As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Non-alcoholic fatty liver disease （NAFLD） is one of the most prevalent forms of liver diseases globally. Its progression can lead to cirrhosis and end-stage liver disease， and there is currently a lack of effective pharmacological treatments. Adenosine monophosphate-activated protein kinase （AMPK）， as a regulatory hub for maintaining cellular energy homeostasis， can coordinate key cellular processes such as adipogenesis， glucose metabolism， and mitochondrial functions. Its activation exerts metabolic regulatory effects through pathways including inhibiting lipogenesis， enhancing mitochondrial β-oxidation， regulating inflammation and oxidative stress， and promoting autophagy. Accordingly， AMPK emerges as a potential target for the prevention and treatment of NAFLD. Traditional Chinese Medicine （TCM）， with low toxicity， high accessibility， and multi-component， multi-target synergistic effects， has demonstrated unique value in NAFLD treatment， particularly showing notable advantages in regulating the AMPK signaling pathway. Sichuan is known as the treasure house of TCM， and the active components of its authentic medicinal materials such as Coptidis Rhizoma not only reflect regional characteristics in AMPK signaling regulation but also form a multi-level metabolic regulatory network through crosstalk with pathways such as sirtuin 1 （SIRT1） and peroxisome proliferator-activated receptor α （PPARα）. They can achieve specific regulation by directly activating AMPK and modulating upstream and downstream targets， exerting prominent effects in ameliorating hepatic steatosis and inflammation. This study systematically reviews the research findings on TCM for the prevention and treatment of NAFLD over the past five years， elaborating the mechanisms by which TCM treats NAFLD through regulating the AMPK signaling pathway. It aims to provide new perspectives and references for clinical diagnosis and treatment， basic research， and drug development.

Background: s/Aims: Non-invasive models stratifying clinically significant portal hypertension (CSPH) are limited. Herein, we developed a new non-invasive model for predicting CSPH in patients with compensated cirrhosis and investigated whether carvedilol can prevent hepatic decompensation in patients with high-risk CSPH stratified using the new model. Methods: Non-invasive risk factors of CSPH were identified via systematic review and meta-analysis of studies involving patients with hepatic venous pressure gradient (HVPG). A new non-invasive model was validated for various performance aspects in three cohorts, i.e., a multicenter HVPG cohort, a follow-up cohort, and a carvediloltreating cohort. Results: In the meta-analysis with six studies (n=819), liver stiffness measurement and platelet count were identified as independent risk factors for CSPH and were used to develop the new “CSPH risk” model. In the HVPG cohort (n=151), the new model accurately predicted CSPH with cutoff values of 0 and –0.68 for ruling in and out CSPH, respectively. In the follow-up cohort (n=1,102), the cumulative incidences of decompensation events significantly differed using the cutoff values of <–0.68 (low-risk), –0.68 to 0 (medium-risk), and >0 (high-risk). In the carvediloltreated cohort, patients with high-risk CSPH treated with carvedilol (n=81) had lower rates of decompensation events than non-selective beta-blockers untreated patients with high-risk CSPH (n=613 before propensity score matching [PSM], n=162 after PSM). Conclusions Treatment with carvedilol significantly reduces the risk of hepatic decompensation in patients with high-risk CSPH stratified by the new model.

Objective To evaluate the position of the talus on the axial images of magnetic resonance imaging(MRI)of the ankle joint in patients with chronic ankle instability(CAI)and to identify the indirect signs for diagnosing CAI.Methods Fifty patients hospitalized in our hospital between January 1,2021 and July 1,2023 for chronic ankle instability(CAI)were selected into the experimental group,while 50 counterparts treated in our hospital for other diseases were chosen into the control group.The basic information of both groups was recorded.The internal measurement tools of the Picture Ar-chiving and Communication System(PACS)were used to measure the malleolar talus index(MTI)and two new measurement methods:talus movement index(TMI)and talus comprehensive index(TCI)on the axial images of ankle MRI to evaluate the position of the talus in the ankle mortise.Sta-tistical analysis was then performed.Results There was no significant difference between the two groups in terms of age,sex ratio,affected side ratio,height,weight and body mass index(BMI)(P>0.05).Compared with the control group,the MTI(86.56°±3.54° vs.85.28°±2.77°,P<0.05),TMI(2.00°±2.36° vs.-2.00°±2.54°,P<0.001)and TCI(4.70°±2.98° vs.1.90°±2.01°,P<0.001)of the experi-mental group increased.The area under the ROC curve of TMI and TCI was 0.841 and 0.794,respec-tively.The optimal cut-off points for diagnosing CAI based on TMI and TCI were 0.5° and 4.5°,re-spectively.Conclusion Patients with CAI show changes in the bony structure of the ankle joint.Specifi-cally,on the axial MRI images of the ankle joint,there are simultaneous posterior displacement and internal rotation of the talus,which may be an indirect sign for the diagnosis of CAI.

