Background/Aims: Acetyl coenzyme A (acetyl-CoA) is one of the most essential metabolites in cell metabolism but its function and concentration in hepatocellular carcinoma (HCC) remain elusive and controversial. Methods: A comprehensive analysis of acetyl-CoA levels and acetyl-CoA synthetase 2 (ACSS2) expression across a range of samples, including patient specimens from both hepatitis B virus (HBV) positive and HBV negative HCC individuals, HBV-transgenic mouse HCC models, and multiple cell lines. Furthermore, to evaluate the functional significance of ACSS2 in HBV-related HCC, we implemented both genetic and pharmacological inhibition strategies targeting ACSS2. Molecular mechanism and mitophagy assessment were revealed by cleavage under target and tagmentation sequencing, RNA sequencing, bioinformatic analyses, transmission electron microscopy and JC-1 staining. Results: Our study revealed a distinct metabolic signature of HBV-related HCC, marked by elevated acetyl-CoA, which was driven by ACSS2. ACSS2 was upregulated by the carbohydrate response element-binding protein in HBV-related HCC. Furthermore, ACSS2 improved tumor cell proliferation, an effect that was dependent on its enzymatic activity. Mechanistically, ACSS2-induced acetyl-CoA accumulation activated voltage-dependent anion channels 1 transcription through increased H3K27ac occupancy, which subsequently promoted mitophagy and HBV-related HCC tumorigenesis. Notably, targeting ACSS2 by depletion or inhibition with a catalytic inhibitor significantly suppressed tumor growth. Conclusions These findings not only illustrate the interplay between metabolic reprogramming, epigenetic modification, and tumorigenesis in the context of HBV infection, but also highlight ACSS2 as a novel metabolic vulnerability in HBV-related HCC. Therefore, targeting ACSS2 could be a novel strategy against HBV-related HCC.

Objective To analyze the acupoint selection law in acupuncture treatment for sinusitis using data mining techniques.Methods Relevant literature on acupuncture treatment for sinusitis was retrieved from CNKI,Wanfang Data,VIP and CBM from January 1,2000 to December 20,2024.Descriptive statistics were performed on the frequency of acupoint usage,meridian tropism,and regional distribution.SPSS Modeler 18.0,Cytoscape 3.10.3 and Origin Pro were employed to conduct association rule mining,co-occurrence network analysis,and systematic cluster analysis on the acupoints.Results A total of 69 articles were included,yielding 114 acupoint prescriptions involving 65 distinct acupoints.The most frequently used acupoints were Yingxiang,Yintang and Hegu,etc.;the most commonly used meridians were large intestine meridian,Governor Vessel,gallbladder meridian and bladder meridian.Acupoint selection was predominantly concentrated in the head/neck region,lower limbs and upper limbs.Among the specific acupoint categories,Jiaohui acupoint,Wushu acupoint and Yuan acupoint were used most frequently.The acupoint combinations with the strongest associations were Hegu-Yingxiang,Hegu-Yintang-Yingxiang and Fengchi-Yingxiang.The top 22 high-frequency acupoints could be grouped into 5 clusters.Conclusion Acupuncture treatment for sinusitis can exert the functions to disperse wind and unblock the orifices,drain heat and resolve turbidity,expel pathogens and alleviate pain,tonify deficiency and dissipate cold,as well as harmonize qi and blood.The characteristics of acupoint combination include a primary focus on local points supplemented by distal points,pattern differentiation-based selection,and a propensity for unblocking yang qi.The core acupuncture formula is Yingxiang-Yintang-Hegu-Fengchi.

