Objective: To analyze the epidemiological characteristics and influencing factors of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province from 2019 to 2023, so as to provide the reference for strengthening SFTS prevention and control. Methods: Data on laboratory-confirmed SFTS cases in Zhejiang Province from 2019 to 2023 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. Meteorological data, geographic environment and socioeconomic factors during the same period were collected from the fifth-generation European Centre for Medium-Range Weather Forecasts, Geospatial Data Cloud, and Zhejiang Statistical Yearbook, respectively. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of SFTS from 2019 to 2023, and a Bayesian spatio-temporal model was constructed to analyze the influencing factors of SFTS incidence. Results: A total of 578 SFTS cases were reported in Zhejiang Province from 2019 to 2023, with an annual average incidence of 0.23/105. The peak period was from May to July, accounting for 52.60%. There were 309 males and 269 females, with a male-to-female ratio of 1.15∶1. The cases were mainly aged 50-<80 years, farmers, and in rural areas, accounting for 82.53%, 77.34%, and 75.43%, respectively. Taizhou City and Shaoxing City reported more SFTS cases, while Shaoxing City and Zhoushan City had higher annual average incidences of SFTS. The Bayesian spatio-temporal interaction model showed good goodness of fit. The results showed that mean temperature (RR=1.626, 95%CI: 1.111-2.378) and mean wind speed (RR=1.814, 95%CI: 1.321-2.492) were positively correlated with SFTS risk, while altitude (RR=0.432, 95%CI: 0.230-0.829) and population density (RR=0.443, 95%CI: 0.207-0.964) were negatively correlated with SFTS risk. Conclusions SFTS in Zhejiang Province peaks from May to July. Middle-aged and elderly people and farmers are high-risk populations. Taizhou City, Shaoxing City, and Zhoushan City are high-incidence areas. Mean temperature, mean wind speed, altitude, and population density can all affect the risk of SFTS incidence.

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.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.

Objective:To investigate the effectiveness of the 5A (Ask, Assess, Advise, Assist, Arrange follow-up) management model based on personalized health education records in community patients with type 2 diabetes mellitus.Methods:A convenience sampling method was used to select patients with type 2 diabetes mellitus who were enrolled with family doctors in Yuxin Community, Haidian District, Beijing, from January 2022 to May 2023. Using a random number table method, the patients were divided into an observation group ( n=68) and a control group ( n=68). The control group received routine community management, while the observation group received management based on the 5A model and personalized health education records. Differences in metabolic indicators, including glycated hemoglobin (HbA1c), fasting blood glucose, 2-hour postprandial blood glucose, body mass index (BMI), and waist circumference, as well as self-management behaviors were compared between the two groups at 3, 6, and 12 months of intervention. Results:During the entire intervention period, four cases were lost in the observation group and eight cases were lost in the control group. Finally, data from 124 patients were included in the analysis, including 64 cases in the observation group and 60 cases in the control group. Repeated measures analysis of variance showed interaction effects between time points and groups for HbA1c, BMI, waist circumference, and self-management behavior scores among patients with diabetes, with statistically significant differences ( P<0.05) . Conclusions:The 5A management model based on personalized health education records has a positive impact on improving metabolic indicators and self-management behaviors in community patients with type 2 diabetes mellitus.

ObjectiveTo reveal the active substances and mechanisms of modified Qing'e formula （MQEF） in delaying skin photoaging by ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry （UPLC-Q-TOF-MS），network pharmacology， and cell experiments. MethodsUPLC-Q-TOF-MS and a literature review were employed to analyze the transdermally absorbed components in mice after the topical application of MQEF. The potential targets of MQEF in treating skin photoaging were retrieved from databases.The compound-potential target network and protein-protein interaction network were constructed to screen the key components and core targets. A photoaging cell model was established by irradiating HaCaT cells with medium-wave ultraviolet B （UVB）. The safe doses of bakuchiol （BAK） and salvianolic acid B （SAB） for treating HaCaT cells and the effects of BAK and SAB on the viability of cells exposed to UVB irradiation were determined by the cell counting kit-8 （CCK-8） method.The reactive oxygen species （ROS） fluorescent probe was used to measure the ROS production in the cells treated with BAK and SAB.The expression levels of genes related to oxidative stress，inflammation，collagen metabolism，and circadian rhythm clock were measured by Real-time PCR. ResultsA total of 24 transdermally absorbed components of MQEF were identified，which acted on 367 potential targets，and 417 targets related to skin photoaging were screened out，among which 47 common targets were predicted as the targets of MQEF in treating skin photoaging. MQEF exerted the anti-photoaging effect via key components such as BAK and SAB，which acted on core proteins such as serine/threonine kinase 1 （Akt1） and mitogen-activated protein kinase 3 （MAPK3） and intervened in core pathways such as the tumor necrosis factor （TNF） and phosphatidylinositol-3-kinase （PI3K）/protein kinase B （Akt） signaling pathways.Compared with the model group，the administration of BAK and SAB increased the survival rate of HaCaT cells （P<0.01），down-regulated the mRNA levels of cyclooxygenase-2 （COX-2），interleukin-6 （IL-6），tumor necrosis factor-α （TNF-α），matrix metalloproteinase-1 （MMP-1），and matrix metalloproteinase-9 （MMP-9） （P<0.01），and up-regulated the mRNA levels of heme oxygenase-1 （HO-1） and NAD（P）H quinone dehydrogenase 1 （NQO-1） （P<0.05，P<0.01） in photoaged HaCaT cells.In addition，it eliminated excess ROS production induced by UVB and up-regulated the mRNA levels of brain and muscle ARNT-like 1 （BMAL1） and circadian locomotor output cycles kaput （CLOCK） associated with circadian clock （P<0.05，P<0.01）. ConclusionMQEF delays skin photoaging through the coordinated effects of various components，multiple targets，and diverse pathways.The key components BAK and SAB in MQEF exhibit anti-photoaging properties，which involve inhibiting oxidative stress，preventing collagen degradation，mitigating inflammation，and maintaining normal skin circadian rhythms by regulating clock gene expression.

