Traditional treatment for type 1 diabetes mellitus （T1DM） primarily involves insulin replacement， yet some patients encounter issues such as significant blood glucose fluctuations， high risk of hypoglycemia， and weight gain. In recent years， the adjuvant therapeutic role of non-insulin hypoglycemic drugs in T1DM has gradually gained attention. This article reviews the mechanisms of action and clinical research progress of five types of non-insulin hypoglycemic drugs in the treatment of T1DM： amylin analogues （pramlintide）， biguanides （metformin）， sodium-glucose co-transporter 2 inhibitor， dipeptidyl peptidase-4 inhibitor， and glucagon-like peptide-1 receptor agonist. It is found that these drugs can enhance clinical benefits for T1DM patients by improving insulin sensitivity， delaying gastric emptying， promoting urinary glucose excretion， and regulating incretin levels， thereby reducing glycated hemoglobin levels， decreasing insulin dosage， and managing body weight. Simultaneously， these drugs also present limitations such as low patient compliance due to complex dosing regimens， increased risk of diabetic ketoacidosis， and heterogeneity in glycemic control. Future research could focus on developing individualized treatment strategies， combining pharmacogenomics with novel biomarkers to precisely identify subpopulations of patients who may benefit， and delving into the potential value of these drugs in delaying diabetic vascular complications and improving patients’ quality of life.

ObjectiveTo investigate the short-term efficacy and safety of different doses of Botulinum toxin type A (BTX-A) injected under ultrasound guidance combined with modified catheter-balloon localization for post-stroke cricopharyngeal dysfunction (CPD), and to explore a relatively appropriate dose. MethodsA total of 136 patients with post-stroke CPD admitted to Taizhou Hospital of Zhejiang Province from December, 2023 to February, 2026 were randomly assigned into control group, 50 U group, 70 U group and 100 U group, with 34 patients in each group. The control group received conventional rehabilitation, whereas the three BTX-A groups received conventional rehabilitation plus the corresponding dose of BTX-A injected under ultrasound guidance combined with modified catheter-balloon localization. Videofluoroscopic Swallowing Study (VFSS) scores, Functional Oral Intake Scale (FOIS) scores, Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS) grades, Murray Secretion Severity Scale (MSS) grades and ultrasonographic parameters were compared before and two weeks after intervention. ResultsAfter intervention, FOIS scores improved significantly in all groups (|Z| > 2.843, P < 0.01), and YPR-SRS and MSS grades also showed significant improvements in all BTX-A groups (|Z| > 4.147, P < 0.001). Pairwise comparisons revealed that the order of improvement from best to worst for FOIS, YPR-SRS and MSS grades was the 100 U group, followed by 70 U group, and then 50 U group (P < 0.05). For VFSS scores, the effect of time, group and interaction were all significant (F > 9.68, P < 0.001); pairwise comparisons showed that 100 U group achieved the best outcomes (P < 0.001). Regarding the activity and velocity of the geniohyoid muscle, the effects of time, group and interaction were also significant (F > 7.34, P < 0.001); pairwise comparisons indicated that 100 U group outperformed the other groups in both activity and velocity (P < 0.001). For hyoid bone displacement distance and shortening rate, the effects of time and interaction were significant (F > 3.07, P < 0.05), and the main effects of time on duration and velocity were significant (P < 0.01); pairwise comparisons showed that the 100 U group had superior displacement distance and shortening rate compared to the other groups (P < 0.05). During the treatment and follow-up periods, no serious adverse event occurred in any group. ConclusionUltrasound-guided BTX-A injection assisted by modified catheter-balloon localization may further improve short-term swallowing function in patients with post-stroke CPD， with a dosage of 100 U.

Objective To explore the effects of breast-conserving surgery (BCS), simple mastectomy (SM), and modified radical mastectomy (MRM) on early postoperative upper limb motor function, physical and psychological status in breast cancer patients. Methods A total of 212 female breast cancer patients undergoing surgery at the Department of Breast Surgery of Zhangzhou Affiliated Hospital of Fujian Medical University from October 2024 to December 2025 were enrolled. Patients were divided into the BCS group (n＝34), SM group (n＝79), and MRM group (n＝99). General demographic and clinical data were collected. At 3–7 days postoperatively, the Constant-Murley score (CMS), active range of motion (AROM) of the shoulder joint, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score were used to assess upper limb function; the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate patients’ psychological status, quality of life, and sleep quality. Results The total CMS score, pain score, and range of motion score in the BCS group were higher than those in the SM and MRM groups (P＜0.05). The BCS group showed greater forward flexion range of motion than that in the SM and MRM groups (P＜0.05); and the SM group showed smaller internal rotation range of motion than that in the MRM and BCS groups (P＜0.05). The PHQ-9 depression score in the BCS group was significantly higher than that in the MRM group (P＜0.05). There were no statistically significant differences among the three groups in QuickDASH, GAD-7, FACT-B, or PSQI scores. Conclusions Early postoperative upper limb function and depression status varied among breast cancer patients undergoing different surgical procedures. Patients undergoing BCS had better preservation of upper limb function but higher depression scores.

