As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

Aim To explore the possible regulatory effect of leptin on acyl-CoA synthetase long chain fami-ly member ACSL5 and their effect on migration and in-vasion of breast cancer cell,and to explore the underly-ing mechanism.Methods The expression of leptin receptor was detected by immunofluorescence assay.The migration and invasion ability of MCF-7 cells were detected by wound healing assay and Transwell assay respectively.The downstream target gene of leptin was analyzed by PCR microarray data.The expression of ACSL5 in breast cancer and its correlation with the staging and prognosis of breast cancer patients were as-sessed uing bioinformatics methods.The expression of ACSL5 in MCF-7 cells treated with different concentra-tions of leptin was detected using real time fluorescence quantitative polymerase chain reaction(RT-qPCR).Overexpressing ACSL5 was constructed by lentiviral transfection;the expressions of EMT related proteins,AMPK-α and p-AMPK-α were detected by Western blot.Results Leptin promoted breast cancer cell mi-gration and invasion and EMT.ACSL5 was significant-ly low expressed in breast cancer and related to progno-sis.Leptin downregulated the expression of ACSL5 through OBR.Leptin activated AMPK pathway to downregulate ACSL5 and promote migration,invasion and EMT of breast cancer cells.Conclusions Leptin may promote the migration,invasion and EMT of breast cancer by downregulating ACSL5 through activating AMPK pathway.

Objective To explore the influencing factors on foot function recovery after distraction device-assisted repositioning of small incisions treatment for Sanders Ⅱ and Ⅲ calcaneal fractures,and to provide guidance for timely clinical interventions.Methods A retrospective analysis was conducted on 80 patients with Sanders type Ⅱ and Ⅲ calcaneal fractures admitted to the People's Hospital of Bozhou from January 2021 to June 2023.Data were collected using a general information questionnaire,the hospital's electronic medical record system,the visual analog scale(VAS),the Marland foot function scale(MFS),the perceived social support scale(PSSS),and the perceived stress scale(PSS).The influencing factors of postoperative foot function recovery were analyzed using univariate factor analysis,multivariate linear regression,and structural equation modeling.Results The MFS scores of 80 patients at 6 months post-operation were significantly higher than preoperative scores(P＜0.001).The rates of excellent,good,fair,and poor foot function at 6 months post-operation were 56.3％,31.3％,10.0％,and 2.5％,respectively.Univariate analysis revealed significant differences in MFS scores based on different ages,time to start full weight-bearing exercise,bone mineral density,surgical timing,body mass index(BMI),postoperative VAS score,PSSS score,PSS score,and the presence of postoperative peroneal muscle spasm and peroneal muscle tendon adhesion(P＜0.05).Multivariate linear regression identified age,time to start full weight-bearing exercise,surgical timing,BMI,postoperative fibular muscle spasm,postoperative fibular muscle tendon adhesion,postoperative VAS score,PSSS score,and PSS score as significant factors affecting foot function recovery(P＜0.05).Structural equation modeling indicated that age,time to start full weight-bearing exercise,bone density,operative timing,BMI,postoperative peroneal muscle spasm,postoperative peroneal tendon adhesion,and pain severity directly influenced postoperative foot functional recovery.Additionally,psychological stress not only directly affected postoperative foot functional recovery but also indirectly influenced it through the mediating effect of social support.Conclusions Foot function recovery after surgery for Sanders type Ⅱ and Ⅲ calcaneal fractures is influenced by multiple factors.Psychological stress not only directly affects the recovery of foot function after surgery,but also mitigates the harm to foot function through social support.

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.