Objective To explore the diagnostic value of the radiomic model based on panoramic radiographs in differentiating single or multiple root canals in mandibular first premolars.Methods A retrospective analysis was conducted on 68 patients with CBCT and panoramic radiographs from the affiliated Stomatological Hospital of Nanjing Medical University between July 2022 and November 2023.One hundred and thirty one mandibular first premolars(105 single-root and 26 multiple-root canals)were included in this study.Using stratified random sampling,the mandibular first premolars were divided into a training cohort(104 teeth)and a test cohort(27 teeth)at a ratio of 8∶2.CBCT was used to confirm the root canal configuration,and radiomic features were extracted from panoramic radio-graphs.After feature screening,radiomic models were constructed using extratrees,LightGBM,logistic regression(LR),multi-layer perceptron(MLP),random forest,support vector machine(SVM),and XGBoost.The optimal radiomic model was selected based on receiver operating characteristic(ROC)curve,accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and decision curve analysis(DCA).Results A total of 107 radiomicfeatures were extracted from panoramic radiographs.After feature filtering,4 radiomic features were ultimately selected using the Lasso model.The XGBoost model showed higher predictive efficiency and stability,with an AUC of 0.962 in the training cohort and 0.770 in the test cohort.DCA curves also in-dicated that the XGBoost model was optimal.Conclusion The radiomic model based on panoramic radiographs demonstrates good per-formance in differentiating single or multiple root canals in mandibular first premolars.

Objective To analyze the acupoint selection law in acupuncture treatment for sinusitis using data mining techniques.Methods Relevant literature on acupuncture treatment for sinusitis was retrieved from CNKI,Wanfang Data,VIP and CBM from January 1,2000 to December 20,2024.Descriptive statistics were performed on the frequency of acupoint usage,meridian tropism,and regional distribution.SPSS Modeler 18.0,Cytoscape 3.10.3 and Origin Pro were employed to conduct association rule mining,co-occurrence network analysis,and systematic cluster analysis on the acupoints.Results A total of 69 articles were included,yielding 114 acupoint prescriptions involving 65 distinct acupoints.The most frequently used acupoints were Yingxiang,Yintang and Hegu,etc.;the most commonly used meridians were large intestine meridian,Governor Vessel,gallbladder meridian and bladder meridian.Acupoint selection was predominantly concentrated in the head/neck region,lower limbs and upper limbs.Among the specific acupoint categories,Jiaohui acupoint,Wushu acupoint and Yuan acupoint were used most frequently.The acupoint combinations with the strongest associations were Hegu-Yingxiang,Hegu-Yintang-Yingxiang and Fengchi-Yingxiang.The top 22 high-frequency acupoints could be grouped into 5 clusters.Conclusion Acupuncture treatment for sinusitis can exert the functions to disperse wind and unblock the orifices,drain heat and resolve turbidity,expel pathogens and alleviate pain,tonify deficiency and dissipate cold,as well as harmonize qi and blood.The characteristics of acupoint combination include a primary focus on local points supplemented by distal points,pattern differentiation-based selection,and a propensity for unblocking yang qi.The core acupuncture formula is Yingxiang-Yintang-Hegu-Fengchi.

Objective:Papillary thyroid carcinoma with a maximum tumor diameter of ≤1 cm was defined as papillary thyroid carcinoma (PTC). To explore the clinical risk factors of central lymph node metastasis (CLNM) in PTC at different locations.Methods:The clinical and pathological data of 1383 cases with solitary PTC in Hangzhou First People’s Hospital were retrospectively analyzed, and they were divided into isthmus group (175 cases), near-isthmus group (95 cases) and lateral lobe group (1113 cases) according to their tumor location. Univariate and multivariate analyses were used to analyze the relationship between gender, age, tumor maximum diameter, Hashimoto’s thyroiditis (HT) and CLNM, and the threshold for the occurrence of CLNM in each group of age and tumor maximum diameter was determined by the area under the receiver operating characteristic (ROC) .Results:The proportion of CLNM in the isthmus group, near-isthmus group and the lateral lobe group were 39.4% (69/175), 35.8% (34/95) and 29.6% (329/1113), respectively ( χ2=7.84, P=0.020). The intra-group comparison showed that there were statistical differences between the isthmus group and the lateral lobe group ( χ2=6.90, P=0.011), and there were no statistical differences between the isthmus group and near-isthmus group ( χ2=0.35, P=0.601), and near-isthmus group and the lateral leaf group ( χ2=1.62, P=0.313). Univariate and multivariate analysis showed that male ( OR: 3.697) and age < 38.5 years ( OR: 4.727) were independent risk factors for CLNM in PTC in the Isthmus Group, while male ( OR: 2.193), without HT ( OR: 1.702), tumor maximum diameter > 6.5 mm ( OR: 2.535) and age < 45.5 years ( OR: 3.030) were independent risk factors for CLNM in PTC in the lateral lobe group. Conclusions:Male sex and age are independent risk factors for CLNM in isthmus and lateral lobe PTC, and uncomplicated HT and tumor maximum diameter are also independent risk factors for CLNM in lateral lobe PTC. The incidence of CLNM in PTC in the isthmus, near-isthmus and lateral lobes decreased sequentially, and PTC in the near isthmus can not be simply regarded as the isthmus or lateral lobe PTC, and the lymph nodes in the central area should be fully evaluated before surgery to provide individualized treatment.

