Myopia is a highly prevalent refractive error worldwide, with scleral remodeling accompanying excessive axial elongation being one of its core pathological features. As the crucial outer layer responsible for maintaining eyeball morphology and biomechanical stability, the sclera plays a decisive role in the pathogenesis and progression of myopia through abnormal alterations in its cellular components, extracellular matrix(ECM)metabolism, and regulatory networks. This review systematically summarizes recent research advances in scleral remodeling. It focuses on elucidating, from cellular and molecular perspectives, the mechanisms by which dysfunction of scleral fibroblasts, dysregulation of ECM metabolism(e.g., decreased collagen content, disrupted MMP-2/TIMP-2 balance), and complex regulatory networks involving multiple signaling pathways such as TGF-β, Wnt/β-catenin, and MAPK drive scleral thinning and reduced mechanical strength. Concurrently, the review provides a comprehensive analysis of the potential roles and existing controversies regarding factors like inflammatory responses and novel regulatory axes(e.g., FOXM1/METTL3/APOA1)in scleral remodeling. Furthermore, it discusses the current research status and application prospects of sclera-targeted intervention strategies(e.g., modulating specific pathways, supplementing exogenous factors), aiming to provide a theoretical basis and directional reference for a deeper understanding of myopia pathogenesis and the development of new prevention and treatment approaches.

Abstract Adolescents are a high risk group for non suicidal self injury (NSSI), and the severity of the issue has been increasing. However, stigma originating from self perceptions, the public, and healthcare professionals poses significant barriers to help seeking and recovery among adolescents with NSSI. The paper systematically reviews the main intervention strategies targeting NSSI related stigma in adolescents, along with their effectiveness, from three perspectives: educational approaches, contact based interventions, and public advocacy against stigma, aiming to inform the development of a scientific, effective, and multi stakeholder collaborative integrated intervention framework to provide a basis for reducing and ultimately eliminating stigma associated with adolescent NSSI.

Euodiae Fructus， a commonly used Chinese medicinal herb， has been widely used to treat gastrointestinal disorders， headaches， and vomiting， possessing significant medicinal value. According to traditional Chinese medical theory， Euodiae Fructus has the following effects： warming the middle to disperse cold， suppressing adverse Qi to relieve vomiting， and soothing the liver to alleviate pain. It is commonly used to treat diseases associated with cold stagnation in the liver and stomach， as well as gastrointestinal dysfunction. In recent years， as modern research on traditional Chinese medicine has advanced， increasing attention has been paid to the chemical constituents and pharmacological effects of Euodiae Fructus. Studies have isolated and identified various chemical constituents in this herb， including alkaloids， terpenoids， phenols， steroids， and volatile oils. Among them， alkaloids and terpenoids have been most extensively investigated. Studies suggest that Euodiae Fructus and some of its active constituents exhibit anti-inflammatory， anti-tumor， cardiovascular and cerebrovascular protective， and metabolic syndrome-regulating effects. However， current studies mainly focus on a few representative constituents. A systematic understanding of the overall bioactive material basis and mechanisms of action of this herb still requires further investigation. Additionally， more in vivo pharmacodynamic studies， clinical evaluations， and toxicological assessments are needed. This article summarizes recent advances in the pharmacological effects of Euodiae Fructus based on a systematic review of its major chemical constituents， aiming to provide a reference for further research and the rational development and utilization of this medicinal herb.

Ocular surface inflammation constitutes a core pathological mechanism underlying prevalent ocular disorders, including dry eye disease, allergic conjunctivitis, and infectious keratitis. Its pathogenesis is intimately linked to the dysregulated activation of multiple intracellular signaling cascades. This review systematically delineates the pivotal functions of four core signaling pathways—nuclear factor-kappa B(NF-κB), mitogen-activated protein kinase(MAPK), Janus kinase/signal transducer and activator of transcription(JAK/STAT), and the NOD-like receptor protein 3(NLRP3)inflammasome—in the ocular surface inflammation. Specifically, NF-κB functions as a master regulator driving the expression of pro-inflammatory factors; MAPK acts as a central signaling hub that integrates diverse stress stimuli and potentiates inflammatory amplification; JAK/STAT mediates cytokine-driven signal transduction and modulates immune cell differentiation; and NLRP3 senses danger signals and thereby promotes the maturation of inflammatory factors such as interleukin-1β(IL-1β). Notably, these pathways do not function independently but constitute a highly interconnected regulatory network via phosphorylation, and the assembly of transcription factor complexes, which results in limited efficacy of single-targeted therapies due to the reactivation of bypass pathways. Therefore, future treatment for ocular surface inflammation is expected to prioritize multi-target synergistic strategies and personalized precision medicine, thereby enabling more sustained and effective therapeutic options for clinical practice.