Objective: To investigate the antibody testing demand and its influencing factors among college students in Shaoxing City Zheijiang Province, so as to provide evidence for carrying out HIV antibody testing services for college students. Methods: From November to December 2022, stratified cluster random sampling method was used to survey college students from 13 colleges in Shaoxing City. Data on socio-demographic information, demand for HIV antibody testing, sexual behaviors, and HIV-related knowledge were collected through a self - designed questionnaire. Factors affecting HIV antibody demand among college students were analyzed using a multivariable logistic regression model. Results: A total of 43 716 college students were surveyed, including 19 471 males (44.54%) and 24 245 females (55.46%). There were 2 004 college students (4.58%) with HIV antibody testing demand. Multivariable logistic regression analysis showed that female students (OR=1.344, 95%CI: 1.217-1.485), those in undergraduate institutions (OR=1.296, 95%CI: 1.168-1.438), homosexuals (OR=1.742, 95%CI: 1.301-2.333) or bisexual/uncertain (OR=1.342, 95%CI: 1.171-1.537), those who had sexual experience (OR=1.416, 95%CI: 1.210-1.657), those who had sex with men in the past 6 months (OR=2.164, 95%CI: 1.405-3.333), those who received HIV testing promotion at school in the past year (OR=1.500, 95%CI: 1.327-1.695), and those with perceived risk of HIV infection (OR=5.875, 95%CI: 5.336-6.468) had greater HIV antibody testing demand. Conclusions The HIV testing demand among college students is associated with gender, school type, sexual orientation, sexual behaviors, HIV testing promotion, and perceived risk of HIV infection. It is recommended to strengthen HIV knowledge dissemination of AIDS knowledge and mobilization for HIV antibody testing in colleges to improve the accessibility of HIV antibody testing services.

Object:To explore the feasibility of using artificial intelligence for quality control of echocardiographic images.Methods:Retrospectively，5 000 two-dimensional echocardiographic video images within the period from 2021 to 2023 were randomly retrieved from the echocardiography database of Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School，Nanjing University. Among these selected images，1 559 of them were apical views. The physician team formulated the scoring rules，which specifically included four scoring criteria：gain，scaling ratio，cardiac axis angle，and structure. Subsequently，the data were labeled with view classification and image quality scores. The labeled data were further partitioned into the training set（ n = 643），the validation set（ n = 276），and the test set（ n = 640）. The training and validation sets were utilized for constructing the models for view classification and quality assessment，while the test set was employed to verify the models' effectiveness. The view classification module was implemented using the SlowFast model，and the quality assessment module involved algorithms such as ResNet，Video Swin Transformer，SSD，and U-Net. Results:The average accuracy，precision，recall rate and F1 score of the classification model in identifying each apical view were 0.987 1，0.983 0，0.987 1 and 0.984 9 respectively，and the inference time was（333.4 ± 105.4）ms. The average accuracies of the quality assessment module in terms of gain，scaling ratio，cardiac axis angle and display of main structures were 0.915 1，0.928 2，0.938 7 and 0.965 6 respectively，and the overall scoring accuracy was 0.912 7.Conclusions:The echocardiogram quality control system developed in this research can effectively classify and evaluate the quality of two-dimensional images of the apical views in echocardiograms. Moreover，it guarantees the objectivity，timeliness and high-efficiency of quality control，which has reference value for the establishment of the echocardiogram quality control system.

AIM To optimize the extraction process for Bletillae Rhizoma,and to evaluate its anti-oxidant,tyrosinase inhibitory activities.METHODS With ultrasound time,ethanol concentration and solid-liquid ratio as influencing factors,the total extraction content of gastrodin,protocatechualdehyde,p-hydroxybenzaldehyde,1,4-bis[4-(gluconoxy)benzyl]-2-isobutylmalate-2-glucoside,1,4-bis[4-(gluconoxy)benzyl]-2-isobutylmalate,yam Ⅲ,dihydropinosin and 3'-O-methylyam Ⅲ as an evaluation index,the extraction process was optimized by Box-Behnken response surface method.Subsequently,the extract's scavenging effects on DPPH,ABTS+free radicals,and inhibitory ability on tyrosinase were determined.RESULTS The optimal conditions were determined to be 49 min for ultrasound time,55％for ethanol concentration,1∶30 for solid-liquid ratio,and 2 times for extraction frequency,the total extraction content was 13.18 mg/g.The extract demonstrated the IC50 of 10.12,314.07 and 1.70 μg/g on DPPH,ABTS+free radicals and tyrosinase,respectively.CONCLUSION This simple,reliable and stable method can be used for the extraction for Bletillae Rhizoma with strong anti-oxidant,tyrosinase inhibitory activities.