Objective:Papillary thyroid carcinoma with a maximum tumor diameter of ≤1 cm was defined as papillary thyroid carcinoma (PTC). To explore the clinical risk factors of central lymph node metastasis (CLNM) in PTC at different locations.Methods:The clinical and pathological data of 1383 cases with solitary PTC in Hangzhou First People’s Hospital were retrospectively analyzed, and they were divided into isthmus group (175 cases), near-isthmus group (95 cases) and lateral lobe group (1113 cases) according to their tumor location. Univariate and multivariate analyses were used to analyze the relationship between gender, age, tumor maximum diameter, Hashimoto’s thyroiditis (HT) and CLNM, and the threshold for the occurrence of CLNM in each group of age and tumor maximum diameter was determined by the area under the receiver operating characteristic (ROC) .Results:The proportion of CLNM in the isthmus group, near-isthmus group and the lateral lobe group were 39.4% (69/175), 35.8% (34/95) and 29.6% (329/1113), respectively ( χ2=7.84, P=0.020). The intra-group comparison showed that there were statistical differences between the isthmus group and the lateral lobe group ( χ2=6.90, P=0.011), and there were no statistical differences between the isthmus group and near-isthmus group ( χ2=0.35, P=0.601), and near-isthmus group and the lateral leaf group ( χ2=1.62, P=0.313). Univariate and multivariate analysis showed that male ( OR: 3.697) and age < 38.5 years ( OR: 4.727) were independent risk factors for CLNM in PTC in the Isthmus Group, while male ( OR: 2.193), without HT ( OR: 1.702), tumor maximum diameter > 6.5 mm ( OR: 2.535) and age < 45.5 years ( OR: 3.030) were independent risk factors for CLNM in PTC in the lateral lobe group. Conclusions:Male sex and age are independent risk factors for CLNM in isthmus and lateral lobe PTC, and uncomplicated HT and tumor maximum diameter are also independent risk factors for CLNM in lateral lobe PTC. The incidence of CLNM in PTC in the isthmus, near-isthmus and lateral lobes decreased sequentially, and PTC in the near isthmus can not be simply regarded as the isthmus or lateral lobe PTC, and the lymph nodes in the central area should be fully evaluated before surgery to provide individualized treatment.

Objective To explore the diagnostic value of the radiomic model based on panoramic radiographs in differentiating single or multiple root canals in mandibular first premolars.Methods A retrospective analysis was conducted on 68 patients with CBCT and panoramic radiographs from the affiliated Stomatological Hospital of Nanjing Medical University between July 2022 and November 2023.One hundred and thirty one mandibular first premolars(105 single-root and 26 multiple-root canals)were included in this study.Using stratified random sampling,the mandibular first premolars were divided into a training cohort(104 teeth)and a test cohort(27 teeth)at a ratio of 8∶2.CBCT was used to confirm the root canal configuration,and radiomic features were extracted from panoramic radio-graphs.After feature screening,radiomic models were constructed using extratrees,LightGBM,logistic regression(LR),multi-layer perceptron(MLP),random forest,support vector machine(SVM),and XGBoost.The optimal radiomic model was selected based on receiver operating characteristic(ROC)curve,accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),and decision curve analysis(DCA).Results A total of 107 radiomicfeatures were extracted from panoramic radiographs.After feature filtering,4 radiomic features were ultimately selected using the Lasso model.The XGBoost model showed higher predictive efficiency and stability,with an AUC of 0.962 in the training cohort and 0.770 in the test cohort.DCA curves also in-dicated that the XGBoost model was optimal.Conclusion The radiomic model based on panoramic radiographs demonstrates good per-formance in differentiating single or multiple root canals in mandibular first premolars.

