ObjectiveZheng’s San Qi San (ZSQS) power, a classic traditional Chinese medicine (TCM) formula, is used for treating soft tissue injuries involving muscles, tendons, and ligaments. However, its underlying therapeutic mechanisms remain unclear. This study aimed to screen and identify pharmaceutically active ingredients and their candidate biomolecule targets, and further elucidate the molecular mechanism of ZSQS in the treatment of skeletal muscle injury. MethodsNetwork pharmacology was employed to construct “ZSQS-component-target”, “protein-protein interaction (PPI)” and “active ingredient-core protein-pathway” networks to predict the key active ingredients and potential core targets of ZSQS for skeletal muscle injury. The predicted results were then validated via microarray data from the GEO database. Molecular docking was then performed to assess the binding ability between the screened active ingredients of ZSQS and the candidate core targets. Moreover, liquid chromatography-mass spectrometry (LC-MS) was used for qualitative and quantitative analysis to verify the active components of the drug and ZSQS serum. Finally, an animal model of eccentric exercise-induced skeletal muscle injury and a myotube cell model of oxidative stress-induced injury were established to validate the effects of ZSQS and its interventional effects on the biological functions of critical targets, thereby demonstrating the potential therapeutic mechanism of ZSQS. ResultsAmong the 111 active components identified in ZSQS and their corresponding 204 targets related to the skeletal muscle injury repair process, 14 core targets (including AKT1) and 4 core active components (quercetin, luteolin, kaempferol, and β‑sitosterol) were screened out, while the corresponding metabolites of quercetin, luteolin and kaempferol were detected in the ZSQS serum. Among these targets, 5 candidate genes (IL-6, CASP3, HIF1A, STAT3, and JUN) overlapped with the differential expression screening results with GEO data, and IL-6 was confirmed to be enriched in the PI3K/AKT pathway. Combined with the prediction results of the AKT expression levels, these findings suggest that the phosphorylation level of AKT1 plays a core role in the therapeutic mechanism of ZSQS. Molecular docking analysis further revealed that the PH domain of AKT1 had high binding energy with all 4 core active components, as verified by LC-MS. Finally, animal model studies have shown the promoting effect of ZSQS administration on skeletal muscle injury repair and its possible antioxidant damage mechanism. Cell model studies further demonstrated that ZSQS-containing serum, core active ingredient combination therapy, and quercetin monomer could increase the phosphorylation level of AKT, promote the nuclear translocation of Nrf2, upregulate the expression of downstream antioxidant enzymes (SOD, GPx, and GR), and inhibit the expression of inflammatory factors (IL-6 and TNF-α), thereby alleviating oxidative stress and the inflammatory response. ConclusionZSQS alleviates skeletal muscle injury mainly by activating the AKT/Nrf2 signaling pathway, enhancing cellular antioxidant and anti-inflammatory capabilities. The results of this study provide a scientific basis for the clinical application and modernized development of ZSQS.

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 explore the characteristics and prognosis of follicular lymphoma(FL)with bulky disease under rituximab-based first-line treatment.Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treat-ment[342 patients received rituximab combined with chemotherapy(R-chemo),183 patients received rituximab plus lenalidomide(R2)].The clinicopathologic characteristics,gene mutations,and prognosis of bulky FL patients were analyzed.Results Compared to non-bulky FL patients,bulky FL patients had a significantly higher proportion of lymph node≥5 sites,≥2 extranodal involvement,bone marrow involvement,elevated LDH,and a higher proportion in the high-risk group of FLIPI1 and FLIPI2.Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients.In patients receiving R-chemo as the first-line treatment,there was no significant difference in progression-free survival(PFS)and overall survival(OS)between bulky and non-bulky FL patients.However,in patients treated with R2,the PFS and OS of bulky FL patients was significantly shorter.Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics.For bulky FL at diagnosis,chemo-free regimens require further exploration on the basis of R2.