Aim To explore the possible regulatory effect of leptin on acyl-CoA synthetase long chain fami-ly member ACSL5 and their effect on migration and in-vasion of breast cancer cell,and to explore the underly-ing mechanism.Methods The expression of leptin receptor was detected by immunofluorescence assay.The migration and invasion ability of MCF-7 cells were detected by wound healing assay and Transwell assay respectively.The downstream target gene of leptin was analyzed by PCR microarray data.The expression of ACSL5 in breast cancer and its correlation with the staging and prognosis of breast cancer patients were as-sessed uing bioinformatics methods.The expression of ACSL5 in MCF-7 cells treated with different concentra-tions of leptin was detected using real time fluorescence quantitative polymerase chain reaction(RT-qPCR).Overexpressing ACSL5 was constructed by lentiviral transfection;the expressions of EMT related proteins,AMPK-α and p-AMPK-α were detected by Western blot.Results Leptin promoted breast cancer cell mi-gration and invasion and EMT.ACSL5 was significant-ly low expressed in breast cancer and related to progno-sis.Leptin downregulated the expression of ACSL5 through OBR.Leptin activated AMPK pathway to downregulate ACSL5 and promote migration,invasion and EMT of breast cancer cells.Conclusions Leptin may promote the migration,invasion and EMT of breast cancer by downregulating ACSL5 through activating AMPK pathway.

This study investigated the drug resistance and genetic relationships among strains co-existing in animals,the environ-ment,and the living quarters of employees at large-scale pig farms in certain regions of Shandong Province,to provide a scientific ba-sis for elucidating the transmission mechanisms of drug-resistant bacteria through bacterial traceability analysis.Samples were col-lected from two pig farms,and bacteria were isolated and purified.The species of the isolated strains were identified via 16S rRNA gene sequencing.Antimicrobial susceptibility testing was conducted with a VITEK-2 Compact system and the disk diffusion method for strains present in pigs,the environment,and living areas.Furthermore,whole-genome sequencing was performed on the Illumina Miniseq platform to annotate drug resistance genes,and multilocus sequence typing(MLST)and core genome single nucleotide poly-morphism(cgSNP)analyses were used to trace the resistant strains.Three species—Staphylococcus aureus,Pseudomonas aeruginosa,and Bacillus cereus—were isolated and cultured from animals,the environment,and employee living areas,and their distributions were analyzed.These strains exhibited diverse drug resistance spectra and genetic diversity.Additionally,the strains displayed highly consistent resistance profiles,resistance genes,ST types,and SNP loci in pig urine,soil both inside and outside the facility,human drinking water,and the cafeteria and dormitories.Our findings indicated a potential risk of transmission of opportunistic pathogens be-tween the pig farming area and the living quarters.Particular attention should be paid to the environmental transmission of methicillin-resistant Staphylococcus aureus.

