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.

ObjectiveTo construct a risk prediction model for frequent acute exacerbations of chronic obstructive pulmonary disease （COPD） under disease-syndrome combination， thus providing decision support for precise clinical intervention. MethodsA total of 2 029 patients with acute exacerbations of COPD admitted to the First Affiliated Hospital of Anhui University of Chinese Medicine from January 2020 to August 2024 were retrospectively included. These patients were classified into groups of frequent acute exacerbations （≥2 times/year） and infrequent acute exacerbations （<2 times/year） according to the hospitalization times per year. Risk factors were screened by LASSO regression combined with logistic regression， and a nomogram model was constructed. The model performance was assessed based on the area under the curve （AUC）， calibration curves， and decision curve analysis （DCA）. ResultsThe differences in baseline characteristics between the frequent acute exacerbations group （1 196 cases） and infrequent acute exacerbations group （833 cases） were not statistically significant. LASSO regression combined with multivariate logistic regression screened the following independent risk factors： body mass index （BMI）， hospitalization days， number of smoking years， place of residence， use of noninvasive ventilators， oxygen-demanding therapy， liver cirrhosis， use of systemic glucocorticosteroids， and traditional Chinese medicine syndrome （phlegm and stasis obstructing the lung）. The nomogram model showed good discrimination and calibration in both the training set （AUC=0.748） and validation set （AUC=0.774）. ConclusionThe risk prediction model for frequent acute exacerbations of COPD， integrating traditional Chinese medicine syndrome， constructed in this study has high accuracy. It can provide a scientific basis for early clinical identification of high-risk patients and individualized intervention.

Objective:To investigate protective mechanism of resveratrol(RES)on brain injury after ischemic stroke(IS)and its regulatory mechanism on nico-tinamide adenine dinucleotide phosphate oxidase 2(NOX2)mediated polarization of microglia.Methods:Low and high doses of RES were used for intervention.Tetrabromocinnamic acid(TBCA),a specific agonist of NOX2,was used to save function.PC12 and LMAI Bio cell models with oxygen-glucose deprivation/reoxygenation(OGD/R)were constructed.TUNEL was used to detect apoptosis of PC12 cells.Immunofluorescence was used to detect polarization of LMAI Bio cells.Western blot was used to detect expressions of NOX2,NF-κB,TNF-α,IL-1β,IL-10 and TGF-β in PC12 and LMAI Bio cells.Results:RES could significantly inhibit apoptosis of PC12 cells induced by OGD/R,and regulate LMAI Bio cells polarization to M2 type.Western blot showed that RES could significantly down-regulate NOX2,NF-κB,TNF-α and IL-1β expressions in OGD/R cells,up-regulate IL-10 and TGF-β expressions,while TBCA could partially reverse protective effect of RES on neurons.Conclusion:RES can inhibit neuronal apoptosis after IS,which may be related to its regulation of NOX2-mediated polarization of microglia.

Objective:To investigate protective mechanism of resveratrol(RES)on brain injury after ischemic stroke(IS)and its regulatory mechanism on nico-tinamide adenine dinucleotide phosphate oxidase 2(NOX2)mediated polarization of microglia.Methods:Low and high doses of RES were used for intervention.Tetrabromocinnamic acid(TBCA),a specific agonist of NOX2,was used to save function.PC12 and LMAI Bio cell models with oxygen-glucose deprivation/reoxygenation(OGD/R)were constructed.TUNEL was used to detect apoptosis of PC12 cells.Immunofluorescence was used to detect polarization of LMAI Bio cells.Western blot was used to detect expressions of NOX2,NF-κB,TNF-α,IL-1β,IL-10 and TGF-β in PC12 and LMAI Bio cells.Results:RES could significantly inhibit apoptosis of PC12 cells induced by OGD/R,and regulate LMAI Bio cells polarization to M2 type.Western blot showed that RES could significantly down-regulate NOX2,NF-κB,TNF-α and IL-1β expressions in OGD/R cells,up-regulate IL-10 and TGF-β expressions,while TBCA could partially reverse protective effect of RES on neurons.Conclusion:RES can inhibit neuronal apoptosis after IS,which may be related to its regulation of NOX2-mediated polarization of microglia.

Radiation-induced heart disease(RIHD)is a common and severe complication following radiotherapy for thoracic tumors,significantly impacting patients' long-term prognosis and quality of life.Its pathogenesis is complex,primarily involving oxidative stress,inflammatory responses,endothelial dysfunction,and chronic fibrosis.Currently,there is a lack of effective clini-cal prevention and treatment methods,highlighting the urgent need to develop intervention strategies for RIHD.Tanshinone ⅡA,the main active component of Salvia miltiorrhiza,exhibits mul-tiple pharmacological effects,including antioxidant,anti-inflam-matory,anti-fibrotic,and anti-apoptotic properties.Studies have shown that Tanshinone ⅡA can significantly mitigate radiation-induced myocardial injury and fibrosis,as well as improve cardi-ac function,by scavenging reactive oxygen species,inhibiting in-flammatory pathways,and modulating fibrotic signaling path-ways.This article summarizes the pathogenesis of RIHD and the research progress on Tanshinone ⅡA in the prevention and treat-ment of RIHD,providing new theoretical insights for developing effective cardioprotective strategies.

