review outlines directions for future research.

Facial features and personality traits in traditional Chinese medicine five-element typology based on 3D point-cloud data

Lin Jin, Jia Hongxiao, Lü Hongpeng, Dai Zhiqing, Jiang Xinyue, Duan Yuhang, Xu Huanshu, Zhao Ziyi, Zhang Yunhe

2026, 47(3):  532-540.  doi:10.3969/j.issn.1006-7795.2026.03.016

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Objective  To objectively quantify facial features using 3D point-cloud facial data under the traditional Chinese medicine (TCM) framework of “unity of form and spirit” (xing-shen unity), and to evaluate the predictability of personality traits from facial features in TCM five-element typology. Methods  Typical healthy participants of TCM five elements type were recruited. The 3D point-cloud facial data and the Sixteen Personality Factor Questionnaire (16PF)  were collected. A deep-learning algorithm was used to automatically localize 3D facial landmarks and extract 39 facial features. Ridge regression models were contructed for each 16PF factor as the dependent variable with facial features as predictors, adjusting for age and sex, and evaluated using 10-fold cross-validation. Factors with at least moderate predictive performance (R²≥ 0.15) were identified. Key facial features were identified based on permutation importance, and the moderating effect of sex on the associations between key facial features and personality traits was further assessed. Results  A total of 804 participants were included. Facial features showed at least moderate predictive performance for five 16PF factors: Abstractedness (M), Tension (Q4), Openness to change (Q1), Rule consciousness (G), and Perfectionism (Q3). Key predictors mainly involved indices of facial surface undulation and curvature statistics, soft-tissue morphology, and craniofacial structure as well as facial component geometry. Following the inclusion of interaction terms between key facial features and sex, the model exhibited no substantial improvement in predictive performance. Conclusion  The 3D facial features can predict several 16PF factors to a certain extent, suggesting a quantifiable correspondence between facial morphology and personality traits in TCM five-element typology, and providing modern empirical support for the TCM theory of xing-shen unity.

A study on the differences in excitation-inhibition balance between Wood Element and Metal Element individuals among the Traditional Chinese Medicine Five Element people

Lin Jin, Jia Hongxiao, Lü Hongpeng, Dai Zhiqing, Jiang Xinyue, Xu Huanshu, Zhao Ziyi, Zhang Yunhe

2026, 47(3):  541-548.  doi:10.3969/j.issn.1006-7795.2026.03.017

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Objective  To compare excitation-inhibition (E/I) balance between Wood Element and Metal Element individuals by using the electroencephalography (EEG) derived functional excitation-inhibition ratio (fEI), and to investigate their functional regulatory characteristics from a neuroelectrophysiological perspective within the Traditional Chinese Medicine (TCM) Five Element typology. Methods  Typical Wood Element and Metal Element participants were recruited according to the previously established Quantitative Specification for Facial Phenotype Classification of TCM Five Element (Morphological) Types. Resting-state, eyes-closed EEG was recorded. Electrodes were grouped into six regions of interest: prefrontal, frontal, central, parietal, temporal, and occipital. Frequency bands were defined as theta (4-8 Hz), alpha (8-13 Hz), lower beta (13-19 Hz), high beta (19-30 Hz), and gamma (30-45 Hz). Power spectral density (PSD) and fEI were calculated for each band. Group comparisons were conducted at both whole-brain and regional levels, with Bonferroni correction applied for multiple comparisons. Results  Thirty participants were included in each group. At the whole-brain level, no significant differences in PSD were observed across frequency bands. Whole-brain fEI values in the theta, alpha, and lower beta bands were significantly higher in the Wood Element group than in the Metal Element group, whereas no significant differences were found in the high beta or gamma bands. At the regional level, occipital fEI in the theta band was higher in the Wood Element group than in the Metal Element group; in the alpha band, fEI values in the prefrontal, frontal, central, parietal, and occipital regions were also higher in the Wood Element group than in the Metal Element group. Conclusion  Wood Element and Metal Element individuals exhibit frequency-specific differences in E/I regulation at the neural activity level, indicating distinct patterns of brain functional regulation across TCM Five Element types.

