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.

Abstract To clarify the service targets, service contents, and safeguard mechanisms of the basic public service program for student vision health management, the study grounded in the current status of child and adolescent myopia prevention and control in China and integrated with the practical experience and innovative practices of Wuhan National Demonstration Area for Student Vision Health Management, takes education as the main thread and schools as the base, consolidating resources from multiple stakeholders including education administrative departments, schools, families, and professional technical service institutions. Centering on four core components—vision health education, monitoring and record keeping, risk prevention and control, and dynamic management, the study constructs a multi tiered basic public service system for vision health management of primary and secondary school students. It further proposes the use of an intelligent management platform and a "three tier color coded early warning" mechanism (red, yellow, blue) to prevent and control student myopia at the source, providing schools with replicable and operable implementation pathways to enhance the level of student vision health management.

Background and Aims:Hepatectomy is an important treatment option for hepatic hemangioma,and the approach has gradually shifted from traditional open surgery to laparoscopic and robotic-assisted surgery.However,there is still no consensus on whether robotic assistance provides better treatment outcomes than laparoscopic surgery for hepatic hemangioma.Therefore,this study was performed to evaluate and compare the clinical efficacy and safety of robotic-assisted and laparoscopic hepatectomy for the treatment of hepatic hemangioma.Methods:The clinical data of 184 patients who underwent minimally invasive hepatectomy for hepatic hemangioma in the Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital of Kunming Medical University,between February 2021 and July 2024 were retrospectively collected.Among them,30 cases were in the robotic group,and 154 cases were in the laparoscopic group.Propensity score matching(PSM)was performed based on baseline data such as patient demographics,tumor characteristics,and surgical resection range,with a 1∶2 matching ratio.Intraoperative and postoperative outcomes were compared between the two groups after matching.Results:After 1∶2 PSM,24 patients were in the robotic group and 48 in the laparoscopic group.Preoperative variables were well balanced between the groups(area under the ROC curve was 0.588).The robotic group had significantly shorter operative time(138 min vs.168 min,P=0.024)and hepatic hilum blocking time(25 min vs.45 min,P＜0.001)compared to the laparoscopic group.Postoperative albumin levels on day 1 and day 3 were higher in the robotic group,while transaminase levels on postoperative day 1 and day 3 were lower(all P＜0.05).However,the hospitalization cost was higher in the robotic group than that in the laparoscopic group(74 746 yuan vs.49 644 yuan,P＜0.001).No significant differences were found between the groups in terms of intraoperative blood loss,intraoperative transfusion rate,open conversion rate,postoperative length of stay,and postoperative complication rates as well as complication severity(all P＞0.05).Conclusion:For suitable cases of hepatic hemangioma,robotic-assisted laparoscopic hepatectomy is a safe and feasible treatment option.Compared to traditional laparoscopic surgery,it reduces operative time and hepatic hilum blocking time,and minimizes the impact on postoperative liver function.However,the treatment cost is higher,and selection should be based on the patient's individual needs.

In order to meet the demand for high-quality medical professionals,it is an important goal of higher medical education to cultivate a compound medical professional degree postgraduate with both clinical and research capabilities.This study aims to investigate the current status of research ability training for medical postgraduate students in our university and analyze the main problems.Through designing and distributing questionnaires,feedback data from medical postgraduate students in our uni-versity were collected.The results show that some students lack research experience,have limited research output,and do not have the habit of independent literature reading.In response to the needs of training medical professional degree postgraduate students,this study proposes improvement suggestions.On one hand,optimizing the curriculum and using a closed-loop teaching mode with interactive discussions.On the other hand,strengthening mentor responsibilities and creating a good research atmos-phere.These measures can help improve the research ability of medical postgraduate students and better meet the demand for high-quality medical professionals.

In order to meet the demand for high-quality medical professionals,it is an important goal of higher medical education to cultivate a compound medical professional degree postgraduate with both clinical and research capabilities.This study aims to investigate the current status of research ability training for medical postgraduate students in our university and analyze the main problems.Through designing and distributing questionnaires,feedback data from medical postgraduate students in our uni-versity were collected.The results show that some students lack research experience,have limited research output,and do not have the habit of independent literature reading.In response to the needs of training medical professional degree postgraduate students,this study proposes improvement suggestions.On one hand,optimizing the curriculum and using a closed-loop teaching mode with interactive discussions.On the other hand,strengthening mentor responsibilities and creating a good research atmos-phere.These measures can help improve the research ability of medical postgraduate students and better meet the demand for high-quality medical professionals.

