Machado-Joseph disease, or spinocerebellar ataxia type 3 (SCA3), represents the most common autosomal dominant cerebellar ataxia worldwide. Despite its progressive and debilitating nature, disease-modifying therapies remain elusive. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive intervention; however, its clinical application has been hindered by inconsistent protocols and a lack of mechanistic understanding. A recent landmark study published in Brain Stimulation by Chen et al. addressed these challenges by combining a high-dose intermittent theta-burst stimulation (iTBS) protocol with concurrent transcranial magnetic stimulation-electroencephalography (TMS-EEG). This commentary provides an in-depth analysis of their findings, highlighting the restoration of cerebello-cortical inhibition (CBI) as a key therapeutic mechanism. Furthermore, we discuss the broader implications of this work, proposing that future translational research should integrate accelerated iTBS (aiTBS) paradigms, cortical response measurements (CRM), and individualized neuro-navigation to establish a new era of precision neuromodulation for ataxia.

Machado-Joseph disease, or spinocerebellar ataxia type 3 (SCA3), represents the most common autosomal dominant cerebellar ataxia worldwide. Despite its progressive and debilitating nature, disease-modifying therapies remain elusive. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising non-invasive intervention; however, its clinical application has been hindered by inconsistent protocols and a lack of mechanistic understanding. A recent landmark study published in Brain Stimulation by Chen et al. addressed these challenges by combining a high-dose intermittent theta-burst stimulation (iTBS) protocol with concurrent transcranial magnetic stimulation-electroencephalography (TMS-EEG). This commentary provides an in-depth analysis of their findings, highlighting the restoration of cerebello-cortical inhibition (CBI) as a key therapeutic mechanism. Furthermore, we discuss the broader implications of this work, proposing that future translational research should integrate accelerated iTBS (aiTBS) paradigms, cortical response measurements (CRM), and individualized neuro-navigation to establish a new era of precision neuromodulation for ataxia.

China has become the country with the highest global burden of heart failure(HF).Despite the widespread use of prognostic-improving medications today,the mortality rate of HF remains high,reaching 13.7％at one year-particularly among patients with heart failure with reduced ejection fraction(HFrEF).HF interventional device therapy(structural intervention)targets the structural factors underlying HF,including atrial pressure,ventricular remodeling,and valvular intervention.It leverages the heart's intrinsic physiological properties and pathological progression mechanisms to deliver treatments through interventions without external active forces,achieving anatomical or functional repair.This field has emerged as a rapidly growing area and plays an increasingly critical role in HF management.This article provides a comprehensive review and summary of the latest advancements in HF and cardiomyopathy interventional therapy over the past year.It covers various novel technologies and products currently in the research phase,aiming to provide an in-depth analysis of the current status and future directions of HF interventional therapy,and further advance the development of this discipline.

Objective To investigate the effect of epifriedelanol(Epi)on gene expression of P-glycoprotein(P-gp)in human colorectal adenocarcinoma cell line LS174T and its mechanism.Methods LS174T cells were divided into control group and experimental-L,-M,-H groups.Experimental-L,-M,-H groups were treated with 5,10,20 μmol·L-1 Epi,respectively.Control group was treated with 0.1％dimethyl sulfoxide.Polymerase chain reaction was used to detect the mRNA expression level of P-gp.Theeffect of Epi on multidrug resistance protein 1(MDR1/P-gp)luciferase activity was investigated by pregnane X receptor(PXR)-MDR1/P-gp dual luciferase reporter gene assay.In addition,Western Blot was used to detect the protein expression level of P-gp and the nuclear factor-κB(NF-κB)pathway related proteins.Results The relative expression levels of P-gp mRNA in experimental-M,-H groups and control group were 52.24±5.19,23.00±3.52 and 100.00±9.00;the relative expression levels of P-gp protein were 86.37±9.96,74.85±15.92 and 100.00±12.91;the relative activities P-gp luciferase were 230.19±41.32,203.10±52.84 and 279.67±19.20;the relative expression levels of p65(RelA/p65)in nucleus were 132.36±23.93,145.96±25.15 and 100.00±10.88;the relative expression levels of phosphorylation NF-κB inhibits protein kinase α/β(p-IKKα/β)in cytoplasm were 184.00±54.82,290.10±49.59 and 100.00±15.34;the relative expression levels of phosphorylated NF-κB inhibitory protein α(p-IκBα)in cytoplasm were 125.73±18.77,133.69±20.25 and 100.00±8.12;the relative expression levels of IκBα in cytoplasm were 78.36±14.83,70.44±14.57 and 100.00±22.82,respectively.The above indexes of experimental-M and experimental-H groups were compared with control group,and the differences were statistically significant(P＜0.05,P＜0.01,P＜0.001).Conclusion Epi can down-regulate the gene expression of P-gp in human colorectal adenocarcinoma cell line LS174T,and the mechanism may be related to activation of NF-κB and suppression of PXR.

