Objective:To investigate the variations and co-alteration of KRAS and HER-family genes in the patients with ampullary carcinoma.Methods:A total of 37 formalin-fixed paraffin-embedded primary ampullary carcinoma specimens, which were collected at Peking Union Medical College Hospital from April 2019 to October 2024 were analyzed for KRAS and HER-family gene mutations using next-generation sequencing (NGS). Immunohistochemistry (IHC) was performed for HER2 protein expression in HER2 mutation cases and fluorescence in situ hybridization (FISH) for further gene status in HER2 IHC 2+cases.Results:In our cohort (22 males, 15 females; 31-82 years old), KRAS gene mutations were detected in 51.4% (19/37) of cases, with G12D being the most frequent abnormality (7/19), followed by G12V (5/19) and Q61R (3/19). Other variants of KRAS gene included G12C, A146T, N116H, and Q61H (each 1/19). In this cohort, 27.0% (10/37) of cases harbored HER-family gene alterations with most frequently in HER2 (6/10) and HER3 genes (missense mutations mainly). Notably, 3 cases (8.1%, 3/37) with coexistence of KRAS and HER-family genes mutations were recognized in our series, including KRAS p.G12D/HER2 p.V842I/HER2 p.V777L (c.2329 G>T)/HER3 p.Asp581Asn, KRAS p.Q61R/HER4 p.D1018H and KRAS p.G12C/HER2 p.R678Q. Additionally, a mutation of HER3 p.V104L (c.310 G>C) was identified in our population. Moreover, 4 novel mutations including HER3 p.V296E, HER3 p.V920L (c.2758 G>T), HER3 p.Asp581Asn, and HER4 p.D1018H were detected. In 6 tumors with HER2 gene changes (16.2%, 6/37), 5 variants with the high proportion of HER2 p.S310Y (3/6) were revealed. A tumor (HER2 IHC 2+) with HER2 p.S310Y presented HER2 gene amplification confirmed by NGS and FISH, and another one (also HER2 IHC 2+) with HER2 p.L755S possessed HER2 gene amplification determined by FISH assay.Conclusion:In ampullary carcinoma, co-alteration of KRAS and HER-family genes is observed, and HER2 gene mutations account for more than half of HER-family gene abnormities, which may be accompanied by gene amplification.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

Objective:To investigate the clinical effectiveness of Du Meridian moxibustion combined with brisk walking on negative symptoms, cognitive function, and social function in patients with stable schizophrenia, aiming to provide a feasible adjunctive treatment for clinical practice.Methods:A randomized controlled trial was conducted using convenience sampling to recruit 140 patients with stable schizophrenia hospitalized at the Affiliated Brain Hospital of Guangzhou Medical University from April 1, 2023, to March 31, 2024. Patients were randomly assigned to a control group, Du Meridian moxibustion group, brisk walking group, or combined group, with 35 patients in each group. The control group received standard care. On this basis, the Du Meridian moxibustion group received moxibustion on the Du Meridian, the brisk walking group participated in slow walking exercises, and the combined group received both interventions for 12 weeks. Assessments were conducted at baseline, at 6 and 12 weeks during the intervention, and at 12 weeks post-intervention using the Scale for the Assessment of Negative Symptoms, Mini-Mental State Examination, and Social Functioning Scale for Inpatient Psychiatric Patients.Results:A total of 134 patients completed the study: control group ( n = 34), Du Meridian moxibustion group ( n = 34), brisk walking group ( n = 35), and combined group ( n = 31). The combined group demonstrated significantly lower SANS scores at the 12th week of intervention (49.71 ± 4.66) and at 12 weeks post-intervention (53.45 ± 5.34) compared to the Du Meridian moxibustion group (54.91 ± 4.79) and (59.56 ± 5.84), the brisk walking group (56.69 ± 5.59) and (58.51 ± 5.42), control group (65.71 ± 4.95) and (66.21 ± 4.33), with statistically significant differences ( t values were 3.81-13.37, all P<0.05). Regarding cognitive function, the MMSE scores in the combined group at the 12th week of intervention (28.23 ± 1.28) and at 12 weeks post-intervention (27.35 ± 1.76) were higher than those in the Du Meridian moxibustion group (26.79 ± 1.85) and (25.59 ± 2.27) and the brisk walking group (25.88 ± 2.23) and (25.43 ± 1.84), control group (23.65 ± 2.17) and (22.32 ± 2.14), with statistically significant differences ( t values were - 10.28 to - 3.48, all P<0.001). For social function, the SSPI scores in the combined group at the 12th week of intervention (35.71 ± 3.63) and at 12 weeks post-intervention (32.58 ± 3.71) were also significantly higher than those in the Du Meridian moxibustion group (32.21 ± 3.91) and (28.47 ± 3.70) and the brisk walking group (31.83 ± 3.54) and (30.31 ± 3.59), control group (24.53 ± 4.12) and (24.15 ± 3.50) with statistically significant differences ( t values were - 11.56 to - 2.52, all P<0.05). Conclusions:The combination of Du Meridian moxibustion and brisk walking is an effective adjunctive intervention for patients with stable schizophrenia, as it significantly reduces negative symptoms, enhances cognitive function, and improves social functioning.

