Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

Objective To investigate the expression of lncRNA SENCR in aortic dissection(AD)tissues of AD patients and its effect on and mechanism in the proliferation apoptosis of human vascular smooth muscle cells(HVSMCs).Methods HE staining was done to detect the pathological changes of AD tissues.Fluorescence in situ hybridization(FISH)and RT-qPCR were used to determine the expression of SENCR in the AD tissue and HVSMCs and the expression of SENCR and miR-206 in the tissues,respectively.HVSMCs were cultured and trans-fected with pcDNA3.1-SENCR overexpression plasmids,or pcDNA3.1 blank plasmid.Then cell proliferation and apoptosis were detected by CCK-8 method and Annexin V/PI double staining flow cytometry assay,respectively.Double luciferase report verified the targeting relationship between SENCR and miR-206.Results SENCR was mainly located in the cytoplasm and nucleus of HVSMCs.Compared with the normal tissue,the expression of SENCR in the AD tissues was down-regulated(P＜0.01),but the expression of miR-206 was up-regulated(P＜0.01).Overexpressed SENCR decreased the cell proliferation of HVSMCs(P＜0.01),but significantly increased the cell apoptosis of HVSMCs(P＜0.01).SENCR could target and negatively regulate miR-206.Conclusion The expression of SENCR is down-regulated in AD tissues,and overexpressed SENCR may inhibit the proliferation and promote the apoptosis of HVSMCs by targeting down-regulated miR-206.

Objective:To investigate the predictive value of systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and CT perfusion imaging (CTP) parameters for early neurological deterioration (END) in patients with mild stroke duo to anterior circulation large vessel occlusion.Methods:Patients with minor stroke duo to anterior circulation large vessel occlusion admitted to the First People's Hospital of Suqian from November 2021 to December 2023 were included. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score ≤ 5, and END was defined as an increase of ≥ 4 in NIHSS score within 24 hours of admission compared to the baseline. SIRI and SII were calculated based on the findings of blood routine examination. According to CTP at admission, the cerebral blood volume (CBV) index, infarct core volume, and early infarct growth rate (EIGR) were obtained. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of each predictor on END. Results:A total of 132 patients were included, with 85 males (64.4%) and a median age of 68 years (interquartile range, 58-77 years). Thirty-nine patients (29.5%) experienced END. The baseline NIHSS score, fasting blood glucose, neutrophil count, lymphocyte count, SIRI, SII, infarct core volume, and EIGR in the END group were significantly higher than those in the non-END group, while the CBV index was significantly lower than that in the non-END group (all P<0.05). Multivariate logistic regression analysis showed that SIRI (odds ratio [ OR] 3.672, 95% confidence interval[ CI] 1.838-6.326; P<0.001), SII ( OR 4.824, 95% CI 2.057-7.135; P<0.001), CBV index ( OR 0.968, 95% CI 0.947-0.986; P<0.001), and EIGR ( OR 2.527, 95% CI 1.918-3.589; P<0.001) were the independent predictive factors of END. ROC curve analysis showed that the area under the curves of SIRI, SII, CBV index, and EIGR for predicting END were 0.780 (95% CI 0.692-0.863), 0.798 (95% CI 0.709-0.888), 0.775 (95% CI 0.697-0.853), and 0.772 (95% CI 0.732-0.829), respectively. Conclusion:SIRI, SII, CBV index, and EIGR are the independent predictive factors of END in patients with minor stroke duo to anterior circulation large vessel occlusion, and have certain predictive value for END.

Objective:To examine whether the combination of quantitative regional apparent diffusion coefficient (ADC) and amplitude-integrated electroencephalogram (aEEG) can predict the outcome of comatose patients with severe traumatic brain injury (sTBI).Methods:A prospective study was conducted. The patients with coma caused by sTBI [Glasgow coma scale (GCS) < 8] admitted to Suqian First Hospital from January 2016 to June 2019 were enrolled. All patients underwent aEEG examination and magnetic resonance imaging (MRI) scan within 1 week after emergency treatment. The ADC values of 9 regions of interest (frontal gray matter and white matter, parietal gray matter and white matter, temporal gray matter and white matter, caudate nucleus of basal ganglia, lenticular nucleus and thalamus) were measured by head MRI, and the mean ADC values of frontal lobe, parietal lobe, temporal lobe and basal ganglia were calculated respectively. According to the follow-up results after 12 months, the differences of each index between patients with poor prognosis [Glasgow outcome score (GOS) 1-2] and patients with good prognosis (GOS 3-5) were compared; the receiver operating characteristic curve (ROC curve) was drawn to evaluate the predictive ability of aEEG and ADC for the good prognosis of patients with sTBI, and the predictive value of the combination of aEEG and ADC.Results:A total of 52 patients with sTBI were enrolled, with mean age of (36.7±13.9) years old, 35 of whom were male. Within 12 months follow-up, 29 patients had achieved favorable outcomes and 23 patients had unfavorable outcome. There were 21, 17 and 14 patients with aEEG , and grade, respectively, and 19, 10 and 0 patients had good prognosis respectively. ADC values of 9 regions of interest in patients with good prognosis were significantly higher than those in patients with poor prognosis (×10 -6 mm 2/s: 924±107 vs. 531±87 in frontal gray matter, 804±95 vs. 481±74 in frontal white matter, 831±93 vs. 683±72 in temporal gray matter, 726±87 vs. 654±63 in temporal white matter, 767±79 vs. 690±75 in parietal gray matter, 716±84 vs. 642±62 in parietal white matter, 689±70 vs. 465±68 in caudate nucleus, 723±84 vs. 587±71 in lenticular nucleus, 807±79 vs. 497±67 in thalamus, all P < 0.01). ROC curve analysis showed that the area under ROC curve (AUC) of aEEG for predicting good prognosis of sTBI patients was 0.826, when the cut-off value of aEEG was < 1.5, the sensitivity was 94.7% and the specificity was 72.8%. Among the ADC value prediction abilities in the interested areas, the prediction of ADC value in frontal lobe and basal ganglia area were better than that in sTBI patients. AUC was 0.817 and 0.903 respectively. The best cut-off values were > 726×10 -6 mm 2/s and > 624×10 -6 mm 2/s respectively, the sensitivity of predicting prognosis were both 100%, and the specificity was 63.4% and 61.8%. A model combining frontal ADC and basal ganglia ADC with aEEG was 91.0% sensitive and 93.7% specific for favorable outcome of sTBI patients. Conclusion:Combination of the quantitative measurement of regional ADC and aEEG may be useful for predicting the outcome of the patients with sTBI.