China has become the country with the highest global burden of heart failure(HF).Despite the widespread use of prognostic-improving medications today,the mortality rate of HF remains high,reaching 13.7％at one year-particularly among patients with heart failure with reduced ejection fraction(HFrEF).HF interventional device therapy(structural intervention)targets the structural factors underlying HF,including atrial pressure,ventricular remodeling,and valvular intervention.It leverages the heart's intrinsic physiological properties and pathological progression mechanisms to deliver treatments through interventions without external active forces,achieving anatomical or functional repair.This field has emerged as a rapidly growing area and plays an increasingly critical role in HF management.This article provides a comprehensive review and summary of the latest advancements in HF and cardiomyopathy interventional therapy over the past year.It covers various novel technologies and products currently in the research phase,aiming to provide an in-depth analysis of the current status and future directions of HF interventional therapy,and further advance the development of this discipline.

Objective To analyze the application value of multi-slice spiral CT(MSCT)in the preoperative diagnosis and classification of inguinal hernia.Methods The clinical data of 130 patients with inguinal hernia admitted to our hospital were collected,and all patients underwent inguinal hernia repair.MSCT examination was conducted for the inguinal hernia of the patients,and the efficacy of MSCT in the diagnosis of different types of inguinal hernia was explored by taking the intraoperative diagnosis results as the gold standard.The contents of the hernia sac in patients with different types of inguinal hernia were analyzed,and the accuracy of MSCT under different scanning directions on the relationship between neck of hernia sac and inferior epigastric artery was analyzed.Results The intraoperative diagnosis results confirmed that there were 92 cases of oblique hernia,26 cases of direct hernia and 12 cases of femoral hernia among 130 patients with inguinal hernia.A total of 139 hernia sacs were present,with 121 unilateral and 9 bilateral hernia sacs.Among patients with oblique hernias,87 cases were unilateral and 5 cases were bilateral;among patients with direct hernias,23 cases were unilateral and 3 cases were bilateral;among patients with femoral hernias,11 cases were unilateral and 1 case was bilateral.The MSCT scan results showed that patients with oblique hernia,direct hernia and femoral hernia were 92 cases,26 cases and 12 cases respectively.The sensitivities of MSCT in diagnosing oblique hernia,direct hernia and femoral hernia were 95.65%,84.62%and 100%respectively,and the specificities were 89.47%,96.15%and 100%respectively.The contents of the hernia sac in oblique hernia were mainly small intestine and mesentery,while those in direct hernia and femoral hernia were mainly small intestine and fat.The proportions of fat and bladder in the contents of the hernia sac of direct hernia were higher than those of oblique hernia and femoral hernia(P<0.05).The proportion of mesentery in the contents of the hernia sac of oblique hernia was higher than that of direct hernia and femoral hernia(P<0.05).According to the relationship between hernia sac neck and inferior epigastric artery,the diagnostic accuracy of inguinal hernia by MSCT under coronal scan was the highest.Conclusion The sensitivity and specificity of MSCT in the preoperative differential diagnosis of inguinal hernia are relatively high,and the accuracy of MSCT in classification diagnosis can be improved if combined the contents of the hernia sac and the relationship between the hernia sac neck and inferior epigastric artery.

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.