AIM To investigate the effects of Shuyu Pills combined with evolimus on the epithelial mesenchymal transformation of triple negative breast cancer cells 4T1 and MDA-MB-231 induced by TGF-β1.METHODS The 4T1 and MDA-MB-231 cells were divided into the blank group and the induction group to induce the epithelial mesenchymal transformation with TGF-β1 cytokine treatment,followed by the assignment into the model group,the Shuyu Pills group,the everolimus group and the Shuyu Pills combined with everolimus group.CCK8 method,plate cloning method,cell scratch test and Transewll test were used to detect the proliferation,cloning formation,migration and invasion ability of the cells whose expressions of E-cadherin,N-cadherin,Vimentin,MMP9,MMP2 and pathway proteins PTEN,PI3K,Akt and mTOR were detected by Western blot.RESULTS Compared with the blank group,the induction group displayed a cell morphological change from epithelioid to stromal,decreased expression of E-cadherin protein(P＜0.01);and increased protein expressions of N-cadherin and Vimentin(P＜0.05).Compared with the model group,each group intervened with the medicine displayed decreased proliferation,clone formation,migration and invasion ability of both kinds of cells(P＜0.01);increased protein expressions of PTEN and E-cadherin(P＜0.05,P＜0.01);and decreased protein expressions of PI3K,Akt,mTOR,N-cadherin,Vimentin,MMP9 and MMP2(P＜0.05,P＜0.01);and more significantly in the Shuyu Pills combined with evolimus group(P＜0.05,P＜0.01).CONCLUSION With a more ideal effect than the single uses in inhibiting the TGF-β1-induced epithelial mesenchymal transformation of triple-negative breast cancer cells,the combination use of Shuyu Pills and everolimus may work through the regulation of PI3K/Akt/mTOR signaling pathway.

Chronic kidney disease(CKD)is a chronic disease characterized by renal structural damage and dysfunction.At present,there is still a lack of effective therapeutic drugs and prevention and treatment methods for CKD in clinical practice.More and more studies have shown that necroptosis,as a new type of programmed cell death,plays a vital role in the onset and progression of CKD.Targeting key molecules in the necroptosis pathway,such as RIPK1,RIPK3 and MLKL,the development of small molecule inhibitors has become an emerging strategy for the treatment of CKD,and has shown significant potential to pro-tect the kidneys and alleviate renal fibrosis in a variety of in vitro and in vivo models.Therefore,this article summarizes the re-search progress of the mechanism of necroptosis in recent years,and focuses on the potential role of necroptosis in the pathogene-sis of CKD and the therapeutic potential of targeting this path-way,providing a new perspective and research direction for the prevention and treatment of CKD in the future.

Aim To explore the compatibility and po-tential mechanism of effective components of Biejia-Ezhu against triple negative breast cancer(TNBC)and verify it by experiments.Methods Effective compo-nents and targets of Biejia-Ezhu were obtained by TC-MSP and Swiss Target Prediction.Disease targets of TNBC were obtained from OMMI and GeneCards data-bases.The PPI network was constructed using STRING database.GO and KEGG path enrichment analysis was performed using DAVID database.Cytoscape3.9.1 software was used to construct the"drug-component-target-disease"network,screen key targets and compo-nents for molecular docking,and further verify the com-patibility of key components and targets in vitro.Re-sults ① A total of 71 effective components were iden-tified in the Biejia-Ezhu drug pair.There were 146 drug targets associated with the disease.A total of 113 signaling pathways were identified by KEGG analysis.The 71 potential active components of Biejia-Ezhu mainly acted on key targets such as mTORC1,ULK1,TNF,EGFR,ESR1,STAT3,HIF1A,and PTGS2.Mo-lecular docking results showed that glycine and curcu-min were the key active components of Biejia-Ezhu,and both had strong docking activity against key target proteins mTORC1 and ULK1.②The results of in vitro experiment showed that glycine combined with curcu-min significantly inhibited the proliferation and clonal formation ability of TNBC cells(P＜0.05),up-regula-ted the expression of autophagy marker LC3 Ⅱ/Ⅰ,down-regulated the expression of EGFR,down-regula-ted the expression of pathway protein mTORC1,p-mTOR,p-ULK1,and promoted the expression of path-way protein ULK1(P＜0.05).Conclusion The key component of Biejia-Ezhu against triple-negative breast cancer is glycine-curcumin,the mechanism of which may be related to the regulation of the mTORC1/ULK1 signaling pathway to promote autophagy.

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.