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 epidemiological characteristics of malaria and provide a basis for developing improved prevention and control measures. Methods Data were obtained from the Chinese Disease Prevention and Control Information System. Malaria surveillance data for Nanning City from January 1,2023, to December 31,2024, were exported from the Infectious Disease Reporting Information Management Subsystem. The characteristics of the two groups of malaria cases were compared. Results A total of 103 imported malaria cases were reported in Nanning City in 2024, representing a 38.32% decrease compared with the same period of the previous year. No statistically significant difference were observed between cases reported in 2023 and 2024 in terms of average age, gender ratio, proportion of parasite species, and monthly reporting distribution;however, statistically significant differences were found in the proportion of reporting areas and current residence areas(χ2= 13.572 and 10.355, respectively; P = 0.001 and 0.035, respectively). The proportion of cases reported in Shanglin County and the proportion of cases residing in Shanglin County were both lower than those during the same period of the previous year. Conclusions The high aggregation of imported malaria cases in Nanning City has decreased. Medical institutions in areas other than Shanglin County should strengthen their vigilance against malaria.

ObjectiveThe quality of fresh Gastrodiae Rhizoma directly determines the efficacy of its terminal products. According to the theory of excellent shape， high quality， and superior effect of authentic medicinal materials， this study aimed to develop a novel quality evaluation system for fresh Gastrodiae Rhizoma by systematically quantifying and integrating appearance traits with bioactive components. MethodsFresh Gastrodiae Rhizoma samples were collected from four major producing regions. After herbal textural research and a literature review， tuber weight， width， length， and aspect ratio were selected as quantitative indicators of appearance， and they were measured by an electronic balance and a digital vernier caliper. Key active components， including gastrodin， p-hydroxybenzyl alcohol， parishins， and total polysaccharides， were quantified via ultra performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS） and the phenol-sulfuric acid method. Descriptive statistics and K-means clustering analysis were employed to establish the threshold ranges for the excellent shape and high quality indicators. ResultsTwo specific quantitative evaluation systems for characterizing the excellent shape and high quality of fresh Gastrodiae Rhizoma were established. System 1： tuber weight > 83.90 g， tuber width > 3.50 cm， total gastrodin and p-hydroxybenzyl alcohol content > 0.277%， and total parishin content > 0.561%. System 2： tuber length < 9.89 cm， aspect ratio < 3.41， and total polysaccharide content > 195.274 mg·g^-1. The verification results showed that the systems effectively identified fresh Gastrodiae Rhizoma samples with both excellent appearance features and stable bioactive components. ConclusionThis study establishes a multi-dimensional evaluation and grading system for fresh Gastrodiae Rhizoma based on the correlation between shape and quality. This framework provides a scientific basis for the quality control and resource grading of fresh Gastrodiae Rhizoma and lays a methodological foundation for the efficient utilization of both the medicinal and edible value of this herbal medicine.

Objective:To analyze the application value of the Health Action Process Approach(HAPA)model in re-habilitation exercise intervention of patients with supraventricular tachyarrhythmia.Methods:We enrolled clinical data of 117 patients diagnosed as supraventricular tachyarrhythmia in Xinzhou District People's Hospital of Wuhan between February 2019 and January 2023.They were divided into routine group(n=57)and HAPA model group(n=60)according to different intervention method.Participants in routine group received routine rehabilitation exer-cise,while those in HAPA model group received HAPA model rehabilitation exercise.Both groups were intervened for 6 months.Cardiac function,medication compliance[Morisky medication adherence scale(MMAS-8)],daily living capacity(Barthel index),quality of life[the short-form 36 health survey(SF-36)],total effective rate of intervention,incidence of adverse events within 6-month follow-up were compared between two groups.Results:Compared with patients in routine group,those in HAPA model group had significant higher left ventricular ejection fraction(LVEF)[(56.75±1.13)％vs.(52.65±1.57)％],Barthel index[(65.60±9.76)points vs.(56.37±9.98)points],MMAS-8 score[(6.73±1.83)points vs.(4.91±1.33)points],SF-36 total score[(67.50±15.25)points vs.(55.28±9.05)points]and total effective rate(88.33％ vs.71.93％)(P＜0.01 all),and signifi-cant lower left ventricular end-systolic volume(LVESV)[(54.97±2.60)ml vs.(64.61±2.50)ml],left ventric-ular end-diastolic volume(LVEDV)[(117.50±4.23)ml vs.(133.38±4.47)ml]and incidence of adverse events within 6-month follow-up(5.00％ vs.22.81％)(P＜0.01 all).Conclusion:Rehabilitation exercise based on HAPA model could significantly improve cardiac function,medication compliance,daily living capacity and quality of life with good safety in patients with supraventricular tachyarrhythmia.