Objective:To explore the expression of bone marrow stromal antigen 2(BST2)in advanced non-small cell lung cancer(NSCLC)tissues and its impact on the prognosis of cisplatin chemotherapy.Methods:This study was a prospective study,127 advanced NSCLC patients who received treatment at Shangrao People's Hospital from January 2022 to December 2023 were prospective selected,all patients received cisplatin+gemcitabine chemotherapy regimen.They were divided into survival group(n=85)and death group(n=42)according to the prognosis.The relationship between expression of BST2 and clinicopathological characteristics was analyzed.The survival situation was analyzed by Kaplan-Meier method.Influencing factors of prognosis after cisplatin chemotherapy were discussed by univariate and multivariate COX regression analyses.Results:The positive expression rate of BST2 in cancer tissues(34.65％)in advanced NSCLC tissues was significantly higher than that in adjacent tissues(7.09％)(P＜0.05).Expression of BST2 was associated with tumor TNM staging,lymph node metastasis and differentiation degree(P＜0.05).The 1-year survival rate of patients with high expression of BST2(56.98％)was significantly lower than that of patients with low expression(87.80％)(P＜0.05).High expression of BST2 and TNM stage Ⅳ were independent prognostic risk factors for cisplatin chemotherapy in patients with advanced NSCLC(P＜0.05).Conclusion:The expressed of BST2 is highly in patients with advanced NSCLC tissues and closely related to cisplatin chemotherapy poor prognosis,suggesting its potential as a prognostic biomarker.

Objective:To explore the expression of bone marrow stromal antigen 2(BST2)in advanced non-small cell lung cancer(NSCLC)tissues and its impact on the prognosis of cisplatin chemotherapy.Methods:This study was a prospective study,127 advanced NSCLC patients who received treatment at Shangrao People's Hospital from January 2022 to December 2023 were prospective selected,all patients received cisplatin+gemcitabine chemotherapy regimen.They were divided into survival group(n=85)and death group(n=42)according to the prognosis.The relationship between expression of BST2 and clinicopathological characteristics was analyzed.The survival situation was analyzed by Kaplan-Meier method.Influencing factors of prognosis after cisplatin chemotherapy were discussed by univariate and multivariate COX regression analyses.Results:The positive expression rate of BST2 in cancer tissues(34.65％)in advanced NSCLC tissues was significantly higher than that in adjacent tissues(7.09％)(P＜0.05).Expression of BST2 was associated with tumor TNM staging,lymph node metastasis and differentiation degree(P＜0.05).The 1-year survival rate of patients with high expression of BST2(56.98％)was significantly lower than that of patients with low expression(87.80％)(P＜0.05).High expression of BST2 and TNM stage Ⅳ were independent prognostic risk factors for cisplatin chemotherapy in patients with advanced NSCLC(P＜0.05).Conclusion:The expressed of BST2 is highly in patients with advanced NSCLC tissues and closely related to cisplatin chemotherapy poor prognosis,suggesting its potential as a prognostic biomarker.

