BACKGROUND:Rapid and accurate segmentation of brain tissue in medical images is of great significance for three-dimensional biomechanical modeling and diagnosis of craniocerebral injuries.Currently,artificial intelligence(AI)-based baseline models exhibit excellent generalization capabilities on large-scale datasets.However,due to the specificity and complexity of craniocerebral tissues,these models have certain limitations in their application to craniocerebral tissue segmentation.Additionally,the scarcity of craniocerebral tissue samples makes it difficult for baseline models to achieve precise segmentation results through fine-tuning.OBJECTIVE:To construct a craniocerebral tissue segmentation model based on texture feature retrieval enhancement to improve segmentation accuracy under a small number of samples.METHODS:Segment Anything in Medical Images(MedSAM)model was selected as the basic framework,and texture features were combined with deep learning to build a brain tissue segmentation model based on texture feature retrieval enhancement(DP-MedSAM).Dice Coefficient and mean intersection over union(MIoU)were selected to evaluate the efficiency of image segmentation results.In comparison with the original MedSAM model,the ablation experiment systematically evaluated the influence of key components on the model performance.The sensitivities of MedSAM,the Segment Anything Model(SAM)for medical image segmentation(SAM-Med2D)and DP-MedSAM in the mandible,left optic nerve,and left parotid gland were compared.RESULTS AND CONCLUSION:(1)By verifying the impact of the number of point prompts on segmentation results on the HaN-Seg dataset,the experimental results indicated that the optimal Dice score was achieved with the addition of three points.(2)DP-MedSAM demonstrated performance improvements compared with MedSAM and SAM-Med2D on two datasets(HaN and Public Domain Database for Computational Anatomy).Especially on the Public Domain Database for Computational Anatomy dataset,in terms of the MIoU metric,DP-MedSAM outperformed MedSAM by 6.59％and SAM-Med2D by 37.35％;in terms of the Dice metric,DP-MedSAM outperformed MedSAM and SAM-Med2D by 4.34％and 25.32％,respectively.(3)The ablation experiment results showed that removing the texture feature extraction module in the DP-MedSAM model,relying solely on original image features,led to a significant decrease in results on the test set.Furthermore,removing the vector cache database and its retrieval enhancement function from the model,which deprived the ability of the model to perform similarity retrieval using an external knowledge base,further reduced model performance.(4)Under conditions of limited data resources,the DP-MedSAM model outperformed the other two models in all evaluation metrics.The DP-MedSAM model performed excellently when processing simple and moderately difficult samples,demonstrating a clear advantage over the other two models and indicating good generalization ability.Processing the fine structures of difficult samples placed higher demands on the model's segmentation capabilities.Although the performance of the DP-MedSAM model declined slightly,it still outperformed the other two models.(5)This study proposes an innovative craniocerebral tissue segmentation model,DP-MedSAM,which improves the baseline model's performance in capturing local details and global structural information in medical images by introducing target region texture feature extraction.Through vector similarity retrieval technology,DP-MedSAM can retrieve the feature vector most similar to the current target region from a pre-constructed vector database,providing more precise guiding information for the segmentation process.

