To systematically synthesize evidence on multiple KRAS G12C inhibitors(KRAS G12C inhibitors, KRAS G12Ci) as monotherapy within a unified population and recommended-dose framework, establish a comparable benchmark range of efficacy and safety for previously treated patients with advanced or metastatic KRAS G12C-mutant non-small cell lung cancer(NSCLC), and explore potential effect modifiers.

Objectives:This study aimed to compare the disease-free survival(DFS)and cervical lymph node metastasis risk in lip squamous cell carinoma(LSCC)patients between microwave thermochemotherapy and traditional surgical resection.Methods:A retrospective analysis was conducted on 106 eligible LSCC patients treated between January 2010 and January 2022.Patients were divided into the microwave thermochemotherapy group(n=37)and the surgery-alone group(n=69).Survival curves were generated using the Kaplan-Meier method,with DFS differences evaluated by Log-Rank test.Cox proportional hazards models and logistic re-gression were employed to screen prognostic factors and assess variables associated with cervical lymph node metastasis,respective-ly.Statistical analyses were performed using SPSS 26.0.Results:By September 2024,the objective response rate in the microwave thermochemotherapy group reached 94.59％(35/37).Survival analysis revealed no statistically significant difference in DFS be-tween the two groups(P=0.300).Multivariate logistic regression demonstrated that treatment modality was associated with cervical lymph node metastasis risk(P=0.022).The microwave thermochemotherapy group exhibiting a trend toward lower cervical lymph node metastasis rates compared to the surgery group.Conclusion:This study suggests that microwave thermochemotherapy achieves disease control efficacy comparable to surgical resection in early-stage LSCC patients and may reduce the likelihood of regional lymph node metastasis.

Objectives:This study aimed to compare the disease-free survival(DFS)and cervical lymph node metastasis risk in lip squamous cell carinoma(LSCC)patients between microwave thermochemotherapy and traditional surgical resection.Methods:A retrospective analysis was conducted on 106 eligible LSCC patients treated between January 2010 and January 2022.Patients were divided into the microwave thermochemotherapy group(n=37)and the surgery-alone group(n=69).Survival curves were generated using the Kaplan-Meier method,with DFS differences evaluated by Log-Rank test.Cox proportional hazards models and logistic re-gression were employed to screen prognostic factors and assess variables associated with cervical lymph node metastasis,respective-ly.Statistical analyses were performed using SPSS 26.0.Results:By September 2024,the objective response rate in the microwave thermochemotherapy group reached 94.59％(35/37).Survival analysis revealed no statistically significant difference in DFS be-tween the two groups(P=0.300).Multivariate logistic regression demonstrated that treatment modality was associated with cervical lymph node metastasis risk(P=0.022).The microwave thermochemotherapy group exhibiting a trend toward lower cervical lymph node metastasis rates compared to the surgery group.Conclusion:This study suggests that microwave thermochemotherapy achieves disease control efficacy comparable to surgical resection in early-stage LSCC patients and may reduce the likelihood of regional lymph node metastasis.