Objective:To investigate the clinical effectiveness of Du Meridian moxibustion combined with brisk walking on negative symptoms, cognitive function, and social function in patients with stable schizophrenia, aiming to provide a feasible adjunctive treatment for clinical practice.Methods:A randomized controlled trial was conducted using convenience sampling to recruit 140 patients with stable schizophrenia hospitalized at the Affiliated Brain Hospital of Guangzhou Medical University from April 1, 2023, to March 31, 2024. Patients were randomly assigned to a control group, Du Meridian moxibustion group, brisk walking group, or combined group, with 35 patients in each group. The control group received standard care. On this basis, the Du Meridian moxibustion group received moxibustion on the Du Meridian, the brisk walking group participated in slow walking exercises, and the combined group received both interventions for 12 weeks. Assessments were conducted at baseline, at 6 and 12 weeks during the intervention, and at 12 weeks post-intervention using the Scale for the Assessment of Negative Symptoms, Mini-Mental State Examination, and Social Functioning Scale for Inpatient Psychiatric Patients.Results:A total of 134 patients completed the study: control group ( n = 34), Du Meridian moxibustion group ( n = 34), brisk walking group ( n = 35), and combined group ( n = 31). The combined group demonstrated significantly lower SANS scores at the 12th week of intervention (49.71 ± 4.66) and at 12 weeks post-intervention (53.45 ± 5.34) compared to the Du Meridian moxibustion group (54.91 ± 4.79) and (59.56 ± 5.84), the brisk walking group (56.69 ± 5.59) and (58.51 ± 5.42), control group (65.71 ± 4.95) and (66.21 ± 4.33), with statistically significant differences ( t values were 3.81-13.37, all P<0.05). Regarding cognitive function, the MMSE scores in the combined group at the 12th week of intervention (28.23 ± 1.28) and at 12 weeks post-intervention (27.35 ± 1.76) were higher than those in the Du Meridian moxibustion group (26.79 ± 1.85) and (25.59 ± 2.27) and the brisk walking group (25.88 ± 2.23) and (25.43 ± 1.84), control group (23.65 ± 2.17) and (22.32 ± 2.14), with statistically significant differences ( t values were - 10.28 to - 3.48, all P<0.001). For social function, the SSPI scores in the combined group at the 12th week of intervention (35.71 ± 3.63) and at 12 weeks post-intervention (32.58 ± 3.71) were also significantly higher than those in the Du Meridian moxibustion group (32.21 ± 3.91) and (28.47 ± 3.70) and the brisk walking group (31.83 ± 3.54) and (30.31 ± 3.59), control group (24.53 ± 4.12) and (24.15 ± 3.50) with statistically significant differences ( t values were - 11.56 to - 2.52, all P<0.05). Conclusions:The combination of Du Meridian moxibustion and brisk walking is an effective adjunctive intervention for patients with stable schizophrenia, as it significantly reduces negative symptoms, enhances cognitive function, and improves social functioning.

Objective:To investigate the variations and co-alteration of KRAS and HER-family genes in the patients with ampullary carcinoma.Methods:A total of 37 formalin-fixed paraffin-embedded primary ampullary carcinoma specimens, which were collected at Peking Union Medical College Hospital from April 2019 to October 2024 were analyzed for KRAS and HER-family gene mutations using next-generation sequencing (NGS). Immunohistochemistry (IHC) was performed for HER2 protein expression in HER2 mutation cases and fluorescence in situ hybridization (FISH) for further gene status in HER2 IHC 2+cases.Results:In our cohort (22 males, 15 females; 31-82 years old), KRAS gene mutations were detected in 51.4% (19/37) of cases, with G12D being the most frequent abnormality (7/19), followed by G12V (5/19) and Q61R (3/19). Other variants of KRAS gene included G12C, A146T, N116H, and Q61H (each 1/19). In this cohort, 27.0% (10/37) of cases harbored HER-family gene alterations with most frequently in HER2 (6/10) and HER3 genes (missense mutations mainly). Notably, 3 cases (8.1%, 3/37) with coexistence of KRAS and HER-family genes mutations were recognized in our series, including KRAS p.G12D/HER2 p.V842I/HER2 p.V777L (c.2329 G>T)/HER3 p.Asp581Asn, KRAS p.Q61R/HER4 p.D1018H and KRAS p.G12C/HER2 p.R678Q. Additionally, a mutation of HER3 p.V104L (c.310 G>C) was identified in our population. Moreover, 4 novel mutations including HER3 p.V296E, HER3 p.V920L (c.2758 G>T), HER3 p.Asp581Asn, and HER4 p.D1018H were detected. In 6 tumors with HER2 gene changes (16.2%, 6/37), 5 variants with the high proportion of HER2 p.S310Y (3/6) were revealed. A tumor (HER2 IHC 2+) with HER2 p.S310Y presented HER2 gene amplification confirmed by NGS and FISH, and another one (also HER2 IHC 2+) with HER2 p.L755S possessed HER2 gene amplification determined by FISH assay.Conclusion:In ampullary carcinoma, co-alteration of KRAS and HER-family genes is observed, and HER2 gene mutations account for more than half of HER-family gene abnormities, which may be accompanied by gene amplification.