Objective To evaluate the efficacy and safety of a novel intravascular lithotripsy(IVL)balloon—Vesscrack shockwave balloon—for vascular preparation before stent implantation in patients with severe coronary artery calcification(CAC).Methods This was a prospective,single-arm,multicenter study conducted in China from June 2022 to October 2022.Patients with severe CAC were treated with the Vesscrack shockwave balloon for lesion preparation,followed by drug-eluting stent(DES)implantation.Of these,33 patients underwent optical coherence tomography(OCT).The primary endpoint was procedural success,defined as successful stent implantation with residual stenosis≤30％and the absence of in-hospital major adverse events,including cardiac death,target vessel-related myocardial infarction,or target lesion revascularization.Results A total of 170 patients[mean age:(65.9±7.9)years,116 males]were enrolled.After treatment with IVL and DES,the minimum lumen diameter increased significantly compared to baseline[(2.34±0.40)mm vs.(0.95±0.33)mm,P＜0.001],the degree of stenosis was significantly reduced[(13.24±6.60)％vs.(65.18±10.59)％,P＜0.001].Procedural success was achieved in 100％of cases,and device success was 98.8％.The 30-day patient-related cardiovascular clinical composite endpoint(POCE)rate was 0.0,with no target lesion failure,no confirmed or potential thrombotic events were observed.The shockwave energy generator demonstrated excellent stability and ease of use.Among the 33 patients assessed with OCT,after IVL intervention,the maximum calcified area of the lumen[(3.51±1.51)mm2 vs.(2.85±1.80)mm2,P＜0.001],and the minimum lumen area within the target lesion[(3.08±1.04)mm2 vs.(2.02±0.75)mm2,P＜0.001],and after DES intervention,the luminal area of the largest calcified site[(6.59±1.64)mm2 vs.(2.85±1.80)mm2,P＜0.001]and the minimum luminal area within the target lesion[(6.19±1.45)mm2 vs.(2.02±0.75)mm2,P＜0.001]were significantly increased,and the differences were statistically significant.Conclusions The Vesscrack shockwave balloon is effective and safe for vascular preparation in patients with severe CAC prior to stent implantation.It achieves significant calcified plaque modification,high procedural success rates,and minimal complications.

Objective To explore the characteristics and prognosis of follicular lymphoma(FL)with bulky disease under rituximab-based first-line treatment.Methods A retrospective analysis was conducted on 525 FL patients diagnosed between September 2009 and September 2021 who received rituximab as a first-line treat-ment[342 patients received rituximab combined with chemotherapy(R-chemo),183 patients received rituximab plus lenalidomide(R2)].The clinicopathologic characteristics,gene mutations,and prognosis of bulky FL patients were analyzed.Results Compared to non-bulky FL patients,bulky FL patients had a significantly higher proportion of lymph node≥5 sites,≥2 extranodal involvement,bone marrow involvement,elevated LDH,and a higher proportion in the high-risk group of FLIPI1 and FLIPI2.Gene sequencing revealed a significantly higher mutation rate of ZNF608 in bulky FL patients compared to non-bulky FL patients.In patients receiving R-chemo as the first-line treatment,there was no significant difference in progression-free survival(PFS)and overall survival(OS)between bulky and non-bulky FL patients.However,in patients treated with R2,the PFS and OS of bulky FL patients was significantly shorter.Conclusions Bulky FL patients compared to non-bulky FL patients have a significantly higher proportion of high-risk baseline characteristics.For bulky FL at diagnosis,chemo-free regimens require further exploration on the basis of R2.

Objective:To explore the spatial correlation between gray matter volume (GMV) changes and neurotransmitter receptors/transporters in patients with first-episode schizophrenia (FES) .Methods:Fifty-four FES patients(FES group) and fifty-nine healthy controls (HC group) were selected from June 2014 to May 2020 in the Psychiatry Department of Renmin Hospital of Wuhan University. Structural magnetic resonance imaging (sMRI) was conducted on all subjects. Differences of GMV were compared across 400 cortical regions and 32 subcortical regions. Based on the positron emission tomography(PET) data from Neuromaps, which provides the density of 19 different neurotransmitter receptors and transporters, Spearman correlation analysis was performed to evaluate the spatial correlation between GMV changes and neurotransmitter systems.Results:Compared to the HC group, FES group exhibited significant GMV reductions in widespread cortical (90/400) and subcortical (6/32) regions (all FDR-corrected P<0.05). The effect size of GMV reduction (Cohen’s d) showed significant positive correlations with the density of 5-hydroxytryptamine 1a(5HT1a) ( r=0.400, Pspin=0.002), γ-aminobutyric acid type A receptor(GABA A)( r=0.307, Pspin=0.002), and metabotropic glutamate receptor 5(mGluR5) ( r=0.275, Pspin=0.020) receptors (all FDR-corrected P<0.05). Conclusion:GMV reductions in a wide range of brain regions existed in patients with FES. There are significant correlations between 5HT1a, GABA A and mGluR5 receptors and gray matter reduction in patients with FES. The disorder of these neurotransmitter receptors may be the potential neurobiological mechanism of gray matter structural abnormalities in the early stage of schizophrenia.

