Ductular reaction （DR） refers to the adaptive pathological changes that occur after hepatobiliary injury， and it is essentially a repair response involving the proliferation， fibrosis， and inflammation of biliary epithelial cell （BEC）. With the understanding of the biological function of BEC， the potential value of DR in disease prognosis and treatment has gradually become a research hotspot. This article systematically reviews the molecular mechanism of DR， its potential as a therapeutic target， and future development directions， as well as novel therapies suggested by targeting these molecular mechanisms， in order to provide a new direction for overcoming current bottlenecks in the treatment of bile duct diseases.

Animal model research on spleen and stomach diseases in traditional Chinese medicine （TCM） is of great significance for elucidating the nature of diseases and syndromes and for revealing the mechanisms of action of Chinese herbal medicinals. At present， studies on classical TCM syndrome models of spleen and stomach diseases mainly focus on spleen deficiency syndrome， liver constraint syndrome， and damp-heat syndrome. Model construction is mostly based on the etiological and pathophysiological characteristics of syndrome， and model evaluation primarily involves macroscopic manifestations and physicochemical indicators. This paper summarizes the current research status of animal models integrating disease and syndrome for seven common spleen and stomach diseases， including chronic gastritis and gastric precancerous lesions， gastroesophageal reflux disease， functional dyspepsia， inflammatory bowel disease， irritable bowel syndrome， functional constipation， and functional diarrhea. The modeling methods and characteristics of disease-syndrome combined animal models for each disease are analyzed. It is proposed that future research on disease-syndrome integration in spleen and stomach diseases should move toward syste-matic， precise， and integrative development， and that interdisciplinary and cross-disciplinary research approaches should be adopted to enhance the predictive value and application efficiency of disease-syndrome combined animal models.

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 investigate the role of JAK2/STAT3 signaling pathway mediated Treg/Th17 imbalance in children with cow's milk protein allergy and the effect of dietary avoidance on the imbalance.Methods A total of 103 children with cow's milk protein allergy in the hospital were enrolled and divided in-to the IgE-mediated group(n=38)and the non-IgE-mediated group(n=65).All patients underwent a 3-month strict dietary avoidance intervention.A total of 100 healthy children who underwent health checkups at the hospital's physical examination center during the same period,with no history of food allergy or other im-mune-related diseases,were selected as the healthy control group.The percentages of Treg and Th17 cells were measured by flow cytometry.The mRNA expression levels of JAK2,STAT3,SOCS1,and SOCS3 were determined by qPCR.Differences between groups,changes before and after dietary avoidance,and correlations between these indicators and clinical symptoms were analyzed using Pearson's test.Results At baseline,both the IgE-mediated group and the non-IgE-mediated group had significantly lower Treg percentages and SOCS1/SOCS3 mRNA levels,and higher Th17 percentages and JAK2/STAT3 mRNA levels compared to the healthy control group(P＜0.05).After dietary avoidance,Treg percentages and SOCS1/SOCS3 mRNA levels in-creased,while Th17 percentages and JAK2/STAT3 mRNA levels decreased in the IgE-mediated group and the non-IgE-mediated group(P＜0.05).The increase of Treg percentage and the decrease of Th17 percentage in the non-IgE-mediated group were greater than in the IgE-mediated group,whereas the increases of SOCS1 and SOCS3 mRNA levels were smaller in the non-IgE-mediated group(P＜0.05).Logistic regression identified JAK2,STAT3,SOCS1,and SOCS3 mRNA levels as factors influencing Treg and Th17 percentages(P＜0.05).Pearson correlation analysis revealed that allergic symptom scores and serum milk-specific IgE levels were positively correlated with JAK2/STAT3 mRNA levels and Th17 percentage,and negatively correlated with SOCS1/SOCS3 mRNA levels,Treg percentage,and the Treg/Th17 ratio(P＜0.05).Conclusion Dieta-ry avoidance can modulate the activity of JAK2/STAT3 signaling pathway,with a more pronounced improve-ment in non-IgE-mediated cow's milk protein allergy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