Vulvar lichen sclerosus(LS)is a chronic inflammatory skin and mucosal disease with unknown pathogenesis,which may lead to scar formation of the external genitalia and sexual dysfunction,seriously affecting the quality of life of patients.Genetic factors,autoimmune factors,infections,environment,and hormones are associated with the onset of vulvar LS,and there are also many uncertainties in its clinical diagnosis and treatment.Therefore,based on extensive literatures,this article provides a review of the pathogenesis,diagnosis and evaluation,treatment methods,prognosis and management of vulvar LS.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Objective To develop a fused model based on combined intratumor-peritumor radiomics features and clinical risk factors to accurately predict the efficacy of radiotherapy for hepatocellular carcinoma(HCC).Methods A retrospective study was conducted on 124 HCC patients(95 males and 29 females)undergoing IMRT at the radiotherapy center of some hospital,who were divided into a training set and a validation set in a 7∶3 ratio.According to relevant standards for evaluating solid tumor treatment efficacy the patients at the progressive disease phase were enrolled into a non-response group,and the ones at the phases of complete response,partial response and stable disease were included into a response group.Firstly,radiomics features were extracted from pre-radiotherapy contrast-enhanced CT images,and were screened with the least absolute shrinkage and selection operator(LASSO)regression to obtain valuable radiomics features;secondly,the scores of intratumor radiomics features,peritumor radiomics features and combined intratumor-peritumor radiomics features underwent binary Logistic regression(LR)analysis by using the glmnet package in R software(version 4.2.0),so as to construct three models for intratumor radiomics features,peritumor radiomics features and combined intratumor-peritumor radiomics features;finally,a fused model was established based on the scores of combined intratumor-peritumor radiomics features and clinical risk factors,and the corresponding Nomogram,calibration curve and clinical decision curve were plotted.R software(version 4.4.1)was used for image analysis and statistical analysis.Results The fused model based on the scores of combined intratumor-peritumor radiomics features and clinical risk factors achieved an AUC of 0.87 on both the training and validation sets,outperforming the models based solely on intratumor radiomics features,peritumor radiomics features or combined intratumor-peritumor radiomics features.The Nomogram plot showed the prediction probability of the fused model for the short-term treatment response rate was 10%-90%within the total score range of 42-93 points,and the calibration and clinical decision curves indicated that the fused model gained advantages in prediction and clinical application.Conclusion The fused model based on the scores of combined intratumor-peritumor radiomics features and clinical risk factors predicts the short-term efficacy of HCC radiotherapy effectively,providing references for formulating radiotherapy plans and guiding subsequent treatment decisions.