Coronavirus-NL63 is a common respiratory virus, which often causes severe respiratory symptoms such as fever, cough, expectoration, pneumonia and so on. The damage of central nervous system is rare. A case of acute necrotizing encephalitis caused by respiratory coronavirus-NL63 infection with cognitive impairment as the first symptom is reported, finding of CT/magnetic resonance imaging scanning indicating necrosis combined with a striated encephalomalacia of the corpus callosum and bilateral cerebral hemispheres.

Objective To assess cognitive impairment and its correlation with power of quantitative electroencephalogram (qEEG) in patients with temporal lobe epilepsy (TLE).Methods Fifty-five patients with TLE seen consecutively in Suqian First Hospital and 40 healthy controls (HC) were assessed by Mini-Mental State Examination (MMSE),Brief Cognitive Battery (BCB) and qEEG.The global interhemispheric and intrahemispheric difference values for power spectral ratios (Dv-PSR) were calculated.Cognitive functions and Dv-PSR of the TLE patients and the HC were compared,and correlation between cognitive impairment and power of qEEG was assessed using Spearman correlation analysis.The significance level was set at P≤0.05.Results Statistical analysis showed that MMSE scores did not have statistically significant difference between the TLE patients and the HC (26.9±2.4 vs 27.3±2.6,t=0.502,P=0.549).However,BCB examination showed that immediate memory,incidental memory,delayed recall,learning test,verbal fluency and recognition differed significantly between the TLE and the HC groups (7.34± 1.33 vs 8.92±1.37,6.05±1.12 vs 7.93±1.20,6.77±1.08 vs 8.19±1.14,11.87±4.47 vs 16.8±4.56,8.52±1.74 vs 9.75 ± 1.36,8.74 ± 1.19 vs 9.87 ± 1.18,respectively;t=2.916,Z=3.204,t=2.549,Z=3.937,t=1.341,t=2.791,P＜ 0.05).Interhemispheric Dv-PSR in frontal,central,temporal and parietal area was higher in the TLE group than in the HC group (0.478±0.043 vs 0.252±0.028,0.441±0.051 vs 0.306±0.039,0.394±0.027 vs 0.247± 0.018,0.511±0.036 vs 0.224±0.021,respectively;t=3.711,2.403,3.144,4.327,P＜0.05),and intrahemispheric Dv-PSR in frontal,central,parietal and occipital area (minus temporal area respectively) was also higher in the TLE group than in the HC group (0.521±0.024 vs 0.221±0.017,0.249±0.012 vs 0.167±0.008,0.187± 0.013 vs 0.104 ± 0.007,0.313 ± 0.021 vs 0.127 ± 0.009,respectively;t=4.208,3.192,2.611,3.737,P＜0.05).Spearman analysis showed positive correlations between intrahemispheric,interhemispheric Dv-PSR and several cognitive domains impairment assessed by BCB (P＜0.05).Conclusion There was mild cognitive impairment in TLE patients,which was significantly associated with Dv-PSR assessed by qEEG,suggesting that Dv-PSR measurement may be used as a marker for cognitive impairment in epilepsy.