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 correlation between the proximal angle of carotid atherosclerotic plaques and neovascularization scores,and their clinical application value in predicting recurrent cerebral infarction.Methods A total of 88 patients who underwent carotid plaque ultrasound examination in our hospital were selected.According to CT/MRI results,patients were divided into the non-cerebral infarction group(45 cases)and the cerebral infarction group(43 cases).Conventional ultrasound examination was performed followed by contrast-enhanced ultrasound.Plaque length,thickness and proximal angle were measured,and the neovascularization score of the proximal end was evaluated using contrast-enhanced ultrasound,and the results were compared and analyzed.Results In the cerebral infarction group,plaque thickness,proximal angle,and neovascularization score were significantly higher than those in the non-cerebral infarction group(P＜0.05),while there was no significant difference in plaque length.The proportion of plaques with a proximal neovascularization score of 2 or 3 was higher in the cerebral infarction group than those of the non-cerebral infarction group(79.1%vs.24.4%,P＜0.01).A positive correlation was found between the proximal angle and neovascularization score in all patients(rs=0.374,P＜0.01).There was no significant difference between the area under the ROC curve for neovascularization score in predicting recurrent cerebral infarction and the proximal angle(P＞0.05).The optimal cutoff value of the proximal angle was 18.8,and the sensitivity and the specificity for predicting recurrent cerebral infarction were 93.0%and 62.2%.In the cerebral infarction group,seven patients(16.3%)had recurrent infarction within one year,and these patients had higher proximal neovascularization scores,with angles greater than 18.8°.Conclusion There is a strong correlation between proximal angle of carotid plaques and neovascularization score,which has a positive predictive role in the recurrence of cerebral infarction,providing a reliable auxiliary diagnostic basis for clinical practice.

Objective To explore the correlation between the proximal angle of carotid atherosclerotic plaques and neovascularization scores,and their clinical application value in predicting recurrent cerebral infarction.Methods A total of 88 patients who underwent carotid plaque ultrasound examination in our hospital were selected.According to CT/MRI results,patients were divided into the non-cerebral infarction group(45 cases)and the cerebral infarction group(43 cases).Conventional ultrasound examination was performed followed by contrast-enhanced ultrasound.Plaque length,thickness and proximal angle were measured,and the neovascularization score of the proximal end was evaluated using contrast-enhanced ultrasound,and the results were compared and analyzed.Results In the cerebral infarction group,plaque thickness,proximal angle,and neovascularization score were significantly higher than those in the non-cerebral infarction group(P＜0.05),while there was no significant difference in plaque length.The proportion of plaques with a proximal neovascularization score of 2 or 3 was higher in the cerebral infarction group than those of the non-cerebral infarction group(79.1%vs.24.4%,P＜0.01).A positive correlation was found between the proximal angle and neovascularization score in all patients(rs=0.374,P＜0.01).There was no significant difference between the area under the ROC curve for neovascularization score in predicting recurrent cerebral infarction and the proximal angle(P＞0.05).The optimal cutoff value of the proximal angle was 18.8,and the sensitivity and the specificity for predicting recurrent cerebral infarction were 93.0%and 62.2%.In the cerebral infarction group,seven patients(16.3%)had recurrent infarction within one year,and these patients had higher proximal neovascularization scores,with angles greater than 18.8°.Conclusion There is a strong correlation between proximal angle of carotid plaques and neovascularization score,which has a positive predictive role in the recurrence of cerebral infarction,providing a reliable auxiliary diagnostic basis for clinical practice.