Objective:To evaluate the effect of gender factors on the potency of oxycodone inhibiting responses to laryngeal mask airway (LMA) insertion in patients.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-59 yr, with a body mass index of 18-28 kg/m 2, scheduled for elective surgery with general anesthesia using LMA, were divided into 2 groups according to gender: male group (group M) and female group (group F). The dose of oxycodone was determined by using modified Dixon′s up-and-down method. Oxycodone 0.1 mg/kg was intravenously infused in the first patient of each group, and propofol 3 μg/ml was simultaneously given by target-controlled infusion. When bispectral index value ≤60 after the equilibration between effect-site concentration and plasma concentration was achieved, cisatracurium 0.2 mg/kg was intravenously injected, and 3 min later the LMA was inserted. When the response to LMA insertion was positive, the dose of oxycodone was increased in the next patient, otherwise the dose was decreased, and the ratio between the two successive doses was 1.1. The process was repeated until the 7th turning point occurred. The positive response to LMA insertion was defined as an increase in the maximum heart rate or in the maximum mean arterial pressure >20% of the baseline value with 2 min after insertion. The median effective dose (ED 50) and 95% confidence interval of oxycodone inhibiting responses to LMA insertion were calculated by the probit analysis. Results:Twenty-eight cases were finally included in M group and 25 cases in F group. The ED 50 (95% confidence interval) of oxycodone was 0.105 (0.091-0.115) mg/kg in group M and 0.087 (0.082-0.094) mg/kg in group F. The ED 50 of oxycodone was significantly higher in group M than in group F ( P<0.001). Conclusions:The effect of oxycodone inhibiting responses to nociceptive stimulation induced by LMA insertion is related to gender factors, with increased potency in females.

Based upon the experiences of planning and implementation of "Dynamic changes of Torque Teno virus load in Chinese renal transplant recipients with immunosuppressive therapy: A multi-center prospective observational double-blind cohort study", this article explored the current status and major difficulties of investigator-initiated multi-center prospective clinical trials of kidney transplantation in China. Various issues of organization design and implementation process management were discussed for enhancing the quality of implementing the relevant trials.

Objective To construct and validate of a nomogram predictive model for high-volume lymph node metastasis(HVM)in multifocal papillary thyroid carcinoma(MPTC).Methods Between January 2010 to January 2024,a total of 1146 and 234 patients with multifocal papillary thyroid carcinoma(MPTC)were diagnosed at Hangzhou First People's Hospital(Center A)and Hangzhou Cancer Hospital(Center B),respectively.Patients from Center A were randomly allocated to training set(n=803)and testing set(n=343)in a 7:3 ratio,while those from Center B(n=234)comprised an external validation set.Independent risk factors for HVM in MPTC patients were identified through univariate and multivariate Logistic regression analysis in training set,leading to the development of a nomogram predictive model.The generalizability of this model was subsequently assessed using both testing set and external validation set.The area under the curve(AUC)of receiver operating characteristic curve,sensitivity,and specificity evaluate the discriminative ability of the model.Results The incidence of HVM was 13.3％at center A and 12.8％at center B.Logistic regression identified male gender(OR=2.91,95％CI:1.835-4.599),maximum lesion diameter(OR=1.05,95％CI:1.021-1.070),and age(OR=0.95,95％CI:0.936-0.972)as independent risk factors for HVM.Anomogram based on these factors showed an AUC of 0.767 with 72.6％sensitivity and 70.2％specificity in training set,and 0.838 with 94.9％sensitivity and 68.4％specificity in testing set,and 0.769 with 63.3％sensitivity and 84.3％specificity in external validation set.The calibration curve demonstrated good agreement with the ideal curve.Conclusion The prediction model constructed based on clinical risk factors can effectively predict the probability of HVM in MPTC patients.