Objective To investigate the epidemiological trends,temporal and spatial distribution characteristics of pulmonary tuberculosis in Lanping County.Methods Based on tuberculosis management data and basic information systems from the"China Disease Prevention and Control Information System,"pulmonary tuberculosis data from Lanping County for 2018-2023 were obtained.Descriptive epidemiology,concentration method,circular distribution method,and spatial autocorrelation analysis were used to conduct epidemiological and spatial analyses of the pulmonary tuberculosis data.Results A total of 2836 TB cases were reported in Lanping County from 2018 to 2023,with an average annual incidence rate of 233.26 per 100000,showing a declining trend.The male-to-female ratio was 1.95∶1,with the highest incidence among individuals aged 60 and above(932 cases,32.86%).Cases were predominantly among farmers(91.01%)and the Lisu ethnic group(52.68%).TB incidence showed weak seasonality with a bimodal distribution,with primary peak occurring from October to March and secondary peak from June to August.Tu'e Township(324.74 per 100,000),Shideng Township(307.42 per 100000),and Jinding Town(260.98 per 100,000)had the highest incidence rates,accounting for 1,284 cases or 45.28%of the county's total cases.In 2020,the incidence of pulmonary tuberculosis in Lanping County showed a spatial clustering distribution(global Morans's I value<0,P value<0.05),with Shideng Township consistently showing high-low aggregation characteristics.Conclusion Between 2018-2023,while the tuberculosis incidence rate in Lanping County has declined,it still falls short of Yunnan Province's tuberculosis prevention and control targets,and the prevention and control work continues to face significant challenges.Strengthening screening of high-risk populations and providing medical support to remote areas will be key measures for future prevention and treatment.

Objective:To summarize the initial experience of 5G-ultra-long-distance robotic hepatectomy.Methods:This is a retrospective case series study. The clinical information from 5 cases of 5G ultra-long-distance robot-assisted hepatectomy performed was collected from June 2023 to October 2024, in collaboration between Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Hangzhou and Alaer Hospital, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine in Alaer, located 4 600 km apart. The patients comprised 1 male and 4 females, aged from 36 to 59 years, with an average age of 48 years. Their body mass index ranged from 20.4 to 30.9 kg/m2, with an average of 24.62 kg/m2. Preoperatively, 5 patients were diagnosed with liver disease requiring hepatectomy. The operations used 5G ultra-remote four-arm endoscopic robot surgery system. The remote control room was located in Sir Run Run Shaw Hospital (Hangzhou, Zhejiang), and the robot operating room was located in Alaer Hospital (Alaer, Xinjiang). The wired network relied on 60 Mb/s high-speed public Internet special line (China Telecom). In order to ensure the security of data transmission, the system implemented a double-layer encryption strategy for the wired network, and carried out strict debugging and verification for both the wired and wireless networks. Perioperative data and information on network performance were collected for 5 patients.Results:The surgical duration of the 5 cases of 5G ultra-long-distance robot-assisted hepatectomy ranged from 49 to 342 minutes, with an average of 184 minutes. Intraoperative blood loss varied from 5 to 800 ml, averaging 183 ml. Network performance was evaluated during the surgery, revealing an average network latency of 108.2 ms, with no significant lag or delay observed during any of the procedures. All patients recovered smoothly, with a postoperative hospital stay ranging from 5 to 10 days, averaging 7.2 days. Postoperative complications included 1 case of hypoproteinemia and 1 case of pleural effusion. Pathological examination confirmed that all cases suffered benign liver diseases (three patients with hepatic hemangioma, one with regenerative nodule in cirrhosis, and one with hepatolithiasis and choledocholithiasis).Conclusion:The preliminary exploration of clinical practice indicated that 5G-ultra-long-distance robot-assisted surgery is feasible for hepatectomy, with no severe complications affecting patients′ recovery.