Efficacy of Wenyang jieyu recipe on residual fatigue in major depressive disorder: a randomized double-blind controlled trial

Xu Huanshu, Yin Dongqing, Jia Hongxiao

2026, 47(3):  549-557.  doi:10.3969/j.issn.1006-7795.2026.03.018

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Objective  To investigate the clinical efficacy and safety of Wenyang Jieyu recipe in treating residual fatigue symptoms in patients with depressive disorder. Methods  A randomized, double-blind, placebo-controlled trial was conducted. Patients with unipolar depressive episodes and residual fatigue symptoms (kidney deficiency and liver depression syndrome) who met the inclusion criteria were enrolled, with 111 patients completing the study. They were randomly assigned in a 1∶1 ratio to the experimental group (Wenyang Jieyu formula granules + maintenance dose of escitalopram oxalate, n=55) and the control group (Chinese herbal placebo + maintenance dose of escitalopram oxalate, n=56). Assessments were performed at baseline and at weeks 2, 4 and 8, including the Fatigue Scale-14 (FS-14), traditional Chinese medicine (TCM) symptom score, Hamilton Depression Scale-17 Item (HAMD-17) , Hamilton Anxiety Scale (HAMA), Clinical Global Impression (CGI) , Young Mania Rating Scale (YMRS) , Personal and Social Performance Scale-Chinese Version (PSP-CHN) , and Treatment Emergent Symptom Scale (TESS) . Inflammatory markers and brain-derived neurotrophic factor (BDNF) levels were measured at week 8. The primary outcome was the change in FS-14 score from baseline to week 8. Results  Compared with the control group, the experimental group showed more obvious improvement in fatigue symptoms. Repeated-measures ANOVA revealed significant time (P<0.01) and group effects (P<0.01) for FS-14 scores. At weeks 4 and 8, the experimental group had lower FS-14 score than the control group (P<0.01 for both time points). For secondary outcomes, the experimental group also showed greater reductions in HAMD-17, HAMA, and TCM symptom scores (all P<0.01). There was no significant difference between the two groups in baseline YMRS score (P>0.05). At week 8, the experiment group had significantly lower YMRS score than the control group (P0.01), with no significant difference between the two groups at weeks 2 and 4.  PSP scores also showed no statistical difference between groups. Patients tolerated the treatment well, and no increased risk of adverse events was observed. Conclusion  Wenyang Jieyu recipe can improve residual fatigue symptoms in patients with depression, and it also provides additional benefits for depressive and anxiety symptoms as well as TCM patterned kidney deficiency and liver depression syndrome. This therapy does not increase the risk of mania with a favorable safety profile, and show potential for clinical application.

A network analysis of the Traditional Chinese Medicine psychic and somatic symptoms in panic disorder

Zhao Shuang, Xu Tianchao, Song Mingkang, Jia Hongxiao, Li Dongdong, Yin Dongqing, Li Xue

2026, 47(3):  558-568.  doi:10.3969/j.issn.1006-7795.2026.03.019

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Objective  To explore the associations between Traditional Chinese Medicine  (TCM) symptoms in patients diagnosed with panic disorder (PD) and identify the core TCM psychic and somatic symptoms. Methods  A TCM psychic symptom network, a somatic symptom network, a somatic symptom and core psychic symptom network, a core psychic and core somatic symptom network were constructed by using network analysis based on the TCM psychic and somatic symptoms in 183 PD patients. Centralization indices were calculated. Results  In the TCM psychic symptom network, the betweenness was higher for difficulty initiating sleep; the closeness was higher for difficulty initiating sleep, being easily to be frightened and alarmed; the expected influence was higher for nervous and restless, excessive worry inclued. In the TCM somatic symptom network, the betweenness centrality was higher for palpitations, chest tightness; and the closeness  centrality  was higher for palpitations, chest tightness, yellow tongue coating; expected influence was higher for palpitations, and gastric distension. For the network of somatic symptoms and core psychic symptoms,  nervousness and restlessness exhibited high expected influence among  psychic symptoms. Palpitations emerged as the most central symptom in the core psychic and core somatic symptom network. Conclusion  The core TCM psychic symptoms of PD difficulty initiating sleep, nervous ness and restless ness, excessive worry , and being easily to be frightened and alarmed, while the core TCM somatic symptoms are palpitation, chest tightness, abdominal distension and  stomach is swollen, yellow tongue coating. The network structure and core symptoms mainly reflect the pathological connections of the kidney, heart and spleen. The study emphasizes the necessity of syndrome differentiation and treatment for PD based on psychic symptoms and provides feasible strategies for the clinical diagnosis and  therapeutic interventions of PD in TCM.