BACKGROUND:Rapid and accurate segmentation of brain tissue in medical images is of great significance for three-dimensional biomechanical modeling and diagnosis of craniocerebral injuries.Currently,artificial intelligence(AI)-based baseline models exhibit excellent generalization capabilities on large-scale datasets.However,due to the specificity and complexity of craniocerebral tissues,these models have certain limitations in their application to craniocerebral tissue segmentation.Additionally,the scarcity of craniocerebral tissue samples makes it difficult for baseline models to achieve precise segmentation results through fine-tuning.OBJECTIVE:To construct a craniocerebral tissue segmentation model based on texture feature retrieval enhancement to improve segmentation accuracy under a small number of samples.METHODS:Segment Anything in Medical Images(MedSAM)model was selected as the basic framework,and texture features were combined with deep learning to build a brain tissue segmentation model based on texture feature retrieval enhancement(DP-MedSAM).Dice Coefficient and mean intersection over union(MIoU)were selected to evaluate the efficiency of image segmentation results.In comparison with the original MedSAM model,the ablation experiment systematically evaluated the influence of key components on the model performance.The sensitivities of MedSAM,the Segment Anything Model(SAM)for medical image segmentation(SAM-Med2D)and DP-MedSAM in the mandible,left optic nerve,and left parotid gland were compared.RESULTS AND CONCLUSION:(1)By verifying the impact of the number of point prompts on segmentation results on the HaN-Seg dataset,the experimental results indicated that the optimal Dice score was achieved with the addition of three points.(2)DP-MedSAM demonstrated performance improvements compared with MedSAM and SAM-Med2D on two datasets(HaN and Public Domain Database for Computational Anatomy).Especially on the Public Domain Database for Computational Anatomy dataset,in terms of the MIoU metric,DP-MedSAM outperformed MedSAM by 6.59％and SAM-Med2D by 37.35％;in terms of the Dice metric,DP-MedSAM outperformed MedSAM and SAM-Med2D by 4.34％and 25.32％,respectively.(3)The ablation experiment results showed that removing the texture feature extraction module in the DP-MedSAM model,relying solely on original image features,led to a significant decrease in results on the test set.Furthermore,removing the vector cache database and its retrieval enhancement function from the model,which deprived the ability of the model to perform similarity retrieval using an external knowledge base,further reduced model performance.(4)Under conditions of limited data resources,the DP-MedSAM model outperformed the other two models in all evaluation metrics.The DP-MedSAM model performed excellently when processing simple and moderately difficult samples,demonstrating a clear advantage over the other two models and indicating good generalization ability.Processing the fine structures of difficult samples placed higher demands on the model's segmentation capabilities.Although the performance of the DP-MedSAM model declined slightly,it still outperformed the other two models.(5)This study proposes an innovative craniocerebral tissue segmentation model,DP-MedSAM,which improves the baseline model's performance in capturing local details and global structural information in medical images by introducing target region texture feature extraction.Through vector similarity retrieval technology,DP-MedSAM can retrieve the feature vector most similar to the current target region from a pre-constructed vector database,providing more precise guiding information for the segmentation process.

Objectives: . This study aimed to explore the role of the Pcdh15 gene in hearing maintenance and to examine the effects of its deficiency on cochlear structure, cochlear function, and hearing loss in mice. Methods: . CRISPR/Cas9 technology was used to generate Pcdh15 knockout (KO) mice. Auditory function was evaluated using hearing tests, while histological approaches were employed to assess morphological changes in cochlear hair cells and spiral ganglion neurons (SGNs). RNA sequencing (RNA-seq) was performed on cochlear tissue from postnatal day 18 (P18) wild-type (WT) and Pcdh15 KO mice to identify differentially expressed genes (DEGs). These DEGs were subjected to functional annotation and pathway analysis, with particular emphasis on oxidative phosphorylation (OXPHOS). Reactive oxygen species (ROS) levels were quantified using flow cytometry and DCFH-DA assays. Results: . Pcdh15 KO mice exhibited progressive sensorineural hearing loss, which worsened to profound deafness by P18. Notably, cochlear hair cells and SGNs showed substantial loss and pronounced morphological abnormalities, particularly within the basal high-frequency region. RNA-seq analysis identified 1,359 DEGs, including 1,024 downregulated and 335 upregulated genes. Pathway analysis indicated that Pcdh15 deficiency was associated with inhibition of the OXPHOS pathway, potentially disrupting mitochondrial respiratory chain complexes I, III, IV, and V and thereby impairing energy production and ATP metabolism. In addition, early-stage cochleae from KO mice demonstrated elevated ROS levels and increased oxidative stress, suggesting that redox imbalance may contribute to hearing damage. Conclusion . Pcdh15 plays a critical role in hearing maintenance. Its deficiency is associated with severe hearing loss and marked cochlear abnormalities, which are linked to inhibition of OXPHOS, disruption of energy metabolism, and exacerbation of oxidative stress. Together, these findings provide new insights into the mechanisms underlying hearing loss and suggest potential targets for therapeutic intervention.