OBJECTIVE To explore the effects of meropenem exposure and degradation levels on clinical efficacy in patients with purulent meningitis （PM）. METHODS A total of 131 PM patients treated with meropenem at the Affiliated Suzhou Hospital of Nanjing Medical University from January 2022 to June 2025 were prospectively included. Relevant data were collected and divided into a cured group （91 cases） and a non-cured group （40 cases） based on the efficacy. High-performance liquid chromatography-tandem mass spectrometry was used to determine the concentration of meropenem and its open-loop metabolites. Risk factors that affect efficacy were screened， and their predictive power and correlation were evaluated by univariate analysis， and multivariate Logistic regression analysis， receiver operating characteristic （ROC） curves， and correlation analysis. RESULTS Univariate analysis showed that serum creatinine， creatinine clearance rate， minimum inhibitory concentration of meropenem ≥16 μg/mL， cerebrospinal fluid red blood cell count， cerebrospinal fluid white blood cell count， cerebrospinal fluid glucose content， blood trough concentration， blood open-loop metabolite concentration/trough concentration ratio， and intrathecal injection were all correlated with efficacy （P＜0.05）. The results of multiple Logistic regression analysis showed that serum creatinine blood open-loop metabolite concentration/trough concentration ratio， intrathecal injection， and cerebrospinal fluid glucose content were influencing factors for suboptimal anti-infective ltt efficacy （P＜0.05）. ROC curve analysis showed that when the blood open-loop metabolite concentration/trough concentration ratio was greater than 2.854 （AUC＝0.647）， serum creatinine was less than 59.5 μmol/L （AUC＝0.647）， and cerebrospinal fluid glucose content was less than 3.37 mmol/L （AUC＝0.709）， the risk of treatment failure significantly increased （P＜0.05）. Correlation analysis showed that the blood trough concentration of meropenem was positively correlated with the concentration of its open-loop metabolites （R 2＝0.134 5， P＜0.000 1）. CONCLUSIONS Insufficient exposure level and rapid degradation of meropenem are key mechanisms affecting the anti-infective efficacy of PM. Elevated blood open-loop metabolite concentration/ trough concentration ratio， low serum creatinine level， lack of intrathecal injection， and low cerebrospinal fluid glucose content are independent risk factors for poor efficacy.

Objective To explore the efficacy and safety of conversion therapy for advanced hepatocellular carcinoma(HCC)with macrovascular invasion.Methods A total of 149 patients with advanced HCC with macrovascular invasion who were treated at our hospital from Jul.2019 to Jun.2021 were enrolled.All patients received systemic therapy combined with local therapy,and were assigned to conversion therapy group(n=42)and non-conversion therapy group(n=107)according to whether they ultimately underwent surgical treatment.The long-term prognosis and adverse reactions of these patients after conversion therapy were analyzed.Results The median event-free survival of 149 patients was 15.5 months,and the median overall survival had not been reached.The median event-free survival in the conversion therapy and non-conversion therapy groups were 19.8 months and 10.7 months,respectively,with the median overall survival being not reached and 28.2 months,respectively.Multifactor Cox regression analysis showed that conversion therapy was a protective factor for overall survival(hazard ratio[HR]=0.125,95％confidence interval[CI]0.016-0.966),but not for event-free survival.The 1-year and 2-year overall survival rates of the conversion therapy and non-conversion therapy groups were 100.0％,96.4％and 72.1％,53.4％,respectively,and the difference in survival curves between the 2 groups was statistically significant(P=0.003).The 1-year and 2-year event-free survival rates were 77.5％,33.8％and 47.3％,31.5％,respectively.There was no significant difference in survival curves between the 2 groups(P=0.070).The differences of the overall incidences of targeted and immunotherapy-related adverse reactions in the conversion therapy group and non-conversion therapy group(66.7％[28/42]vs 72.0％[77/107],P=0.524)and the incidences of grade Ⅲ to Ⅳ adverse reactions(23.8％[10/42]vs 27.1％[29/107],P=0.681),were not statistically significant.Conclusion For patients with advanced HCC with macrovascular invasion,conversion therapy can significantly improve the prognosis without serious adverse reactions.

Ribonucleic acid(RNA)molecules with repeat expansion sequences can liquid-liquid phase separate into droplet-like condensates,which usually have good fluidity and can dynamically exchange matter and energy with the outside world,so as to play physiological functions.However,when the conditions are changed,the droplets will undergo a phase transition,forming gel-like or solid-like condensates.The change in the morphology of the condensates is closely related to many diseases.In this work,the effects of the RNA repeat length,concentration,cation and pH value on the liquid-liquid phase separation(LLPS)of RNA with CAG repeats were systematically studied,and the molecular structure of the condensates formed by LLPS was analyzed by Raman spectroscopy.This study revealed the molecular basis of the formation of different condensates from the perspective of structural biology,and provided new insights for in-depth understanding of the molecular assembly of RNA phase separation and phase transition.