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 incidence and types of patient-ventilator asynchrony(PVA)in mechanically ventilated patients within the intensive care unit(ICU),and to identify associated high-risk factors,thereby providing a basis for reducing PVA,enhancing mechanical ventilation efficiency,and refining ventilation strategies.Methods A prospective observational study was conducted among patients admitted to the general ICU of the Affiliated Hospital of Guizhou Medical University from October to December 2024 who were receiving mechanical ventilation.Inclusion criteria were as follows:age ≥18 years and mechanical ventilation duration ≥12 hours.Exclusion criteria included complete controlled mechanical ventilation,palliative care or do-not-resuscitate status,and lack of informed consent.Senior respiratory therapists performed daily bedside observations of ventilator waveforms for 10～15 minutes between 08:00 and 12:00.PVA was diagnosed based on pressure-time and flow-time waveforms,with the types of PVA being recorded.Demographic and clinical data,including age,sex,body mass index(BMI),primary diagnosis,comorbidities,APACHEⅡ score at ICU admission,blood gas analysis,ventila-tion mode and parameters,analgesia and sedation status,duration of mechanical ventilation,and length of ICU stay,were collected.The incidence and types of PVA during the observation period were analyzed.Univariate and multivariate logistic regression analyses were performed to identify high-risk factors for PVA.Clinical outcomes were compared between patients with and without PVA.Results A total of 105 patients and 453 episodes of assisted mechanical ventilation waveforms were analyzed.Among these,60.95％(64/105)experienced at least one episode of PVA.Of the 453 ventilation waveforms assessed,35.76％(162/453)demonstrated PVA.The types of PVA,ranked by incidence,were as follows:cycling mismatch(12.58％,57/453),double triggering(11.92％,54/453),ineffective triggering(9.49％,43/453),flow starvation(5.30％,24/453),and exhalation flow limitation(1.77％,8/453).The incidence of PVA varied significantly across different ventilation modes:45.7％in volume-assist/control ventilation(V-A/C),38.1％in pressure-assist/control ventilation(P-A/C),42.9％in synchronized intermittent mandatory ventilation(SIMV),and 16.7％in pressure support ventilation(PSV)(P<0.001).Multi-variate logistic regression analysis revealed that the mechanical ventilation mode[reference:PSV;V-A/C:OR=4.687,95％CI:2.140～10.263,P<0.001;P-A/C:OR=2.922,95％CI:1.489～5.734,P=0.002;SIMV:OR=4.682,95％CI:1.758～12.466,P=0.002]and actual respiratory rate(OR=1.07,95％CI:1.016～1.127,P=0.011)were significant high-risk factors for PVA.Patients with PVA had a significantly longer duration of mechanical ventilation[8.21(5.35,13.91)days vs.3.00(1.96,5.71)days,P<0.001]compared to those without PVA.Conclusions PVA is commonly observed in ICU patients receiving assisted invasive mechanical ventilation,with cycling mismatch,double triggering,and ineffective triggering being the most prevalent types.The incidence of PVA tends to be lower when using the PSV mode.Clinically,real-time monitoring of patient-ventilator synchrony via ventilator waveforms,along with the optimization of ventilator modes and parameters,should be employed to minimize the occurrence of PVA and enhance the efficiency of mechanical ventilation.

Background:Optimizing cultivation techniques for traditional Chinese medicine has become a crucial means to improve the quality of medicinal materials.Microbial agents,as environmentally friendly and efficient plant growth promoters and soil conditioners,have increasingly attracted attention in eco-agriculture research.Objective:Our understanding remains limited regarding how the application of microbial agents,alone or in combination,affects changes in the rhizosphere microbiome and its association with the bioactive components of medicinal materials.Methods:In this study,Epimedium pubescens Maxim.was employed as a model plant to examine the effects of 2 microbial agents(Paenibacillus mucilaginosus and Bacillus subtilis)applied individually and in combination on plant growth and the accumulation of bioactive components.Additionally,this study explored the relationship between the rhizosphere microbiome and plant development.Results:The application of microbial agents increased the yield of E.pubescens leaves by 20.30％to 33.66％and enhanced the total flavonol glycosides content by 11.40％to 29.94％.Meanwhile,microbial treatments reshaped the rhizosphere microbiome,promoted the enrichment of beneficial microorganisms(e.g.,Frankia and Paenibacillus),suppressed phytopathogenic fungi such as Didymella and Scytalidium,and enhanced the stability of the soil microbial co-occurrence network.The partial least squares path model suggested that microbial agents not only directly impact the quality of medicinal herbs but also indirectly alter the accumula-tion of bioactive components by modulating the soil microbiome.Conclusion:These findings deepen our understanding of the relationship between medicinal plant quality and rhizosphere micro-biomes as mediated by microbial agents.They also provide a basis for designing and manipulating synthetic microbial communities to promote sustainable development in eco-agriculture.