Objective:To analyze the clinical value of delayed solidification of cement at freezing point combined with establishment of cement channels in the treatment of further leakage of cement in percutaneous kyphoplasty (PKP).Methods:A retrospective analysis was performed for the medical records of 261 patients with osteoporotic vertebral fracture in the thoracolumbar segment who underwent PKP treatment in Beijing Puren Hospital from April 2019 to April 2023. According to the method of dealing with PKP cement leakage, it was divided into freezing point group (using bone cement combined with cement channel reconstruction treatment at freezing point temperature) and temperature gradient group (using temperature gradient method). There were 128 cases in the freezing point group, including 37 males and 91 females, aged 75.57±4.60 years (range, 65-85 years), and fracture locations were 18 cases in T 10, 30 cases in T 11, 44 cases in T 12, 23 cases in L 1 and 13 cases in L 2. There were 133 cases in the temperature gradient group, including 36 males and 97 females, aged 75.66±4.51 years (range, 65-85 years), and fracture locations were 17 cases in T 10, 32 cases in T 11, 51 cases in T 12, 22 cases in L 1, and 11 cases in L 2. The intraoperative blood loss, operation time, intravertebral cement area, cement leakage area, cement leakage area increase, cement bolus time and incidence of injection difficulty, as well as the pain visual analogue scale (VAS), Oswestry disability index (ODI), kyphosis angle, the height of the anterior edge of the injured vertebral body and the difference between it before and after surgery were compared. Results:All patients were followed up for 3 consecutive months. The intraoperative blood loss and initial cement leakage area were 9.48±2.64 ml and 32.56±7.05 mm 2 in the freezing point group and 9.04±2.25 ml and 32.86±7.00 mm 2 in the temperature gradient group, respectively, and the difference was not statistically significant ( P>0.05) ; The operation time, the area of bone cement in the vertebral body, the final leakage area of bone cement, and the increase of bone cement leakage in the freezing point group were 55.08±4.13 min, 1 175.45±117.11 mm 2, 35.84±8.67 mm 2, and 0.00(0.00, 13.32) mm 2, respectively, and the temperature gradient group were 53.02±3.96 min, 823.70±144.79 mm 2, and 73.38±29.16 mm 2 and 44.39(20.13, 56.61) mm 2, the differences were statistically significant ( P<0.05). The height of the anterior edge of the vertebral body was 21.54±2.06 mm and 21.24±2.33 mm immediately after surgery and 3 months after surgery in the freezing point group, which were higher than those in the temperature gradient group 21.10±1.60 mm and 18.92±1.51 mm, respectively, and the difference was statistically significant ( P<0.05). The VAS scores of the freezing point group were 2.29±0.62 and 1.03±0.66 points, ODI were 23.20%±3.97%, 10.43%±4.33%, and the kyphosis angles were 9.09°±2.80° and 9.44°±2.93°, respectively, which were lower than those of the temperature gradient group (4.11±0.79 and 2.79±0.65 points), ODI (35.97%±6.42%, and 23.73%±5.72%), and the kyphosis angles (10.24°±2.33° and 13.22°±2.56°), the differences were statistically significant ( P<0.05). The operating time of bone cement in the freezing point group was 10.89±2.35 min, which was longer than that in the temperature gradient group 5.77±0.52 min, and the difference was statistically significant ( t=24.021, P<0.001). The incidence of cement injection difficulty was 0 in the freezing point group and 27.1% (36/133) in the temperature gradient group. Conclusion:The establishment of bone cement combined with bone cement channel at freezing point temperature can effectively prolong the bolus time of bone cement and reduce the re-leakage of bone cement, which is conducive to increasing the injection volume and distribution area of bone cement in the vertebral body, effectively reducing the amount of bone cement leakage and obtaining better clinical efficacy.

Objective To investigate the diagnostic value of masseter muscle thickness fraction(MMTF)measured by ultrasound for the occurrence of dysphagia in patients with Parkinson's disease(PD).Methods A total of 100 patients were selected as the study group,and another 50 healthy individuals who received medical checkups with matched age,gender and body mass index(BMI)in our hospital during the same period were selected as the control group.The demographic data and disease characteristics of PD patients were recorded,and patients were divided into the dysphagia group(n=34)and the non-dysphagia group(n=66)according to the occurrence of dysphagia.The demographic data,and disease characteristics such as Hoehn-Yahr(H&Y)stage,Unified Parkinson's Disease Rating Scale(UPDRS)Ⅲ score,levodopa equivalent daily dose(LEDD)and MMT-related parameters measured by ultrasound were compared between the two groups.The indicators with P＜0.05 in univariate analysis were used as independent variables,and the influencing factors of dysphagia in patients with PD were investigated by binary Logistic regression analysis.The diagnostic efficacy of each index for dysphagia in patients with PD was evaluated by constructing receiver operating characteristic(ROC)curves,and the area under the curve(AUC)was calculated.Results The MMT during forceful biting and MMTF were lower in the study group than those in the control group(all P＜0.05).Compared with the non-dysphagia group,the dysphagia group was older and had higher H&Y stage and UPDRS III scores(all P＜0.05).The MMT during forceful biting and MMTF in the dysphagia group were lower than those in the non-dysphagia group(all P＜0.05).Multivariate Logistic regression analysis showed that increased UPDRSⅢ score was the risk factor for dysphagia in patients with PD,and increased MMT during forceful biting and MMTF were protective factors.The ROC curve analysis indicated that the AUC(95%CI)of UPDRS Ⅲ score,MMT during forceful biting and MMTF for diagnosing dysphagia in patients with PD were 0.714(0.615-0.800),0.744(0.647-0.826)and 0.888(0.809-0.942),respectively.The AUC of MMTF for diagnosing dysphagia in patients with PD was higher than those of UPDRS Ⅲscores and MMT during forceful biting(Z values were 2.611 and 2.208,respectively,P＜0.05).Conclusion MMTF is an independent influencing factor for dysphagia in patients with PD and can be used as a screening indicator for dysphagic patients.