Objective To establish a rapid screening and analysis method for etomidate and its ana-logues using a portable mass spectrometer equipped with a thermal desorption-atmospheric pressure chemical ionization source-linear ion trap.Methods A 10 μL aliquot of a standard solution at a con-centration of 1 μg/mL was taken,and after the solvent evaporated,the sample was inserted into the in-let of the portable mass spectrometer for detection.By adjusting the collision-induced dissociation pa-rameters,the molecular ion peak and fragment ion peak information of the standard were obtained and used to establish a reference database.In addition,the method was applied to 29 seized liquid and plant samples.Results A screening system for etomidate and its analogues was established based on the portable mass spectrometer and the corresponding mass spectrometry library.The system enables qualitative screening analysis by identifying primary protonated molecular ions and secondary product ions of etomidate and its analogues.The limits of detection for etomidate and its 12 analogues ranged from 0.1 to 10 μg/mL.Etomidate and its analogues were detected in all 29 liquid and plant samples.However,this method could not distinguish between isomeric imidazole esters,such as isopropoxate and propoxate.Additionally,when testing 2-SH-etomidate,there was a false positive for the detection of etomidate.Conclusion This study established a rapid screening method for etomidate and its ana-logues using a portable mass spectrometer.The method combines the high sensitivity of mass spectrome-try with the on-site applicability of portable devices,significantly improving detection efficiency and meeting the on-site detection needs of etomidate and its analogues.

Objective To investigate the expression and clinical significance of serum microRNA-141-3p(miR-141-3p)and Kelch like epichlorohydrin associated protein 1(KEAP1)in neonatal acute respiratory dis-tress syndrome(NARDS).Methods A total of 121 children with NARDS admitted to the hospital from Janu-ary 2022 to March 2024(NARDS group)and 65 healthy neonates during the same period(control group)were selected.According to the degree of disease,the children with NARDS were divided into the mild NARDS group(4≤oxygen index<8,48 cases),the moderate NARDS group(8≤oxygen index<16,46 ca-ses),the severe NARDS group(oxygen index≥16,27 cases),and the children with NARDS were divided into the death group(18 cases)and the survival group(103 cases)according to the 28-day prognosis.Serum miR-141-3p and KEAP1 levels were detected by fluorescence quantitative polymerase chain reaction and enzyme-linked immunosorbent assay.The correlation between serum miR-141-3p and KEAP1 levels in children with NARDS was analyzed by Pearson correlation coefficient.The correlation between serum miR-141-3p and KEAP1 levels and oxygen index in children with NARDS was analyzed by Spearman correlation coefficient.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficacy of serum miR-141-3p and KEAP1 levels on the death in children with NARDS.Results Serum miR-141-3p level in the NARDS group was lower than that in the control group,and KEAP1 level in the NARDS group was higher than that in the control group(t=14.288,12.596,P<0.001).There was a binding site between miR-141-3p and KEAP1 at the 3'-untranslated region 131-138.Pearson correlation showed that serum miR-141-3p was negatively correlated with KEAP1 level in children with NARDS(r=-0.745,P<0.001).The levels of ser-um miR-141-3p increased sequentially in the severe NARDS group,moderate NARDS group,and mild NARDS group,while the level of KEAP1 decreased sequentially(F=185.469,113.126,P<0.001).Spearman correla-tion coefficient showed that oxygen index in children with NARDS was negatively correlated with serum miR-141-3p level(r=-0.815,P<0.001)and positively correlated with serum KEAP1 level(r=0.827,P<0.001).Serum miR-141-3p level in the dead group was lower than that in the survival group,and KEAP1 level was higher than that in the surviving group(t=4.213,4.495,P<0.001).The area under the curve of the combined prediction of serum miR-141-3p and KEAP1 levels for the death in children with NARDS was 0.878(95%CI:0.806-0.930),which was greater than 0.783(95%CI:0.699-0.853)and 0.786(95%CI:0.702-0.855)predicted by serum miR-141-3p and KEAP1 levels alone(Z=2.963,2.021,P<0.05).Conclu-sion The serum miR-141-3p level is decreased and the KEAP1 level is increased in children with NARDS,which is associated with worsening of the disease and poor prognosis.The combination of serum miR-141-3p and KEAP1 levels has high predictive efficacy for death in children with NARDS.

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.