Background/Aims: Biliary tract cancer (BTC) frequently harbors KRAS mutations, which are associated with resistance to traditional treatment and a poor prognosis. Synthetic lethality (SL) strategy may provide other targets of KRAS. Therefore, we aim to identify and validate potential therapeutic targets of KRAS for the treatment of BTC via SL. Methods: The dependency (DepMap) projects were used to predict the synthetic lethal gene of KRAS. FDA-approved anticancer drug library was applied to screen potential drugs effective against KRAS-mutant BTC. Furthermore, the synthetic lethal effects or corresponding mechanisms of potential genes and drugs on BTC were investigated using KRAS-mutant and KRAS-wild type BTC cell lines, patient-derived xenografts (PDX), and KRAS oncogene-driven tumor models, as well as other KRAS-mutant cancer cell lines. Results: Initially, we discovered that the loss of GATA2 reduced the viability of KRAS-mutant but not KRAS-wild-type BTC. Subsequently, the drug library screened out disulfiram, which primarily exerts a synthetic lethal effect by inhibiting interleukin-1β (IL-1β) in KRAS-mutant BTC. Mechanistically, GATA2 specifically enhanced the transcription of IL-1β to promote NF-κB signaling in KRAS-mutant BTC. IL-1β inhibition phenocopied GATA2 deficiency, leading to reduced KRAS-mutant BTC viability. These synthetically lethal effects were confirmed using PDX, a KRAS oncogene-driven tumor model, as well as in other KRAS-mutant cancer cell lines. Conclusions In summary, these results indicate that inhibiting GATA2/IL1β could be a therapeutic strategy in KRAS-mutant BTC and potentially other cancers.

Occupational disease diagnostician (ODD) is the core technology professional who is responsible for occupational disease diagnosis and identification and the main inspection work for occupational medical examination. The implementation of regular assessment management for ODDs is a key component of standardized workforce management, which facilitates dynamic evaluation of professional competence, regulation of medical practice, and assurance of medical safety. Since January 2025, Guangdong Province has implemented regular assessment management for ODDs within its administrative region. The assessment adopts an integrated model consisting of three components including professional competency evaluation, performance appraisal, and professional ethics evaluation, with each assessment cycle lasting three years. ODDs who passed all three components are classified as qualified ODD, whereas those who failed to pass any one of the three components result in an unqualified assessment outcome. In the implementation of ODD regular assessment management, Guangdong Province has emphasized integrating assessment with quality evaluation, strengthening full-cycle supervision of ODDs′ professional conduct, optimizing assessment strategies for special groups of ODDs, and reinforcing the primary management responsibility of medical institutions. Meanwhile, ODDs′ professional competence, service quality, and professional integrity have been continuously promoted by adopting human-computer interactive assessments, information-based assessment management, and "elimination" mechanism.