Objective To produce a plastic ampoule with an opening that fits syringe adapters to allow solutions to be drawn up without needles (to avoid needle stick and sharps injuries) and to test the effectiveness of the new design in terms of residual fluid volume and risk of microorganism contamination. Methods Evaluation study based on laboratory research was adopted. For the experimental group, 30 ampoules based on the new design were produced by 3D printing. The ampoules were sterilized and filled with 2 ml sterile water. The sterile water was drawn up without the use of needles, and the wastage fluid (i.e., 2 ml minus the quantity drawn up) was calculated. A 1 ml aliquot of sterile water from each ampoule was dropped onto a nutrient agar plate, and the number of colony-forming units was assessed after 48 h. For each ampoule, the experiment was performed twice. Sixty 2 ml glass-packaged sterile water injections constituted the control group. The fluid was drawn up with a needle, and the superfluous fluid and number of colony-forming units were assessed, as in the experimental group. Results The mean wastage fluid was 0.06 ml, 95% CI was 0.05-0.07 ml in the experimental group and the superfluous fluid was 0.06 ml, 95% CI was 0.06-0.07 ml in the control group, there was no significant difference between the two groups (Z=-1.194, P=0.233). The number of colony-forming units was 8 in the experimental group and 4 in the control group, there was no significant difference between the two groups (P=0.224). Conclusions The newly designed plastic ampoule opening could help health workers to avoid needle stick and sharps injuries when drawing up solution. The wastage fluid and microorganism contamination levels met the required standards, indicating that the new design is suitable for clinical application.

Objective To study the clinical value of amplitude integrated EEG(aEEG),EEG reactivity,EEG patterns,and Glasgow Coma Scale(GCS) scores of predicting the prognosis in comatose patients with severe traumatic brain injury.Methods Sixty-four hospitalized comatose patients with severe traumatic brain injury were evaluated by aEEG,EEG reactivity,EEG patterns and GCS and followed up for one year to observe the prognosis of the patients.Results Accuracy of aEEG,EEG reactivity,EEG patterns and GCS in predicting outcomes of comatose patients with severe traumatic brain injury correctly classified as 73.4％,68.8％,73.4％,64.1％ respectively.The accuracy of GCS in evaluating the prognosis of comatose patients with severe traumatic brain injury was lower than that of the other three methods (P＜0.05).There were positive correlations among aEEG,EEG reactivity,EEG patterns,and GCS (r=0.574-0.843,P＜ 0.05).There were positive correlations between aEEG,EEG reactivity,EEG patterns,GCS and the patients' prognosis(r=0.647,0.609,0.621,0.532,P＜ 0.05).Conclusion As a new electroencephalographic technique,aEEG combined with EEG reactivity,EEG patterns,and GCS can be effectively used to evaluate the prognosis of STBI coma patients,which has a certain clinical value.

Objective: To investigate the hospital employee satisfaction and trustworthiness in the background of the trusteeship mode and to find out the problems after trusteeship.Methods: Minnesota satisfaction questionnaire (MSQ) and the self-made questionnaire were used to conduct the survey.Results: The overall employee satisfaction (3.80±0.86) and trustworthiness (3.95±0.77)were higher.The highest level of trustworthiness concerned the cultural connotation (84.8%) followed by the management concept (82.8%) for overall satisfaction.The lowest level of employee satisfaction concerned income and workload (53.7%), followed by the working conditions and environment (55.3%).The administrative staff satisfaction was higher compared to that of medical staff (p=0.001), which showed significant statistical differences.Conclusions: The hospital has made some achievements after the trusteeship system reform, however, it still needs improvement and further strengthening in many aspects.The hospital must always keep abreast of the demands of workforce and improve the staff satisfaction so as to promote its continuous and sustainable development.

Objective To determine whether unilateral-only interictal discharges on pre-surgical scalp EEG or multimodal pre-surgical evaluation are associated with surgical outcomes in patients with MR imaging-negative temporal lobe epilepsy (TLE) who underwent standard anterior temporal lobectomy (ATL). Methods One hundred and seventeen patients with TLE who underwent standard ATL from January 2000 to December 2013 were enrolled. According to the seizures at interictal period, these patients were divided into unilateral-only interictal discharge group (n=54) and bilateral interictal discharge group (n=63). According to the preoperative assessment, these patients were divided into multimodal evaluation group (n=72, two and above evaluation strategies besides electroencephalogram) and single modal evaluation group (n=45, electroencephalogram+one evaluation strategy). Follow-up for 12 months was performed; postsurgical outcomes included excellent outcome, defined as Engel class I, and non-excellent outcome, defined as Engel II-IV. Kaplan-Meier survival analysis and Cox proportion hazards were performed to compare the prognoses of patients from different groups. Results Totally, 73 patients (62.4%) achieved excellent outcome following ATL. In 54 with unilateral-only interictal discharges, 41 had excellent outcome; and in 63 with bilateral interictal discharge group, 32 patients had excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). Fifty of 72 patients receiving multimodal pre-surgical evaluation achieved excellent outcome, and 25 of 45 receiving single modal evaluation achieved excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). However, the patients with unilateral-only interictal discharges receiving multimodal pre-surgical assessment did not achieve further excellent outcomes as compared with those receiving single modal evaluation, without significant difference (P>0.05). Conclusion Multimodal pre-surgical evaluation is associated with better outcomes following standard ATL in the patients with MR imaging-negative TLE; however, for patients with unilateral-only interictal discharges, multimodal pre-surgical evaluation method may be not essential as compared with single modal pre-surgical evaluation method.