Background and Aims:Hepatectomy is an important treatment option for hepatic hemangioma,and the approach has gradually shifted from traditional open surgery to laparoscopic and robotic-assisted surgery.However,there is still no consensus on whether robotic assistance provides better treatment outcomes than laparoscopic surgery for hepatic hemangioma.Therefore,this study was performed to evaluate and compare the clinical efficacy and safety of robotic-assisted and laparoscopic hepatectomy for the treatment of hepatic hemangioma.Methods:The clinical data of 184 patients who underwent minimally invasive hepatectomy for hepatic hemangioma in the Department of Hepatobiliary and Pancreatic Surgery,Second Affiliated Hospital of Kunming Medical University,between February 2021 and July 2024 were retrospectively collected.Among them,30 cases were in the robotic group,and 154 cases were in the laparoscopic group.Propensity score matching(PSM)was performed based on baseline data such as patient demographics,tumor characteristics,and surgical resection range,with a 1∶2 matching ratio.Intraoperative and postoperative outcomes were compared between the two groups after matching.Results:After 1∶2 PSM,24 patients were in the robotic group and 48 in the laparoscopic group.Preoperative variables were well balanced between the groups(area under the ROC curve was 0.588).The robotic group had significantly shorter operative time(138 min vs.168 min,P=0.024)and hepatic hilum blocking time(25 min vs.45 min,P＜0.001)compared to the laparoscopic group.Postoperative albumin levels on day 1 and day 3 were higher in the robotic group,while transaminase levels on postoperative day 1 and day 3 were lower(all P＜0.05).However,the hospitalization cost was higher in the robotic group than that in the laparoscopic group(74 746 yuan vs.49 644 yuan,P＜0.001).No significant differences were found between the groups in terms of intraoperative blood loss,intraoperative transfusion rate,open conversion rate,postoperative length of stay,and postoperative complication rates as well as complication severity(all P＞0.05).Conclusion:For suitable cases of hepatic hemangioma,robotic-assisted laparoscopic hepatectomy is a safe and feasible treatment option.Compared to traditional laparoscopic surgery,it reduces operative time and hepatic hilum blocking time,and minimizes the impact on postoperative liver function.However,the treatment cost is higher,and selection should be based on the patient's individual needs.

Hepatocellular carcinoma (HCC) is one of the common and fatal malignant tumors worldwide, and the burden of HCC is particularly severe in China. Physiologically, the blood supply to healthy liver is mainly from the portal vein, supplemented by the hepatic artery. While in the development of HCC, the main source of blood supply to HCC is changed from the portal vein to the hepatic artery. The characteristics of HCC vascularization are important for imaging, surgery, interventional therapy, targeted therapy, etc. Even in the future, with the development of radiation therapy technology, such as proton and heavy ion therapy and artificial intelligence technology, the dynamic changes in HCC blood perfusion can be used as a new biomarker of tumor activity to provide accurate information on the intensity modulation of radiotherapy, so that accurate measurements of HCC blood perfusion is of great significance in guiding the diagnosis and treatment of HCC. The technologies for measurement of HCC blood perfusion have developed from invasive techniques, such as inert gas scavenging, electromagnetic flowmeter, and radionuclide-labeled erythrocyte elution in the middle of the last century to the present non-invasive techniques of CT. With the development of CT imaging technology in the last 30 years, the CT-based imaging technology can assess the status of organ and tissue perfusion relatively easily and accurately. In this paper, the various CT measurement techniques of blood perfusion in HCC were categorized into three types: semi-quantitative technique, relative quantitative technique, and absolute quantitative technique. Their basic principle, scanning methods, and clinical applications were discussed to provide a reference for the diagnosis and treatment of HCC.

Hepatocellular carcinoma (HCC) is one of the common and fatal malignant tumors worldwide, and the burden of HCC is particularly severe in China. Physiologically, the blood supply to healthy liver is mainly from the portal vein, supplemented by the hepatic artery. While in the development of HCC, the main source of blood supply to HCC is changed from the portal vein to the hepatic artery. The characteristics of HCC vascularization are important for imaging, surgery, interventional therapy, targeted therapy, etc. Even in the future, with the development of radiation therapy technology, such as proton and heavy ion therapy and artificial intelligence technology, the dynamic changes in HCC blood perfusion can be used as a new biomarker of tumor activity to provide accurate information on the intensity modulation of radiotherapy, so that accurate measurements of HCC blood perfusion is of great significance in guiding the diagnosis and treatment of HCC. The technologies for measurement of HCC blood perfusion have developed from invasive techniques, such as inert gas scavenging, electromagnetic flowmeter, and radionuclide-labeled erythrocyte elution in the middle of the last century to the present non-invasive techniques of CT. With the development of CT imaging technology in the last 30 years, the CT-based imaging technology can assess the status of organ and tissue perfusion relatively easily and accurately. In this paper, the various CT measurement techniques of blood perfusion in HCC were categorized into three types: semi-quantitative technique, relative quantitative technique, and absolute quantitative technique. Their basic principle, scanning methods, and clinical applications were discussed to provide a reference for the diagnosis and treatment of HCC.