Humans ; Urinary Bladder Neoplasms/pathology* ; Carcinoma, Transitional Cell/pathology* ; Genetic Markers ; Biomarkers, Tumor/genetics* ; Urothelium/pathology*

BACKGROUND: The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system. METHODS: From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed. RESULTS: A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively. CONCLUSION The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
Male ; Humans ; Robotic Surgical Procedures/methods* ; Robotics ; Treatment Outcome ; Retrospective Studies ; Ureter/surgery* ; Urologic Surgical Procedures/methods* ; Laparoscopy/methods*

Objective    To explore the application value of machine learning models in predicting postoperative survival of patients with thoracic squamous esophageal cancer. Methods    The clinical data of 369 patients with thoracic esophageal squamous carcinoma who underwent radical esophageal cancer surgery at the Department of Thoracic Surgery of Northern Jiangsu People's Hospital from January 2014 to September 2015 were retrospectively analyzed. There were 279 (75.6%) males and 90 (24.4%) females aged 41-78 years. The patients were randomly divided into a training set (259 patients) and a test set (110 patients) with a ratio of 7 : 3. Variable screening was performed by selecting the best subset of features. Six machine learning models were constructed on this basis and validated in an independent test set. The  performance of the models' predictions was evaluated by area under the curve (AUC), accuracy and logarithmic loss, and the fit of the models was reflected by calibration curves. The best model was selected as the final model. Risk stratification was performed using X-tile, and survival analysis was performed using the Kaplan-Meier method with log-rank test. Results    The 5-year postoperative survival rate of the patients was 67.5%. All clinicopathological characteristics of patients between the two groups in the training and test sets were not statistically different (P>0.05). A total of seven variables, including hypertension, history of smoking, history of alcohol consumption, degree of tissue differentiation, pN stage, vascular invasion and nerve invasion, were included for modelling. The AUC values for each model in the independent test set were: decision tree (AUC=0.796), support vector machine (AUC=0.829), random forest (AUC=0.831), logistic regression (AUC=0.838), gradient boosting machine (AUC=0.846), and XGBoost (AUC=0.853). The XGBoost model was finally selected as the best model, and risk stratification was performed on the training and test sets. Patients in the training and test sets were divided into a low risk group, an intermediate risk group and a high risk group, respectively. In both data sets, the differences in surgical prognosis among three groups were statistically significant (P<0.001). Conclusion    Machine learning models have high value in predicting postoperative prognosis of thoracic squamous esophageal cancer. The XGBoost model outperforms common machine learning methods in predicting 5-year survival of patients with thoracic squamous esophageal cancer, and it has high utility and reliability.

Objective:To evaluate the safety and effectiveness of Kangduo endoscopic surgical robot system for partial nephrectomy.Methods:Consecutive patients with stage T 1 renal tumor meeting the inclusion criteria from the Department of Urology, Peking University First Hospital from December 2020 to February 2021 were prospectively enrolled. All patients underwent partial nephrectomy with the Kangduo endoscopic surgical robot system after signing the informed consent. Clinical data including preoperative, perioperative and postoperative pathology and follow-up were collected. Results:Among the 26 patients, there were 16 males and 10 females, with a median age of 53(33-74) years, and a median body mass index of 25.99(20.90-32.91) kg/m 2. There were 12 cases of left kidney tumor and 14 cases of right kidney tumor. The median tumor diameter was 2.2(1.0-3.5) cm. The median time of warm ischemia was 17.7(7.1-29.2) minutes, and all of them were less than 30 minutes. The median docking time was 4.7(2.3-9.9) minutes, and the median time of robotic arm operation was 65.0 (37.0-155.0) minutes. The median National Aeronautics and Space Administration Task Load Index (NASA-TLX) score was 5.3 (2.0-28.0), and no instrument-related adverse events occurred intraoperatively. The median postoperative hospital stay was 4 (4-5) days. All tumor margins were negative on pathologic reports. No Clavien Ⅱ stage operative complications occurred in all patients during perioperative period and 1 month after the surgery. Conclusions:The partial nephrectomy using the kangduo endoscopic surgical robot system were completed successfully, and no instrument-related adverse events and complications occurred, showing that this surgical system used for partial nephrectomy is safe and effective.