Purpose To explore the clinical features and CT/MRI manifestations of fibro-adipose vascular anomaly(FAVA)in children,and to analyze the misdiagnosis reason,in order to improve the diagnostic accuracy.Materials and Methods A retrospective analysis was conducted on 15 pediatric patients with pathologically confirmed FAVA in Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University from January 2014 to April 2024.Among them,11 underwent CT,10 underwent MRI,and 6 underwent both CT and MRI.Their CT and MRI imaging features were analyzed.Results All 15 cases presented single lesion,including eight boys and seven girls,aged from 1 year 7 months to 14 years and the median age was 8 years(6 years and 4 months to 10 years).Clinical manifestations were slow-growing masses in the soft tissues of the limbs or trunk,of which 11 cases were accompanied by pain,two cases by claudication or activity limitation and two cases by skin bruising.CT showed that the lesions were located in intramuscular,intermuscular or subcutaneous tissues;eight cases were iso-hypo-dense,three cases slightly hyper-dense or mixed-dense,ten cases showed fat density and two cases showed venous stone.MRI showed that the lesions were clearer,with fat signals visible in the internal or peripheral areas.The lesions were well defined,with fat signal inside or around the periphery,located in muscle and growing in a shuttle shape along the long axis of the muscle.The fascial tail sign was seen in six cases.All 15 cases showed significant inhomogeneous enhancement,and increased vascularization was seen around the lesions in four cases.Among the 15 pediatric patients,seven were misdiagnosed as vascular malformations,five as hemangiomas,one as angiolipoma,one as inflammatory myofibroblastoma and one was not qualitatively diagnosed.Conclusion The CT and MRI manifestations of FAVA in children have certain characteristics,but they are still prone to misdiagnosis.When intramuscular lesions are found to grow spindle-shaped along the long-axis,containing fat density/signal and blood vessels or vascular clusters,accompanied by fascial tail sign,combined with clinical manifestations such as pain,the possibility of this disease should be considered.

Purpose To explore the clinical features and CT/MRI manifestations of fibro-adipose vascular anomaly(FAVA)in children,and to analyze the misdiagnosis reason,in order to improve the diagnostic accuracy.Materials and Methods A retrospective analysis was conducted on 15 pediatric patients with pathologically confirmed FAVA in Shanghai Children's Hospital,School of Medicine,Shanghai Jiao Tong University from January 2014 to April 2024.Among them,11 underwent CT,10 underwent MRI,and 6 underwent both CT and MRI.Their CT and MRI imaging features were analyzed.Results All 15 cases presented single lesion,including eight boys and seven girls,aged from 1 year 7 months to 14 years and the median age was 8 years(6 years and 4 months to 10 years).Clinical manifestations were slow-growing masses in the soft tissues of the limbs or trunk,of which 11 cases were accompanied by pain,two cases by claudication or activity limitation and two cases by skin bruising.CT showed that the lesions were located in intramuscular,intermuscular or subcutaneous tissues;eight cases were iso-hypo-dense,three cases slightly hyper-dense or mixed-dense,ten cases showed fat density and two cases showed venous stone.MRI showed that the lesions were clearer,with fat signals visible in the internal or peripheral areas.The lesions were well defined,with fat signal inside or around the periphery,located in muscle and growing in a shuttle shape along the long axis of the muscle.The fascial tail sign was seen in six cases.All 15 cases showed significant inhomogeneous enhancement,and increased vascularization was seen around the lesions in four cases.Among the 15 pediatric patients,seven were misdiagnosed as vascular malformations,five as hemangiomas,one as angiolipoma,one as inflammatory myofibroblastoma and one was not qualitatively diagnosed.Conclusion The CT and MRI manifestations of FAVA in children have certain characteristics,but they are still prone to misdiagnosis.When intramuscular lesions are found to grow spindle-shaped along the long-axis,containing fat density/signal and blood vessels or vascular clusters,accompanied by fascial tail sign,combined with clinical manifestations such as pain,the possibility of this disease should be considered.

On the occasion of the 110th Anniversary of the establishment of the Chinese Medical Association, the third conference of the Fourth Editorial Board of Chinese Journal of Digestive Surgery, and the Second Elite Group of Chinese Journal of Digestive Surgery, was successfully held in Kunming on July 4, 2025. This conference systematically summarizes the development experience of the journal over the past 20 years from three aspects: the role of ecological construction of thought in the discipline construction of digestive surgery, the display of the latest academic achievements in the field of digestive surgery, the development difficulties, and breakthrough paths of the discipline, and strategically plans the path of discipline construction in the new era.