Objective:To investigate the distribution and clinical significance of antiphospholipid anti-body(aPL)in patients with Behcet disease(BD).Methods:A total of 222 BD patients admitted to the Department of Rheumatology and Immunology in Peking University People's Hospital from February 2008 to July 2024 were selected retrospectively.General data of the patients including age and gender were collec-ted.Clinical manifestations(including oral ulcers,genital ulcers,and thrombosis)and laboratory indexes(including aPL,human leukocyte antigen-B51,and anti-endothelial cell antibody)were collec-ted.The recurrence of thrombosis in the BD patients with thrombosis was followed up.Chi-square test was used to compare the clinical symptoms and laboratory indicators between aPL positive group and aPL negative group.Log-rank test was used to compare the recurrence rates of the aPL positive group and the aPL negative group,and P correction was performed by Two-stage method.Finally,Graphpad prism was used for plotting.Results:The prevalence of single aPL,double aPL and triple aPL positivity in the BD patients were 22.1％,0.5％and 1.4％,respectively.The positive rates of anti-cardiolipin antibody,anti-β2 glycoprotein Ⅰ antibody and lupus anticoagulant(LAC)were 10.4％,1.8％and 13.1％,re-spectively.The incidence of thrombosis in the aPL positive group was significantly higher than that in the aPL negative group(44.9％vs.16.9％,P＜0.001).The erythrocyte sedimentation rate[(20.78±4.91)mm/h vs.(15.85±4.29)mm/h,P=0.005],C-reactive protein[(12.97±5.17)mg/L vs.(7.49±4.22)mg/L,P=0.010]and IgM[(1.55±0.95)g/L vs.(1.12±0.72)g/L,P＜0.001]in the aPL positive group were significantly higher than those in the aPL negative group.LAC positivity was an independent risk factor for thrombosis in the BD patients(OR=8.51,95％CI:2.71-26.72,P＜0.001).The recurrence rate of the aPL positive group was higher than that of the aPL negative group,but there was no statistical difference(69.23％vs.52.17％,P=0.932).Conclusion:Positive LAC and aneurysm are independent risk factors for thrombosis in BD patients.At the same time,positive antiphos-pholipid antibody can also significantly increase the risk of thrombosis in BD patients,which has impor-tant significance for guiding the treatment of BD.

Objective:To compare the effects of intensive and standard blood pressure control on the outcomes of patients with acute ischemic stroke in the anterior circulation who have successfully recanalized after endovascular therapy (EVT).Methods:A multicenter, open-label, blinded-endpoint, randomized controlled design was used. Patients with anterior circulation stroke received EVT and successfully recanalized in Nanjing First Hospital, Nanjing Medical University and several branch hospitals from July 2020 to October 2022 were prospectively included. They were randomly divided into the intensive blood pressure control group (target systolic blood pressure [SBP] 100-120 mmHg) or the standard blood pressure control group (target SBP 121-140 mmHg). The blood pressure of both groups needs to achieve the target within 1 h and maintain for 72 h. The primary outcome endpoint was outcome at 90 d, and the good outcome was defined as a score of 0-2 on the modified Rankin Scale. Secondary outcome endpoints included early neurological improvement, symptomatic intracranial hemorrhage (sICH) within 24 h, and death and serious adverse events within 90 d.Results:A total of 120 patients were included, including 63 in the intensive blood pressure control group and 57 in the standard blood pressure control group. There was no statistically significant difference in baseline characteristics between the two groups. The SBP at 72 h after procedure was 122.7±8.1 mmHg in the intensive blood pressure control group and 130.2±7.4 mmHg in the standard blood pressure control group, respectively. There were no significantly differences in the good outcome rate (54.0% vs. 54.4%; χ2=0.002, P=0.963), the early neurological improvement rate (45.2% vs. 34.5%; χ2=1.367, P=0.242), the incidence of sICH (6.3% vs. 3.5%; P=0.682), mortality (7.9% vs. 14.0%; χ2=1.152, P=0.283) and the incidence of serious adverse events (12.7% vs. 15.8%; χ2=0.235, P=0.628) at 90 d between the intensive blood pressure control group and the standard blood pressure control group. Conclusion:In patients with anterior circulation stroke and successful revascularization of EVT, early intensive blood pressure control don’t improve clinical outcomes and reduce the incidence of sICH.