Metabolic syndrome （MS） is a clinical syndrome characterized by obesity， insulin resistance， and dyslipidemia， and chronic inflammation is closely associated with its pathogenesis. The imbalance between pro-inflammatory and anti-inflammatory macrophage polarization， as one of the core pathological mechanisms of chronic inflammation， is a crucial driver of MS progression. According to Essential Questions in Yellow Emperor's Inner Canon： Distinctive Theory on Meridians and Diseased Pulses， "the spleen Qi dispersing essence... along all the meridians and collaterals". When the spleen fails in transportation and transformation， the distribution of refined essence becomes disordered， leading to internal accumulation of phlegm-dampness， forming a dynamic pathological state of "root deficiency with branch excess". Accordingly， the core traditional Chinese medicine （TCM） pathogenesis of MS is closely related to "spleen failing in transportation and transformation coupled with the internal accumulation of phlegm-dampness"； however， its modern biological basis remains elusive. Therefore， based on the theory of "spleen Qi dispersing essence" and recent advances in immunometabolism， this paper explored the modern scientific connotation of the TCM pathogenesis of MS from the perspective of macrophage polarization driven by glucose metabolic reprogramming. Through theoretical analysis and literature integration， it was proposed that mitochondrial oxidative phosphorylation participates in the energy metabolism process of "spleen Qi dispersing essence". The dysfunction of the spleen's transportation and transformation prompts macrophage metabolism to shift toward glycolysis， resulting in the accumulation of lactate and succinate， which represents the microscopic manifestation of "refined essence deviating from proper transformation" and can be defined as "microscopic phlegm-dampness". These metabolites subsequently drive M1 macrophage polarization via the hypoxia-inducible factor-1α （HIF-1α）/nuclear factor-κB （NF-κB） signaling pathway， triggering the release of pro-inflammatory cytokines and inducing systemic chronic low-grade inflammation， ultimately manifesting as insulin resistance， lipid metabolic disorders， and other core components of MS， thus achieving immune amplification from local "microscopic phlegm-dampness" to systemic "internal accumulation of phlegm-dampness". Therefore， macrophage polarization driven by glucose metabolic reprogramming constitutes an important biological link connecting the TCM concept of "spleen failing to disperse essence" with the pathology of MS. Furthermore， this paper reviewed the potential mechanisms by which TCM herbal formulas and their monomeric components that "restore spleen transportation and resolve phlegm-dampness" ameliorate MS by modulating macrophage metabolic remodeling， thereby providing novel biological connotations for the modern interpretation of the theory of "spleen Qi dispersing essence". Future research should integrate multi-omics technologies with disease-syndrome animal models to elucidate the regulatory network of formulas that "restore spleen transportation and resolve phlegm-dampness". Additionally， the feasibility of utilizing macrophage metabolic phenotypes as objective diagnostic biomarkers for the phlegm-dampness syndrome in MS warrants further investigation.

Metabolic syndrome （MS） is a clinical syndrome characterized by obesity， insulin resistance， and dyslipidemia， and chronic inflammation is closely associated with its pathogenesis. The imbalance between pro-inflammatory and anti-inflammatory macrophage polarization， as one of the core pathological mechanisms of chronic inflammation， is a crucial driver of MS progression. According to Essential Questions in Yellow Emperor's Inner Canon： Distinctive Theory on Meridians and Diseased Pulses， "the spleen Qi dispersing essence... along all the meridians and collaterals". When the spleen fails in transportation and transformation， the distribution of refined essence becomes disordered， leading to internal accumulation of phlegm-dampness， forming a dynamic pathological state of "root deficiency with branch excess". Accordingly， the core traditional Chinese medicine （TCM） pathogenesis of MS is closely related to "spleen failing in transportation and transformation coupled with the internal accumulation of phlegm-dampness"； however， its modern biological basis remains elusive. Therefore， based on the theory of "spleen Qi dispersing essence" and recent advances in immunometabolism， this paper explored the modern scientific connotation of the TCM pathogenesis of MS from the perspective of macrophage polarization driven by glucose metabolic reprogramming. Through theoretical analysis and literature integration， it was proposed that mitochondrial oxidative phosphorylation participates in the energy metabolism process of "spleen Qi dispersing essence". The dysfunction of the spleen's transportation and transformation prompts macrophage metabolism to shift toward glycolysis， resulting in the accumulation of lactate and succinate， which represents the microscopic manifestation of "refined essence deviating from proper transformation" and can be defined as "microscopic phlegm-dampness". These metabolites subsequently drive M1 macrophage polarization via the hypoxia-inducible factor-1α （HIF-1α）/nuclear factor-κB （NF-κB） signaling pathway， triggering the release of pro-inflammatory cytokines and inducing systemic chronic low-grade inflammation， ultimately manifesting as insulin resistance， lipid metabolic disorders， and other core components of MS， thus achieving immune amplification from local "microscopic phlegm-dampness" to systemic "internal accumulation of phlegm-dampness". Therefore， macrophage polarization driven by glucose metabolic reprogramming constitutes an important biological link connecting the TCM concept of "spleen failing to disperse essence" with the pathology of MS. Furthermore， this paper reviewed the potential mechanisms by which TCM herbal formulas and their monomeric components that "restore spleen transportation and resolve phlegm-dampness" ameliorate MS by modulating macrophage metabolic remodeling， thereby providing novel biological connotations for the modern interpretation of the theory of "spleen Qi dispersing essence". Future research should integrate multi-omics technologies with disease-syndrome animal models to elucidate the regulatory network of formulas that "restore spleen transportation and resolve phlegm-dampness". Additionally， the feasibility of utilizing macrophage metabolic phenotypes as objective diagnostic biomarkers for the phlegm-dampness syndrome in MS warrants further investigation.