Objective:To investigate the surgical situations and perioperative outcome of pancreaticoduodenectomy in Jiangsu Province and the influencing factors for postoperative 90-day mortality.Methods:The retrospective case-control study was conducted. The clinicopathological data of 2 886 patients who underwent pancreaticoduodenectomy in 21 large tertiary hospitals of Jiangsu Quality Control Center for Pancreatic Diseases, including The First Affiliated Hospital of Nanjing Medical University, from March 2021 to December 2022 were collected. There were 1 732 males and 1 154 females, aged 65(57,71)years. Under the framework of the Jiangsu Provincial Pancreatic Disease Quality Control Project, the Jiangsu Quality Control Center for Pancreatic Diseases adopted a multi-center registration research method to establish a provincial electronic database for pancrea-ticoduodenectomy. Observation indicators: (1) clinical characteristics; (2) intraoperative and post-operative conditions; (3) influencing factors for 90-day mortality after pancreaticoduodenectomy. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(IQR), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers or constituent ratio, and comparison between groups was conducted using the chi-square test, continuity correction chi-square test and Fisher exact probability. Maximal Youden index method was used to determine the cutoff value of continuous variables. Univariate analysis was performed using the corresponding statistical methods based on data types. Multivariate analysis was performed using the Logistic multiple regression model. Results:(1) Clinical characteristics. Of the 2 886 patients who underwent pancreaticoduodenectomy, there were 1 175 and 1 711 cases in 2021 and 2022, respectively. Of the 21 hospitals, 8 hospitals had an average annual surgical volume of <36 cases for pancreaticoduodenectomy, 10 hospitals had an average annual surgical volume of 36-119 cases, and 3 hospitals had an average annual surgical volume of ≥120 cases. There were 2 584 cases performed pancreaticoduodenectomy in thirteen hospitals with an average annual surgical volume of ≥36 cases, accounting for 89.536%(2 584/2 886)of the total cases. There were 1 357 cases performed pancrea-ticoduodenectomy in three hospitals with an average annual surgical volume of ≥120 cases, accounting for 47.020%(1 357/2 886) of the total cases. (2) Intraoperative and postoperative conditions. Of the 2 886 patients, the surgical approach was open surgery in 2 397 cases, minimally invasive surgery in 488 cases, and it is unknown in 1 case. The pylorus was preserved in 871 cases, not preserved in 1 952 cases, and it is unknown in 63 cases. Combined organ resection was performed in 305 cases (including vascular resection in 209 cases), not combined organ resection in 2 579 cases, and it is unknown in 2 cases. The operation time of 2 885 patients was 290(115)minutes, the volume of intra-operative blood loss of 2 882 patients was 240(250)mL, and the intraoperative blood transfusion rate of 2 880 patients was 27.153%(782/2 880). Of the 2 886 patients, the invasive treatment rate was 11.342%(327/2 883), the unplanned Intensive Care Unit (ICU) treatment rate was 3.087%(89/2 883), the reoperation rate was 1.590%(45/2 830), the duration of postoperative hospital stay was 17(11)days, the hospitalization mortality rate was 0.798%(23/2 882), and the failure rate of rescue data in 2 083 cases with severe complications was 6.529%(19/291). There were 2 477 patients receiving postoperative 90-day follow-up, with the 90-day mortality of 2.705%(67/2477). The total incidence rate of complication in 2 886 patients was 58.997%(1 423/2 412). The incidence rate of severe complication was 13.970%(291/2 083). The comprehensive complication index was 8.7(22.6) in 2 078 patients. (3) Influencing factors for 90-day mortality after pancreaticoduodenectomy. Results of multivariate analysis showed that age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment were independent risk factors for 90-day mortality after pancreaticoduodenectomy ( odds ratio=2.403, 2.609, 16.141, 95% confidence interval as 1.281-4.510, 1.298-5.244, 7.119-36.596, P<0.05). Average annual surgical volume ≥36 cases in the hospital was an independent protective factor for 90-day mortality after pancreaticoduodenectomy ( odds ratio=0.368, 95% confidence interval as 0.168-0.808, P<0.05). Conclusions:Pancreaticoduodenectomy in Jiangsu Province is highly con-centrated in some hospitals, with a high incidence of postoperative complications, and the risk of postoperative 90-day mortality is significant higher than that of hospitallization mortality. Age ≥ 70 years, postoperative invasive treatment, and unplanned ICU treatment are independent risk factors for 90-day motality after pancreaticoduodenectomy, and average annual surgical volume ≥36 cases in the hospital is an independent protective factor.