An analysis of the neural mechanisms underlying cognitive impairment in depersonalization-derealization disorder based on low-frequency fluctuation

Song Nan, Zheng Sisi, Jia Hongxiao

2026, 47(3):  569-578.  doi:10.3969/j.issn.1006-7795.2026.03.020

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Objective  To investigate the characteristics of spontaneous brain activity in patients with depersonalization-derealization disorder (DPRD) and explore their correlation with cognitive impairment.Methods  Forty-eight patients from Beijing Anding Hospital, Capital Medical University, with DPRD and thirty-two healthy controls were included in the study. Clinical symptoms were assessed, and cognitive functions were evaluated by using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) and the Stroop Color-Word Test. Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired. Amplitude of low-frequency fluctuation (ALFF) analysis was performed, followed by correlation analyses between ALFF values and clinical characteristics.Results  Compared to healthy controls, DPRD patients exhibited significantly reduced ALFF values in the bilateral thalamus, left insula, left lingual gyrus, left cerebellum, bilateral fusiform gyrus, left superior temporal gyrus, and right medial and paracingulate gyri. Conversely, ALFF values were increased in the right insula and the right inferior frontal gyrus (pars triangularis). Correlation analyses revealed that ALFF values in the right insula were negatively correlated with scores on verbal learning and visual memory tests. ALFF values in the left cerebellum and the right medial and paracingulate gyri were negatively correlated with self-unreality scores. ALFF values in the right inferior frontal gyrus (pars triangularis) and the right insula were positively correlated with temporal disintegration scores.Conclusion  Brain functional abnormalities in DPRD primarily involve regions associated with self-processing, emotion regulation, sensory integration, and cognitive control. It may collectively underlies the cognitive impairment and core clinical symptoms observed in these patients.

The role of SETX deficiency in driving cellular senescence and premature ovarian insufficiency

Zheng Zhi , Sun Yujun , Li Yuxiao , He Lin , Hou Lisha , Li Lin#, Chu Chunfang

2026, 47(3):  579-587.  doi:10.3969/j.issn.1006-7795.2026.03.021

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Objective  To investigate the molecular mechanisms by which siRNA-mediated knockdown of Senataxin (SETX) contributes to premature ovarian insufficiency (POI). Methods  Whole-exome sequencing was conducted in patients with premature ovarian insufficiency to screen for candidate pathogenic variants, followed by validation using Sanger sequencing. SETX expression was knocked down in 293FT cells using small interfering RNA (siRNA). Transcriptome sequencing (RNA-seq) was performed to analyze the global transcriptional changes induced by SETX knockdown. Functional enrichment analysis was conducted to interpret the biological implications. The expression of genes related to cellular senescence and the cell cycle was validated by real-time reverse transcription polymerase chain reaction (RT-qPCR). Results  Whole-exome sequencing identified a heterozygous truncating variant in SETX (c.4005_4008del, p.Val1336Glufs*7) in a patient with premature ovarian insufficiency, which was predicted to result in a truncated protein; therefore, SETX knockdown was performed in cells to investigate the pathogenic mechanism of this variant. SETX knockdown induced significant global transcriptional alterations. Differentially expressed genes were implicated in stress response, signal transduction, and cellular structure. Enrichment analysis showed significant involvement of the MAPK signaling pathway, AGE-RAGE signaling pathway, and cytokine-cytokine receptor interaction. qPCR validation confirmed that SETX knockdown downregulated CCND1, SIRT1 and RDX, while upregulating GADD45A, GADD45B, and KLF2.Conclusion  SETX knockdown reshapes the cellular transcriptional program and activates stress-response and senescence-related pathways. This suggests that SETX plays a crucial role in maintaining cellular homeostasis, providing new insights into its potential mechanisms in cellular senescence and premature ovarian insufficiency (POI). 

Skeletal muscle-derived exosomes mediate osteogenesis by activating anaerobic glycolysis in bone marrow mesenchymal stem cells

