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 compare therapeutic efficacy and safety of laparoscopy combined with dienogest and laparoscopy combined with dienogest and TCM in the treatment of endometriosis. METHODS:126 endometriosis patients were selected and divid-ed into control group and observation group,with 63 cases in each group. Control group received combined with dienogest(25 mg/time,qd);observation group was additionally given TCM on the basis of control group. Therapeutic efficacy,recovery time of ovula-tion,menstrual recovery time and ADR were compared between 2 groups,and recurrence and pregnancy of them were followed up for 2 years. RESULTS:The total effective rate of observation group (93.65%) was significantly higher than that of control group (80.96%),with statistical significance (P<0.05). The menstrual recovery time and recovery time of ovulation in observation group were significantly shorter than control group,with statistical significance (P<0.05). The incidence of ADR in observation group (9.52%)was significantly lower than control group(26.98%),with statistical significance(P<0.05);the recurrence rate of observa-tion group (4.76%) was significantly lower than that of control group (17.46%),with statistical significance (P<0.05). In 2-year follow-up,there were 23 pregnancy patients in observation group,which was significantly higher than that of control group (9 cas-es),with statistical significance (P<0.05). CONCLUSIONS:Laparoscopy combined with dienogest and TCM in the treatment of endometriosis have better clinical effect,higher safety and lower recurrence rate. The patients are easily pregnant.