Background and purpose:The treatment of recurrent,metastatic,and treatment-na?ve advanced cervical cancer remains challenging.Immunotherapy in combination with chemotherapy and targeted therapy has shown preliminary clinical benefits,however,current evidence remains limited.This study aimed to evaluate the impact of camrelizumab combined with chemotherapy and targeted therapy on the prognosis of patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer.Methods:In this study,we conducted a retrospective analysis of the clinical data from 130 patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer admitted to Minhang Branch of Fudan University Shanghai Cancer Center from 2019 to 2025.The patients were categorized into the observation group(n=70),which included those who received camrelizumab with or without chemotherapy and targeted therapy,and the control group(n=60),including those who received chemotherapy and targeted therapy.Survival analysis was performed using the log-rank test,and univariate and multivariate Cox regression analyses were conducted to explore prognostic factors.This study was approved by the Ethics Committee of the Minhang Branch of Fudan University Shanghai Cancer Center[Approval number:(2024)Review No.(015)]and all informed consents were exempted.Results:The objective response rate(ORR)in the observation group was 72.9%,and the disease control rate(DCR)was 80.0%,which were significantly higher than those in the control group with an ORR of 20.0%(χ2=36.1,P＜0.001)and a DCR of 40.0%(χ2=21.8,P＜0.001).The median progression-free survival(PFS)in the observation group was not reached,significantly longer than that in the control group of 7.0 months(P＜0.001).Multivariate Cox regression analysis identified camrelizumab treatment as an independent protective factor for PFS(P＜0.001).Age,site of recurrence/metastasis,initial treatment approach,and histopathological type were not significantly associated with PFS.In the observation group,adverse events of grade 3 or higher were reported in 29 patients(41.4%),which primarily included vasculitis,hypothyroidism,hypersensitivity reactions,and diarrhea.Conclusion:The use of camrelizumab significantly improved treatment outcomes and prognosis for patients with recurrent,metastatic,and treatment-na?ve advanced cervical cancer,with significantly improved progression-free survival.Although a certain proportion of patients experienced adverse events of grade 3 or higher,the overall safety profile was acceptable.In clinical practice,immunotherapy offers a more effective treatment option for patients.

Metabolic-bariatric surgery(MBS)has become an important treatment for pathological obesity and metabolic diseases.However,common postoperative nutritional complications—such as protein-energy malnutrition,iron deficiency anemia,and vitamin B12 deficiency—significantly affect patients' long-term prognosis.Traditional nutritional management models rely on static monitoring and standardized supplementation,which are insufficient to address individual variability and dynamic postoperative changes.Artificial intelligence(AI),through integrating multimodal data(such as biochemical indicators,imaging information,and wearable device monitoring)and intelligent modeling,offers new approaches for dynamic monitoring,risk prediction,and personalized intervention.Based on literature from 2017 to 2025,this article systematically evaluates the application of AI in perioperative nutritional management for MBS,covering key technologies including machine learning,deep learning,and natural language processing.It also analyzes current challenges in clinical translation,such as data fragmentation,lack of model interpretability,and limited long-term validation.In the future,enhanced multi-center collaboration,the development of standardized databases,and explainable models will be essential to advancing nutritional management in MBS from empirical practice to precision medicine.