Objective:This study aimed to compare the clinical efficacy of da Vinci robot-assisted subtotal colectomy with laparoscopic surgery in the treatment of slow transit constipation.Methods:A retrospective cohort study was performed. The clinical and follow-up data of 95 patients with slow transit constipation who underwent robotic or laparoscopic subtotal colectomy at the First Affiliated Hospital of Harbin Medical University from July, 2022 to August, 2024 and had a follow-up period of 6 months were retrospectively analyzed. Patients were divided into a robotic surgery group (43 cases) and a laparoscopic surgery group (52 cases) according to surgical approaches. All patients underwent preoperative colonic transit study, barium enema radiography, defecography, and colonoscopy to confirm the diagnosis of slow transit constipation. There were no statistically significant differences in baseline data between the two groups (all P>0.05). Primary observation indicators included Wexner constipation score, gastrointestinal quality of life score, and the time of first ambulation after surgery. Secondary observation indicators included operation time, intraoperative blood loss, first defecation time, length of hospital stay, postoperative defecation frequency, postoperative complications, surgical satisfaction, and postoperative pain. The Wexner constipation score was evaluated at 6 months after surgery as well, and a total score of 15 or above was defined as constipation; the higher the score, the more severe the constipation. The gastrointestinal quality of life index was also evaluated at 6 months after surgery; the lower the score, the poorer the quality of life. Pain assessment was conducted on the 2nd day after surgery using the visual analogue scale (VAS) for self-assessment, and here a higher score indicated greater pain intensity. Observe the patients' intraoperative and pastoperative conditions. Results:Both groups completed the surgery unevenifullg without conversion to laparotomy, and no severe intraoperative complications occurred. Compared to the laparoscopic surgery group, the robotic surgery group had significantly shorter first ambulation time ([18.5±1.3] hours vs. [24.5±0.6] hours, t=-30.437, P<0.001), first defecation time ([21.2±2.2] hours vs. [24.9±0.9] hours, t=-10.818, P<0.001), and hospital stay ([7.8±1.5] days vs. [9.4±3.3] days, t=-3.069, P=0.003), all P<0.05. There were no statistically significant differences between the two groups in terms of operation time, intraoperative blood loss, postoperative pain score, defecation frequency, or incidence of postoperative complications (all P>0.05). Follow-up at 6 months post-operation also showed no statistically significant differences between the two groups in terms of Wexner score, gastrointestinal quality of life score, daily defecation frequency, or surgical satisfaction (all P>0.05). When comparing the follow-up scores between postoperative and preoperative periods in each group, both Wexner scores (laparoscopic group: [2.2±1.2] vs. [17.7±0.9], t=83.580, P<0.001; robotic group: [2.6±1.2] vs. [17.5±0.8], t=69.274, P<0.001) and gastrointestinal quality of life scores (laparoscopic group: [108.6±4.4] vs. [76.0±4.6], t=-41.442, P<0.001; robotic group: [109.3±6.1] vs. [77.8±6.4], t=-29.939, P<0.001) were significantly improved. No additional complications or recurrence were observed in both groups at 6 months post-operation. Conclusion:Compared to laparoscopic subtotal colectomy, da Vinci robot-assisted subtotal colectomy for slow transit constipation is associated with faster postoperative recovery and shorter hospital stays, and the operative times and therapeutic efficacy are similar between the two approaches.

Objective To improve the underwater technique during the start phase of breaststroke swimmers through swimming flume training and assess its effectiveness in enhancing competitive performance.Methods The participants were 14 male swimmers in the short-distance Level 4 category from the Shanghai Swimming Team,and they were randomly divided into the experimental group(n=7)and control group(n=7).The experimental group underwent swimming flume start training,while the control group underwent regular pool start training,and both groups received the training twice a week for 16 weeks.Before and after the 16-week training,a 15-m breaststroke start test was conducted.Repeated measures analysis of variance and paired t-tests were used to compare the changes in kinematic parameters(time,speed,and entry angle)between and within groups.Results After 16 weeks of specialized training,the 15-m performance at the start for the experimental group and control group(F(1,12)=6.52,P＜0.05,η2=0.39)showed an interaction,with the experimental group performing better after training compared to the control group before training(P＜0.05).In the experimental group,the duration of the pull-out phase(F(1,12)=10.28,P＜0.01,η2=0.46)and the second sliding phase(F(1,12)=4.81,P＜0.05,η2=0.22)was improved;the distance of the pull-out phase(F(1,12)=4.71,P＜0.05,η2=0.21)and the second sliding phase(F(1,12)=4.90,P＜0.05,η2=0.21)was improved;the speed of the pull-out phase(F(1,12)=4.77,P＜0.05,72=0.20)was significantl improved.The within-group statistics showed that the experimental group significantly improved their exit speed(P＜0.05).The hand entry angle was optimized(P＜0.05),while changes in other joint angles were not significant.Conclusions Swimming flume training reduced the time spent in the pull-out and second gliding phases during the breaststroke start,effectively preventing the speed loss during underwater gliding.This provides an experimental evidence for enhancing start performance and optimizing training method for breaststroke swimmers.