Objective To objectively quantitative assess the visual quality in patients with myopic foveoschisis (MF) using a double-pass optical quality analysis system (OQASⅡ).Methods Sixty-two subjects participated in this cross-sectional,observational study,who were divided into three groups based on the pathologic conditions including myopic fovcoschisis group (MFG),myopic control group (MCG) and normal control group (NCG).Measurements with OQAS Ⅱ were performed for the modulation transfer function cut off frequency (MTFcut-off),the Strehl ratio (SR) and the objective scatter index (OSI).Visual data were analyzed using ANOVA and Pearson's correlation accompanied by logMAR BCVA and axial length (AL).Results The mean values for MTFcut-off,SRand OSIof MFG,MCGand NCG were 18.18±4.81,0.13± 0.03,3.50±0.44;22.87±2.66,0.14±0.02,2.42±0.29;33.68±4.70,0.23±0.02,1.68±0.20 respectively,and statistical difference were proved except SR between MFG and MCG,or BCVA between MCG and NCG (P＜ 0.05).LogMAR BCVA and AL have negative correlations to MTF cut-off (r =-0.928,-0.658;P＜0.05) and SR (r=-0.577,-0.893;P＜0.05) with high coefficients in MFG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.659,-0.806;P＜0.05) in MCG.Log MAR BCVA has negative correlations to MTF cut-off and SR (r=-0.606,-0.602;P＜0.05) and positively correlated to OSI (r=0.561,P＜0.05) in NCG.Conclusions The mean value of BCVA,MTF cut-off,SR,OSI of myopic foveoschisis patients were lower than those myopic patients without foveoschisis and normal people.there exists a significant negative correlation between Log MAR BCVA,AL to MTF cut-off and SR.Compared with myopic and normal subjects,myopic foveoschisis have lower BCVA,MTF cut off,SR but higher OSI.

OBJECTIVE To investigate the effect of mono-2-ethylhexyl phthalate(MEHP) on proliferation of primary neural stem cells(NSCs)of rats and NE-4C cells of mice and on the migration of NE-4C cells and the mechanism. METHODS NE-4C or NSCs were treated with MEHP 1,10,100 and 1000 μmol · L-1 for 72 h,respectively. The cytotoxicity was estimated with the cell counting kit-8 (CCK-8). Cell proliferation was analyzed by EdU assay. The mRNA expression levels of the glucocorticoid receptor(GR),signal transducer and activator of transcription 3(Stat3)and sex determining region Y (SRY)-box 2(Sox2) were detected by qRT-PCR. The protein expression levels of total GR,GRβ, Sox2,Stat3 and p-Stat3 were measured by Western blotting. RESULTS Cell viability of NE-4C cells and NSCs at MEHP 1000μmol·L-1 was significantly decreased,which was 70.3%and 40.0%of the control group, respectively. EdU assay showed that MEHP 100 μmol · L-1 decreased NE-4C cells and NSCs by 74.8%and 12.0%(P<0.05)compared with control. The effect of MEHP on the cell migration of NE-4C was evidenced by the fact that the migration was obviously reduced to (63.4±2.0)%(P<0.05)after treatment with MEHP 100μmol · L-1 for 72 h. The mRNA expression levels associated with proliferation and migration in NE-4C of GR,Stat3 and Sox2 in MEHP 100 μmol · L-1 group were down-regulated to 49.8%,26.0% and 14.0%of control(P<0.05). At MEHP 100μmol · L-1,mRNA of GR, Stat3 and Sox2 in NSCs declined to 10.0%,14.0% and 15.3% of normal control. Western blotting results revealed that protein expressions of GR,GRβ,Sox2 and p-Stat3 were remarkably inhibited by MEHP 100 μmol · L-1 in that the relative expression of NE-4C was 0.92 ± 0.17,0.87 ± 0.35,0.81 ± 0.22 and 0.62 ± 0.24(P<0.05). The corresponding protein expression in NSCs was 0.82 ± 0.20,0.56 ± 0.12,0.84 ± 0.36 and 0.53 ± 0.20(P<0.05)when the cells were treated with MEHP 100μmol · L-1 for 72 h. CONCLUSION MEHP can inhibit the proliferation and migration of NE-4C cells and NSCs possibly by decreasing Stat3 and Sox2 that are mediated by GRβ.