Echinococcosis is a neglected zoonotic parasitic disease across the world, which imposes a substantial burden on human health and socioeconomic development in endemic areas. From a One Health perspective, this review systematically summarizes the legal framework, scheme, integrated interventions, control achievements, and challenges in the national echinococcosis control programme of China. An integrated strategy centered on control of the source of Echinococcus infections has been implemented for echinococcosis control in China, and cross-sectoral and cross-regional multidisciplinary coordination mechanisms have been progressively established, resulting in remarkable achievements gained in human health, animal health, and integrated environmental management. The endemicity of echinococcosis remarkably reduced in China in 2023 as compared to results from the national echinococcosis epidemiological survey in China between 2012 and 2016 (baseline), with an 82.14% reduction in human prevalence, an 80.00% reduction in detection of echinococcosis among children, a reduction of prevalent echinococcosis patients to 25 400 cases, a 36.96% reduction in the number of dogs, an 88.24% reduction in the prevalence of Echinococcus infections in dogs, a 67.00% reduction in the number of stray dogs, an 80.77% reduction in the prevalence of echinococcosis in live-stock, and a 69.23% reduction in the prevalence of Echinococcus infections in rodents. Nevertheless, an estimated 14 600 canines were found to have Echinococcus infections in endemic areas across China in 2023, and the prevalence of Echinococcus infections increased by 241.03% in wild canines in 2023 relative to in 2021, which underscores the persistent threat to echinococcosis transmission. Future efforts are required to strengthen the One Health governance system, increase the financial investment, foster innovations in integrated control technologies, enhance cross-sectoral collaboration, and improve the capacity building at the grassroots level to advance the achievement of the national target of basically controlling echinococcosis in all endemic counties in China by 2030, thereby facilitating the process towards echinococcosis control and elimination.

This report presented the first imported case of alveolar echinococcosis in Tianzhu Tibetan Autonomous County, Gansu Province. The patient was a local resident who had worked in Hotan Prefecture, Xinjiang Uygur Autonomous Region from 2019 to 2023, an area co-endemic for cystic and alveolar echinococcosis. He presented with hepatic discomfort in June 2023. Imaging examinations revealed an 8 cm × 6 cm mass in the left liver lobe, and serological testing showed positive IgG antibodies against Echinococcus. Post-surgical pathology confirmed the diagnosis of alveolar echinococcosis. Given that Tianzhu County has historically been endemic only for cystic echinococcosis and has not reported local cases of alveolar echinococcosis, this case was identified as an imported case based on epidemiological history. The case underwent left lateral hepatic lobectomy and no recurrence was seen at 2-year follow-up post-surgery. It is recommended to enhance the identification of different types of echinococcosis among clinicians, improve health education among migrant laborers, reinforce active screening among returning labors, and advance a One Health concept-based, cross-regional “human-animal-environment” joint prevention and control mechanism to prevent the risk of imported echinococcosis.

Conventional ocular drug delivery approaches have notable clinical limitations: eye drops achieve only 1%-5% bioavailability, while intravitreal injections carry a 0.01%-0.1% risk of endophthalmitis. As a minimally invasive delivery technology that overcomes the bottlenecks of traditional administration, ocular microneedles can significantly improve drug bioavailability and extend sustained release, showing promising advantages in preclinical studies. Focused on clinical needs, this review systematically summarizes the classification, preclinical evidence, and clinical translation potential of ocular microneedles, outlines their scope of application and efficacy characteristics, analyzes potential risks and translational bottlenecks, and proposes targeted implementation strategies. Currently, this technology still faces challenges such as insufficient puncture precision and insufficient long-term ocular safety data in humans. There is an urgent need to establish an ophthalmology-specific safety evaluation system, improve approval procedures and quality control standards, and prioritize the clinical translation of ocular-surface microneedles ,so as to provide accessible, minimally invasive treatment options for chronic and refractory ophthalmic diseases.