Li Yuan, Li Jianying, Li Xiaoyu, Sai Yida, Yang Xin, Yang Xi

2026, 47(3):  588-596.  doi:10.3969/j.issn.1006-7795.2026.03.022

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Objective  To investigate the effect of skeletal muscle-derived exosomes (SKM-Exos) on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) by inducing the anaerobic glycolysis pathway. Methods  ①BMSCs were isolated, cultured, and purified from 6-8 week-old male C57BL/6 mice by using the whole bone marrow adherence method. SKM-Exos were isolated by using a commercial kit. ② BMSCs were incubated with SKM-Exos and then subjected to osteogenic differentiation induction. On days 7 and 21, alkaline phosphatase (ALP) staining and calcium nodule detection were performed.③After 6 days of incubation with SKM-Exos, the mRNA expression levels of osteogenic differentiation-related genes ［Runx2, Osterix, osteocalcin (Ocn), and collagen-1］ in BMSCs were detected via real-time quantitative reverse transcription polymerase  chain reaction (RT-qPCR). ④BMSCs were treated with drugs that inhibit or activate the anaerobic glycolysis pathway ［rotenone, sodium dichloroacetate (DCA), and oxamate］ for 24 h, followed by osteogenic induction. Through qualitative and quantitative analysis of calcium nodules, as well as comparative measurements of glucose consumption and lactate production in BMSCs, it was preliminarily verified that SKM-Exos may promote the osteogenic differentiation capacity of BMSCs by inducing anaerobic glycolysis and increasing lactate production. Results  ①Skeletal muscle tissue secreted abundant exosomes. SKM-Exos significantly upregulated the expression of osteogenesis-related genes and markedly enhanced the osteogenic differentiation capacity of BMSCs. ②The enhancement of osteogenic differentiation capacity of BMSCs by SKM-Exos was closely associated with increased lactate production induced by the anaerobic glycolysis pathway. Conclusion  Skeletal muscle-derived exosomes can regulate bone formation by inducing the anaerobic glycolysis pathway in BMSCs.

Clinical characteristics and influencing factors of refractory secretory otitis media

Li Jin, Gu Qin, Sun Xuan, Zhao Yahan, Wang Dian, Li Yi

2026, 47(3):  597-602.  doi:10.3969/j.issn.1006-7795.2026.03.023

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Objective  To analyze the clinical characteristics and risk factors of refractory secretory otitis media (rSOM) by comparing it with non-refractory secretory otitis media (nrSOM), providing a basis for early identification and intervention of rSOM. Methods  A case-control study design was used, including 102 patients with chronic secretory otitis media diagnosed and followed up regularly in the Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, between January 2020 and June 2023. Patients were divided into a refractory group (49 cases) and a non-refractory group (53 cases) based on predefined refractory criteria. Demographic data, disease course, comorbidities, lifestyle, and audiological data were systematically collected. Univariate analysis and multivariate Logistic regression were used to analyze the clinical characteristics of rSOM and identify its associated risk factors.Results  The follow-up time was consistent between the two groups, and there was no statistically significant difference in age (P > 0.05). The proportion of patients with a history of snoring and smoking was significantly higher in the rSOM group than that in the nrSOM group (P < 0.05). Among patients with a history of snoring, the duration of snoring history was significantly longer in the rSOM group than that in the nrSOM group (P < 0.05). Multivariate Logistic regression analysis showed that a history of snoring (OR=3.285, 95% CI: 1.109-9.731) and a history of smoking (OR=3.771, 95% CI: 1.129-12.597) were significantly associated with rSOM (both P < 0.05) and were identified as risk factors for refractory secretory otitis media.Conclusion  A history of snoring and smoking may be important risk factors for the progression of adult chronic secretory otitis media to refractory disease. Clinical practice should strengthen the assessment of snoring-related symptoms and lifestyle factors in patients with chronic secretory otitis media in order to improve disease outcomes.

Clinical analysis of refractory epilepsy caused by temporal encephalocele

Gao Wulin, Fan Hongfei, Chen Weida, Cui Tao, Wang Hua

2026, 47(3):  603-611.  doi:10.3969/j.issn.1006-7795.2026.03.024

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Objective This study aims to clarify the diagnostic clues and treatment strategies for temporal lobe encephalocele by analyzing the clinical data of patients with temporal lobe encephalocele.Methods  We retrospectively analyzed patients with temporal lobe epilepsy treated at Beijing Tiantan Hospital, Capital Medical University between January 2020 and August 2025. Among 158 patients who underwent temporal lobe epilepsy surgery, 7 patients with temporal encephalocele were enrolled as the study cohort. Their clinical characteristics, electroencephalography (EEG), neuroimaging, neuropsychological assessments, and longterm prognosis were analyzed. Results  The 7 patients included 4 males and 3 females, with a mean age of 42.4 years (range 28-72 years). All 7 patients presented with focal impaired awareness seizures, and 5 had focal to bilateral tonicclonic seizures. Initial magnetic resonance imaging (MRI) detected temporal encephalocele in only 2 patients; the other 5 were missed. Of the 7 patients, 6 underwent standard anterior temporal lobectomy with meningeal repair, and 1 received medical treatment only. After a mean followup of 28 months (range 14-55 months), 5 patients achieved Engel class I, 1 achieved Engel class Ⅱa, and 1 had Engel class Ⅳ. Pathological findings showed gliosis in 5 patients and gangliocytoma in 1 patient. Cognitive evaluation revealed that memory impairment was more common in patients with leftsided lesions. Conclusion  In patients with drugresistant temporal lobe epilepsy, MRI and other neuroimages should be carefully reviewed to rule out temporal encephalocele. Surgical intervention in patients with temporal lobe epilepsy related to encephalocele can improve longterm clinical prognosis.