Objective The isokinetic muscle strength indicators and surface electromyography(sEMG)signals of the healthy lower limb side of patients with non-contact anterior cruciate ligament(ACL)injury in the acute phase were compared with those of healthy individuals,so to provide a theoretical basis for the prevention of secondary ACL rupture in the healthy lower limb side of patients with ACL injury.Methods 21 patients with ACL injury in the acute phase(ACL injury group)and 21 healthy individuals(control group)were subjected to isokinetic muscle strength tests for hip flexion,extension,adduction,abduction,and knee flexion,and sEMG signals of the vastus medialis,vastus lateralis,semitendinosus,biceps femoris,and gluteus maximus were collected during the single-leg jumping movements.The differences between the two groups in relative peak torque,antagonist muscle ratio,root mean square amplitude,and co-contraction index were analyzed by independent sample t-test.Results The extension of the knee(P=0.040)and hip flexion strength(P=0.041)were lower in the healthy lower limb side of patients with ACL injury.In the single-leg landing action,there were lower activation of the vastus medialis muscle in the pre-activation phase(P=0.014),lower activation of the vastus medialis(P=0.030)and gluteus maximus(P=0.002)in the reaction phase,and also lower co-activation levels of the biceps femoris-semitendinosus(P=0.020).Conclusions At the early stage of injury,the function of the healthy lower limb side of patients with ACL injury changes,which may indicate why these patients face a greater risk of contralateral lower limb injury.

Objective To evaluate the position of the talus on the axial images of magnetic resonance imaging(MRI)of the ankle joint in patients with chronic ankle instability(CAI)and to identify the indirect signs for diagnosing CAI.Methods Fifty patients hospitalized in our hospital between January 1,2021 and July 1,2023 for chronic ankle instability(CAI)were selected into the experimental group,while 50 counterparts treated in our hospital for other diseases were chosen into the control group.The basic information of both groups was recorded.The internal measurement tools of the Picture Ar-chiving and Communication System(PACS)were used to measure the malleolar talus index(MTI)and two new measurement methods:talus movement index(TMI)and talus comprehensive index(TCI)on the axial images of ankle MRI to evaluate the position of the talus in the ankle mortise.Sta-tistical analysis was then performed.Results There was no significant difference between the two groups in terms of age,sex ratio,affected side ratio,height,weight and body mass index(BMI)(P>0.05).Compared with the control group,the MTI(86.56°±3.54° vs.85.28°±2.77°,P<0.05),TMI(2.00°±2.36° vs.-2.00°±2.54°,P<0.001)and TCI(4.70°±2.98° vs.1.90°±2.01°,P<0.001)of the experi-mental group increased.The area under the ROC curve of TMI and TCI was 0.841 and 0.794,respec-tively.The optimal cut-off points for diagnosing CAI based on TMI and TCI were 0.5° and 4.5°,re-spectively.Conclusion Patients with CAI show changes in the bony structure of the ankle joint.Specifi-cally,on the axial MRI images of the ankle joint,there are simultaneous posterior displacement and internal rotation of the talus,which may be an indirect sign for the diagnosis of CAI.