Objective The supine-to-standing transcranial Doppler（TCD） technique is suitable for evaluating cardiovascular autonomic dysfunction， and this study aims to assess its performance in predicting adverse outcomes in diabetic patients with or without orthostatic hypotension （OH）. Methods The patients with type 2 diabetes mellitus who were admitted to Department of Endocrinology and Department of Neurology in The Second Affiliated Hospital of Hainan Medical University from August 2020 to May 2023 were enrolled as subjects. Basic clinical data were collected， and supine-to-standing TCD was performed to monitor and record the changes in blood pressure， heart rate， and cerebral hemodynamics in both supine and standing positions. The patients were followed for 2-4 years to record medication， orthostatic intolerance score， and adverse events. The two-independent-samples t test was used for comparison of normally distributed continuous variables between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between groups； the chi-square test was used for comparison of categorical variables between groups. The binary logistic regression analysis was used to investigate the association between the results of supine-to-standing TCD and adverse outcomes. Results A total of 118 patients （96 male patients and 22 female patients） were enrolled， among whom there were 28 patients with OH （23.7%） and 90 patients without OH（76.3%）. During follow-up， 19 patients （16.1%） experienced adverse outcomes （including syncope， falls， and death）.TCD showed that impaired “W” wave recovery in cerebral blood flow in the standing position was an independent risk factor for adverse outcomes in diabetic patients （OR=3.536， 95% CI 1.136-11.006， P=0.029）. Conclusion Vascular reflex failure and paradoxical cerebral vasoconstriction may be the mechanisms for impaired cerebral blood flow recovery in the standing position. TCD testing has an important role in detecting cerebrovascular abnormalities and cerebral hemodynamic changes， especially in diabetic patients with OH， and it has good performance in predicting adverse outcomes.

Purpose: Considering the high disease burden and unique features of Asian patients with breast cancer (BC), it is essential to have a comprehensive view of genetic characteristics in this population. An institutional targeted sequencing platform was developed through the Korea Research-Driven Hospitals project and was incorporated into clinical practice. This study explores the use of targeted next-generation sequencing (NGS) and its outcomes in patients with advanced/metastatic BC in the real world. Materials and Methods: We reviewed the results of NGS tests administered to BC patients using a customized sequencing platform—FiRST Cancer Panel (FCP)—over 7 years. We systematically described clinical translation of FCP for precise diagnostics, personalized therapeutic strategies, and unraveling disease pathogenesis. Results: NGS tests were conducted on 548 samples from 522 patients with BC. Ninety-seven point six percentage of tested samples harbored at least one pathogenic alteration. The common alterations included mutations in TP53 (56.2%), PIK3CA (31.2%), GATA3 (13.8%), BRCA2 (10.2%), and amplifications of CCND1 (10.8%), FGF19 (10.0%), and ERBB2 (9.5%). NGS analysis of ERBB2 amplification correlated well with human epidermal growth factor receptor 2 immunohistochemistry and in situ hybridization. RNA panel analyses found potentially actionable and prognostic fusion genes. FCP effectively screened for potentially germline pathogenic/likely pathogenic mutation. Ten point three percent of BC patients received matched therapy guided by NGS, resulting in a significant overall survival advantage (p=0.022), especially for metastatic BCs. Conclusion Clinical NGS provided multifaceted benefits, deepening our understanding of the disease, improving diagnostic precision, and paving the way for targeted therapies. The concrete advantages of FCP highlight the importance of multi-gene testing for BC, especially for metastatic conditions.