Risk factors and prediction model for contralateral hip fracture in elderly patients after hip fracture surgery

Xu Hanchi, Long Anhua, Wang Xuefei , Liu Liang

2026, 47(3):  612-620.  doi:10.3969/j.issn.1006-7795.2026.03.025

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Objective  To identify the risk factors associated with contralateral hip fracture and to develop a nomogram-based clinical prediction model. Methods  A retrospective study was conducted including 1 871 elderly patients hospitalized for hip fracture at the bone center of a tertiary hospital in Beijing, China, between January 2016 and December 2022. Patients who developed a contralateral hip fracture within 3 years after surgery (n=76) were assigned to the case group, while those without contralateral hip fracture (n=1 695) as the control group. Demographic characteristics, comorbidities, and laboratory findings were collected. Least absolute shrinkage and selection operator (LASSO) regression followed by multivariate Logistic regression analyses were used to identify the risk factors for contralateral hip fracture, and a nomogram-based prediction model was developed by using R software. The model was evaluated with the receiver operating characteristic (ROC) curve, the Hosmer-Lemeshow goodness-of-fit test, and decision curve analysis (DCA). Results  Overall, 9.4% (176/1 871) of patients experienced a contralateral hip fracture within 3 years after surgery. Multivariate Logistic regression analysis identified age, history of diabetes mellitus, history of osteoporotic fractures at other sites, peripheral vascular disease, visual impairment, and platelet count as independent risk factors for contralateral hip fracture in older patients (P < 0.05). The ROC analysis indicated that the nomogram yield an area under the curve (AUC) of 0.729 (95% CI: 0.685-0.773). The Hosmer-Lemeshow test indicated good agreement between predicted and observed risks, and DCA confirmed that the model provided a net clinical benefit. Conclusion  Age, history of diabetes mellitus, history of osteoporotic fractures at other sites, peripheral vascular disease, visual impairment, and platelet count are independent risk factors for contralateral hip fracture in older patients. The nomogram incorporating these variables exhibits moderate predictive performance and may serve as a useful tool to assist clinicians in perioperative management and treatment decision-making following initial hip fracture surgery.


Establishment and validation of a predictive model for vascular Parkinsonism after multiple lacunar infarcts

Gao Yan, Yang Xue, Wang Hua, Ning Yu, Wang Lingling

2026, 47(3):  621-629.  doi:10.3969/j.issn.1006-7795.2026.03.026

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Objective  To explore the related risk factors of vascular Parkinsonism (VP) in patients with multiple lacunar infarction (MLI), and to evaluate the application value of hematological indicators and neuroimaging features in predicting the risk of VP. Methods  A total of 169 patients with MLI admitted to Dunhua Hospital, Jilin Province from May 2021 to December 2024 were included. They were divided into the MLI group and the vascular Parkinsonism after multiple lacunar infarction (MLI-VP) group based on whether they developed VP. By using a random allocation method, the patients were divided into a model construction set (n=84) and an internal evaluation set (n=85). The clinical data and imaging features of the two groups were compared, and the risk factors for the occurrence of VP in MLI patients were screened. Then, a risk prediction model was constructed, and its performance and clinical application value were evaluated. Results  The results showed that neutrophil count, high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), and basal ganglia involvement were significantly associated with the occurrence of MLI-VP (P<0.05). Neutrophil count (OR=1.730, 95%CI:1.046-3.105, P=0.047), decreased HDL-C (OR=0.166, 95%CI:0.034-0.581, P=0.011), elevated LDL-C (OR=5.884, 95%CI:1.520-31.075, P=0.019), and basal ganglia involvement (OR=3.941, 95%CI:1.019-15.732, P=0.046) were all independent risk factors for MLI-VP. Based on these variables, a nomogram was constructed, and the area under the ROC curve was 0.892 (95%CI：0.806-0.892). The calibration curve showed good fit (Hosmer-Lemeshow P>0.05), and the decision curve analysis confirmed the model's clinical utility. Conclusion  Neutrophil count, HDL-C, LDL-C, and basal ganglia involvement are closely related to MLI-VP and are independent risk factors. Based on hematological indicators and imaging features, the prediction model shows good discriminative ability in this cohort, and it can be applied to early high-risk patients, providing a basis for implementing individualized precise intervention.