Objective:To explore the safety of laparoscopic modified transcystic biliary drainage(modified C-tube technique)in the treatment of biliary stones and application of diagnosing biliary disease.Methods:A retrospective analysis was conducted on the clinical data of 68 cases of biliary stones successfully treated with laparoscopic modified C-tube technique from August 2021 to December 2023.The safety,effectiveness,and area of applications were analyzed.The reliability of the principle of the modified fixation method was verified by using an ex vivo gallbladder.Results:Three cases of ex vivo gallbladder demonstrated that the strength of the modified fixation method was reliable,and the sinus tract formed by suture after immediate extraction of the C tube could be dislocated and closed,resisting the bile outflow caused by the weight of the gallbladder.Among the 68 patients,42 were difficult biliary stones,6 were suspected common bile duct stones,and 5 were extrahepatic bile duct stones combined with intrahepatic bile duct stones.Among them,48 cases underwent choledochoscopy assisted trans-choledochal approach for stone removal,and 10 cases underwent transcystic approach stone removal,Six patients underwent simply basket exploration and removal of stones through the cystic duct(5 patients had no residual stones on postoperative C-tube angiography,1 patient had suspected residual stones,and the patient refused further examination and treatment for no symptom),and 4 patients only underwent biliary drainage through the cystic duct;two patients with retained stone passed after the use of topical nitrate drip infusion via C-tube,seven cases underwent endoscopic retrograde cholangiopancreatography(ERCP),stone removal with the assistance of a C-tube after laparoscopic surgery,and the results were uneventful.The mean surgical time was(131±44)min(76-279 min),the maximum daily drainage volume of the C-tube was(401±235)mL/d(10-1 150 mL/d),the hospital stay was(8.6±3.6)d(2-19 d),and the mean time of C-tube removal was(11±6.9)d(5-46 d).There were 14 overall complications,including 2 residual stones,and 12 C-tube related complications,comprising of 1 gradeⅢ a,2 grade Ⅱ,and 9 grade Ⅰ.There were 9 cases of C-tube related adverse events that did not cause complications,including 3 of early detachment,2 of displacement,and 4 of deep insertion.The median follow-up time after surgery was 21(2-30)months,and 5 patients had recurrent stones.Among them,4 patients had slow contrast outflow during cholangiogram,and 1 patient had obvious pancreaticobiliary reflux.55 patients underwent C-tube amylase measurement,and 9 cases showed a significant increase in bile amylase(349-44 936 U/L),suggesting the presence of pancreaticobiliary reflux.Conclusion:Laparoscopic modified C-tube technique can be effectively used in the treatment of biliary stones,which is relatively safe and can be attempted in the diagnosis of biliary diseases.

AIM To prepare the oral lyophilized tablets of gastrodin-coated micropowder.METHODS Fluidized bed bottom spray method was adopted in the preparation of coated micropowder,after which the oral lyophilized tablets were further prepared.With mannitol consumption,pullulan consumption and xanthan gum consumption as influencing factors,comprehensive score for appearance traits,moisture,disintegration time and the sedimentation volume ratio as an evaluation index,the formulation was optimized by Box-Behnken method,then the taste-masking effect,appearance traits,moisture,disintegration time,content uniformity and dissolution rate were investigated.RESULTS The optimal formulation was determined to be 44.20 mg/tablet for mannitol consumption,3.70 mg/tablet for pullulan consumption,1.30 mg/tablet for xanthan gum consumption,66.67 mg/tablet for coated micropowder,and 1.5 mg/tablet for sucralose micropowder,the comprehensive score was 17.43.The obtained oral lyophilized tablets demonstrated good taste-masking effect,appearance traits and content uniformity with the disintegration time of 3-5 s,whose dissolution rates were less than 5％within 3 min in the simulated oral environment(phosphate buffer solution at pH 6.8)and more than 85％within 15 min in the simulated gastric environment(hydrochloric acid solution at pH 1.2).CONCLUSION The oral lyophilized tablets of gastrodin-coated micropowder display good taste,ease of swallowing and simple and feasible preparation process,which can provide a new idea for the taste improvement of other oral lyophilized tablets and unpleasant-smelling raw medicines.

Objective: To analyze the characteristics and safety risks of preservatives and sweeteners in beverages sold near schools in Anshun City, so as to provide a evidence for formulating targeted regulatory strategies in campus. Methods: From December 2023 to July 2024, 834 beverage samples were collected from sales points near primary and secondary schools in Xixiu District and four surrounding townships of Anshun City by a stratified random sampling method. High performance liquid chromatography was used to detect three preservatives (sorbic acid, benzoic acid and dehydroacetic acid) and four sweeteners (sodium saccharin, acesulfame-K, aspartame, and neotame). Differences were analyzed using the Chi-square test. Results: The overall exceedance rate of preservative was 8.6% (72 samples), with dehydroacetic acid showing the highest exceedance rate (7.0%, 58 samples), significantly higher than sorbic acid (0.6%, 5 samples) and benzoic acid (0.4%, 3 samples) ( χ 2=90.85, P <0.01). The overall exceedance rate of sweetener was 10.4% (87 samples), with sodium saccharin having the highest exceedance rate ( 6.2 %, 52 samples),significantly higher than neotame (2.8%, 23 samples), acesulfame-K (0) and aspartame (0) ( χ 2=262.04, P <0.01). Potential risks were identified due to the co occurrence of multiple additive exceedances, including 0.7% (6 samples) for mixed preservatives and 1.6% (13 samples) for mixed sweetener. No statistically significant differences were found in preservative (7.2%, 26 samples) or sweetener (12.3%, 44 samples) exceedance rates between micro enterprises and large, medium and small enterprises ( χ 2=2.67, 5.16, both P >0.05). Conclusion Systemic misuse risk of food additives in beverages sold near school necessitates a risk traceability based regulatory framework, with emphasis on standardizing enterprise production practices and strengthening oversight of sales outlets near campuses.