Objective The isokinetic muscle strength indicators and surface electromyography(sEMG)signals of the healthy lower limb side of patients with non-contact anterior cruciate ligament(ACL)injury in the acute phase were compared with those of healthy individuals,so to provide a theoretical basis for the prevention of secondary ACL rupture in the healthy lower limb side of patients with ACL injury.Methods 21 patients with ACL injury in the acute phase(ACL injury group)and 21 healthy individuals(control group)were subjected to isokinetic muscle strength tests for hip flexion,extension,adduction,abduction,and knee flexion,and sEMG signals of the vastus medialis,vastus lateralis,semitendinosus,biceps femoris,and gluteus maximus were collected during the single-leg jumping movements.The differences between the two groups in relative peak torque,antagonist muscle ratio,root mean square amplitude,and co-contraction index were analyzed by independent sample t-test.Results The extension of the knee(P=0.040)and hip flexion strength(P=0.041)were lower in the healthy lower limb side of patients with ACL injury.In the single-leg landing action,there were lower activation of the vastus medialis muscle in the pre-activation phase(P=0.014),lower activation of the vastus medialis(P=0.030)and gluteus maximus(P=0.002)in the reaction phase,and also lower co-activation levels of the biceps femoris-semitendinosus(P=0.020).Conclusions At the early stage of injury,the function of the healthy lower limb side of patients with ACL injury changes,which may indicate why these patients face a greater risk of contralateral lower limb injury.

Objective To compare the blood flow perfusion area in different retinal vascular plexuses between adults and children using swept-source optical coherence tomography angiography(SS-OCTA)and explore the correlation of the retinal blood flow perfusion area with spherical equivalent(SE)and axial length(AL).Methods A total of 112 partici-pants,including 58 children(116 eyes,aged 8-13 years)and 54 adults(108 eyes,aged 18-30 years),were recruited from Eye Hospital,Wenzhou Medical University from December 2020 to December 2024.Based on SE,these children and adults were further divided into the emmetropia(-0.50＜SE ≤+0.50 D),low myopia(-3.00＜SE≤-0.50 D),and moderate myopia(-6.00＜SE≤-3.00 D)groups.SS-OCTA was used to acquire the perfusion area data across retinal vascular layers.The inner vascular network of the retina was subdivided into the peripapillary radial vascular network,su-perficial vascular plexus(SVP),middle vascular plexus(MVP),and deep vascular plexus(DVP).The blood flow perfu-sion areas across retinal vascular layers were compared between adults and children.Pearson correlation analysis was per-formed to assess the correlation of the blood flow perfusion areas across retinal vascular layers with AL and SE in adults and children,respectively.Results SE was negatively correlated with AL in both adults and children(r=-0.781 and-0.667,respectively;both P＜0.001).The total inner retinal perfusion area was negatively correlated with AL in both adults and children(r=-0.239 and-0.299,respectively;both P＜0.05).In children,the perfusion area in the peripapil-lary radial vascular network,SVP,and DVP was negatively correlated with AL(r=-0.443,-0.315,and-0.220,respec-tively;all P＜0.05).In adults,the perfusion area in SVP,MVP,and DVP was negatively correlated with AL(r=-0.243,-0.230,and-0.364,respectively;all P＜0.05).Adults with low/moderate myopia exhibited a significantly larger perfu-sion area in the peripapillary radial vascular network compared with children with corresponding myopia levels,and the differences were statistically significant(both P＜0.001).Conclusion There were significant differences in the perfu-sion area of the peripapillary radial vascular network between adult and pediatric myopic patients.AL showed the strongest correlations with the perfusion area of the peripapillary radial vascular network in adults and the perfusion area of DVP in children,respectively,suggesting distinct effects of retinal vascular layers at different stages of ocular growth.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To investigate the application and effectiveness of a zero-trust network architecture(ZTNA)in a hospital's smart-management platform,providing a practical reference for network-architecture optimization in smart-hospital initiatives.Methods A single-arm mode was involved in the deployment of ZTNA.An encrypted tunnel was established by the zero-trust proxy gateway,and the components for zero-trust terminal security,behavior management,firewall,identity authentication,security operation and analysis center were synergized with the help of a logical bus to form a security protection system of end-to-end trust assessment,dynamic access control,micro-isolation and visualization,and the integration and access to the hospital's intelligent management platform were realized by means of ticket injection.Results ZTNA markedly enhanced data protection for the platform,and significantly improved user experience by simplified authentication and enhanced support for mobile operation.Conclusion ZTNA ensures the security of kinds of hospital business systems,and lays a foundation for large comprehensive hospitals to construct cross-region,cross-institution and multi-center medical information platforms and open data sharing modes.[Chinese Medical Equipment Journal,2025,46(8):50-57]