This study aims to describe the population and regional distribution characteristics of smoking behavior among adult twins in the China Twin Registry (CNTR), as well as the concordance rates for smoking behavior in monozygotic and dizygotic twins, and estimate the heritability. The study population included adult twins in CNTR who had smoking questionnaire data. A random-effects regression model was used to describe the distribution of smoking behavior among different subgroups based on various characteristics. The concordance of smoking behavior between different zygosity groups was calculated, and heritability was estimated. A total of 28 444 twin pairs were included in this study, with an average age of (36.6±12.0) years. Among male twins, 41.2% were current smokers, while only 1.2% of females smoked. Higher smoking rates were observed among male smokers in the 50-59 age group ( z=23.0, P<0.001), northern regions ( z=2.9, P<0.01), rural areas ( z=-5.2, P<0.001), those who were divorced/widowed ( z=3.8, P<0.001), and first-born twins ( z=-4.3, P<0.001), while lower smoking rates were found in those with higher education ( z=-16.1, P<0.001) and unmarried individuals ( z=-16.0, P<0.001). The smoking concordance rate for male monozygotic twins was 69.6%, significantly higher than the 57.3% concordance rate for dizygotic twins ( χ 2=105.0, P<0.05). The heritability of smoking behavior in male twins was estimated at 28.9% (95% CI: 24.3%-33.4%). Stratified analyses showed differences in heritability across regions and age groups: the heritability in northern regions was 32.6% (95% CI: 27.3%-38.0%), higher than the 21.0% (95% CI: 12.4%-29.5%) observed in southern regions; the highest heritability of 35.1% (95% CI: 26.3%-43.9%) was found in the 18-29 age group, with heritability decreasing with age. In conclusion, the smoking rate and influencing factors in the twin population are similar to those in the general population, with unique characteristics, such as higher smoking rates in first-born twins. Genetic factors have a significant impact on smoking behavior.

Objective To analyze the application value of multi-slice spiral CT(MSCT)in the preoperative diagnosis and classification of inguinal hernia.Methods The clinical data of 130 patients with inguinal hernia admitted to our hospital were collected,and all patients underwent inguinal hernia repair.MSCT examination was conducted for the inguinal hernia of the patients,and the efficacy of MSCT in the diagnosis of different types of inguinal hernia was explored by taking the intraoperative diagnosis results as the gold standard.The contents of the hernia sac in patients with different types of inguinal hernia were analyzed,and the accuracy of MSCT under different scanning directions on the relationship between neck of hernia sac and inferior epigastric artery was analyzed.Results The intraoperative diagnosis results confirmed that there were 92 cases of oblique hernia,26 cases of direct hernia and 12 cases of femoral hernia among 130 patients with inguinal hernia.A total of 139 hernia sacs were present,with 121 unilateral and 9 bilateral hernia sacs.Among patients with oblique hernias,87 cases were unilateral and 5 cases were bilateral;among patients with direct hernias,23 cases were unilateral and 3 cases were bilateral;among patients with femoral hernias,11 cases were unilateral and 1 case was bilateral.The MSCT scan results showed that patients with oblique hernia,direct hernia and femoral hernia were 92 cases,26 cases and 12 cases respectively.The sensitivities of MSCT in diagnosing oblique hernia,direct hernia and femoral hernia were 95.65%,84.62%and 100%respectively,and the specificities were 89.47%,96.15%and 100%respectively.The contents of the hernia sac in oblique hernia were mainly small intestine and mesentery,while those in direct hernia and femoral hernia were mainly small intestine and fat.The proportions of fat and bladder in the contents of the hernia sac of direct hernia were higher than those of oblique hernia and femoral hernia(P<0.05).The proportion of mesentery in the contents of the hernia sac of oblique hernia was higher than that of direct hernia and femoral hernia(P<0.05).According to the relationship between hernia sac neck and inferior epigastric artery,the diagnostic accuracy of inguinal hernia by MSCT under coronal scan was the highest.Conclusion The sensitivity and specificity of MSCT in the preoperative differential diagnosis of inguinal hernia are relatively high,and the accuracy of MSCT in classification diagnosis can be improved if combined the contents of the hernia sac and the relationship between the hernia sac neck and inferior epigastric artery.

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.