Objective:To investigate the effect of intestinal air cavity on dose distribution of volumetric intensity modulated arc therapy (VMAT) for cervical cancer.Methods:A total of 10 patients who underwent radiotherapy for cervical cancer at Suzhou Municipal Hospital from January to May 2021 were retrospectively analyzed. For each patient, the same optimization parameters were used to design both a normal full-arc plan and a field avoidance-region plan. The intestinal air cavity identified on computed tomography (CT) imaging was outlined as a separate structure. The dose distribution of the two plans were compared before and after changing the CT value (the electron density of the intestinal air cavity) to 0, using a paired t-test. Additionally, consecutive three-week cone beam CT (CBCT) images were collected for each patient. The intestinal air cavities from the three-week CBCT images were mapped onto the original CT, and the dose distributions of both plans were calculated on the CBCT images. The differences in dose distributions compared to the original plan were analyzed to assess plan robustness. Results:The 105% prescription dose coverage of the target volume ( V105) [(43.62±5.18)%)] within the target area for the field avoidance-region plan was greater than that for the normal full-arc plan [(36.38±10.20)%], with a statistically significant difference ( P<0.05). After modifying the electron density of the intestinal air cavity, the dose distribution in the target area worsened for both plans. However, the V100 and V105 for the field avoidance-region plan [(?0.64±0.58)%, (?2.16±1.66)%] were smaller than those for the normal full-arc plan [(?2.52±1.91)%, (?6.79±2.02)%], with a statistically significant difference (both P<0.05).The V30 for the small intestine in the field avoidance-region plan [(40.28±4.77)%] was lower than that in the normal full-arc plan [(42.63±4.82)%]. The V40 for the rectum [(61.70±15.39)%] and the V20 [(36.32±3.09)%, (35.06±5.32)%] and V30 [(17.76±3.05)%, (16.67±8.14)%] for the left and right femoral heads were higher than those in the normal full-arc plan {(59.72±15.13)%, [(31.36±3.97)%, (27.00±7.79%)] and [(12.99±4.55)%, (11.11±7.20)%]}, respectively, with a statistically significant differences (all P<0.05). The changes in V105 on the weekly CBCT images [(3.27±2.91)%, (2.07±2.93)%, (2.14±2.08)%] and V100 on the second and third weeks′ images [(0.44±0.54)%, (0.54±0.50)%] for the field avoidance-region plan were smaller than those for the normal full-arc plan [(8.22±5.87)%, (5.31±3.97)%, (6.91±3.34)% and (1.70±1.53)%, (2.22±1.97)%], with a statistically significant difference (all P<0.05). Conclusions:The field avoidance-region plan demonstrates higher robustness and better small bowel protection than the normal full-arc plan. The influence of intestinal air cavities on dose distribution should be considered during VMAT planing for cervical cancer to guide optimal plan selection.

Objective:To investigate the protocol and clinical efficacy of hair follicle-bearing microskin (HF-MS) transplantation in the treatment of hypertrophic scars.Methods:Prospective randomized controlled trial. From January to November 2024, patients with hypertrophic scars were recruited from the Medical Cosmetic Center of Affiliated Hangzhou First People’s Hospital with Westlake University School of Medicine and the Department of Plastic and Reconstructive Surgery of Ningbo Sixth Hospital. Patients were randomly divided into the observation group and the control group using a random number table. In the observation group, 1.0 mm punch decompression was performed on the hypertrophic scar area, followed by implantation of HF-MS extracted from the scalp donor site using follicular unit excision (FUE) into the decompression pores. The control group underwent only 1.0 mm punch decompression. Vancouver scar scale (VSS) scores (total score 0-15, higher scores indicating more severe scarring) were assessed preoperatively and at 1, 3, and 6 months postoperatively. Efficacy at 6 months, improvement in hypertrophic scar area, hair survival rate (observation group), adverse reactions, and patients’ satisfaction rates were evaluated. Categorical data were expressed as frequency (%) and analyzed using chi-square tests; normally distributed measurement data were expressed as Mean ± SD and analyzed using independent samples t-tests. Results:A total of 50 patients were included (25 per group), with 22 males and 28 females, aged 18-60 years (mean age: 33 years). The effective rate was 92% (23/25) in the observation group and 68% (17/25) in the control group, showing a statistically significant difference ( P<0.05). Preoperative VSS scores did not differ significantly between the observation and control groups [(6.67±3.19) vs. (7.12±2.89), P>0.05]. At 1, 3, and 6 months postoperatively, the observation group had VSS scores of (5.48±2.60), (4.64±2.39), and (3.80±2.10), respectively, compared to (6.36±2.53), (5.84±2.28), and (5.32±2.09) in the control group. The 6-month postoperative VSS scores differed significantly between groups ( P<0.05). Preoperative hypertrophic scar areas showed no significant difference [(5.75±2.83) cm 2 vs. (6.91±3.31) cm 2,P>0.05]. At 6 months postoperatively, the observation group had significantly smaller scar areas than the control group [(3.15±1.55) cm 2 vs. (5.37±2.93) cm 2,P<0.01]. The average hair survival rate in the observation group was 41% at 6 months. Adverse reactions occurred in 3 cases in the observation group (2 skin indurations, 1 hyperpigmentation) and 7 cases in the control group (4 hyperpigmentation, 2 skin atrophy, 1 skin induration). The observation group had a significantly lower adverse reaction rate [12% (3/25) vs. 28% (7/25), P<0.05]. Patient satisfaction rates were 88% (22/25) in the observation group and 64% (16/25) in the control group ( P<0.05). Conclusion:HF-MS transplantation demonstrates definitive clinical efficacy in treating hypertrophic scars, effectively improving scar morphology, clinical symptoms, and patient quality of life.