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.

This paper systematically summarizes the practical experience of the 2025 Dingri earthquake emergency medical rescue in Tibet. It analyzes the requirements for earthquake medical rescue under conditions of high-altitude hypoxia, low temperature, and low air pressure. The paper provides a detailed discussion on the strategic layout of earthquake medical rescue at the national level, local government level, and through social participation. It covers the construction of rescue organizational systems, technical systems, material support systems, and information systems. The importance of building rescue teams is emphasized. In high-altitude and cold conditions, rapid response, scientific decision-making, and multi-party collaboration are identified as key elements to enhance rescue efficiency. By optimizing rescue organizational structures, strengthening the development of new equipment, and promoting telemedicine technologies, the precision and effectiveness of medical rescue can be significantly improved, providing important references for future similar disaster rescues.

[摘 要] 目的：探究泛素特异性蛋白酶20（USP20）在胰腺癌组织中的表达及其对胰腺癌细胞增殖和迁移的作用及分子机制。方法：用癌症基因组图谱（TCGA）数据库数据分析USP20和扭曲家族碱性螺旋-环-螺旋转录因子（TWIST）在胰腺癌组织中的表达，通过Kaplan-Meier曲线评估其与患者预后的相关性。常规培养正常胰腺细胞HPNE和胰腺癌细胞MIAPaca2、BxPC3、PANC1、SW1990和Aspc1，用WB法检测USP20蛋白在其中的表达。将PANC1和SW1990细胞分为shNC组、shUSP20-1组和shUSP20-2组，用转染试剂将相应的慢病毒感染各组细胞，用qPCR法和WB法验证敲减效率，用CCK-8法、克隆形成实验、划痕愈合实验、Transwell实验和流式细胞术分别检测各组细胞的增殖、迁移能力和细胞周期，WB法检测各组细胞中的上皮-间质转化转录因子相关蛋白的表达。免疫共沉淀和泛素化实验检测USP20是否与TWIST相互作用，阐明USP20是否通过泛素化途径调控TWIST表达。结果：USP20、TWIST mRNA在胰腺癌组织中均呈高表达（均P < 0.05），其表达水平与患者预后呈负相关（均P < 0.05）。USP20蛋白在PANC1 、SW1990、MIAPaca2和BxPC3细胞中均呈高表达（均P < 0.001）。敲减USP20均可明显抑制PANC1和SW1990细胞的增殖、迁移能力（均P < 0.001）。USP20与TWIST相互结合（P < 0.05或P < 0.01），USP20通过降低TWIST泛素化水平稳定其表达（P < 0.01）。结论：USP20在胰腺癌组织中呈高表达，通过去泛素化TWIST稳定其表达，从而促进胰腺癌细胞的增殖和迁移，提示USP20可能成为胰腺癌诊断和治疗的潜在靶点。

Objective To understand the epidemiological characteristics of new occupational pneumoconiosis in Zigong City from 2018 to 2022, and to provide the basis for further prevention and treatment of local pneumoconiosis. Methods The information of newly diagnosed and reported cases of pneumoconiosis in Zigong City from 2018 to 2022 was collected through the occupational disease and occupational health information monitoring system, and the characteristics of the distribution of pneumoconiosis in three regions, the composition of diseases and the length of service of exposure to dust were analyzed. Results From 2018 to 2022, the top 3 newly diagnosed pneumoconiosis diseases in Zigong City were silicosis, coal workers&#39; pneumoconiosis and asbestosis. Silicosis cases were mainly distributed in small and medium-sized employers, accounting for 81.41%. Coal workers&#39; pneumoconiosis was mainly distributed in large and medium-sized employers, accounting for 97.24%. Asbestosis mainly distributed in large scale employers, accounting for 96.36%. There was significant difference in dust handling age of different scale employers (H=11.453, P<0.05). The median ages of silicosis, coal workers' pneumoconiosis and other pneumoconiosis were 47.0 years, 52.0 years and 48.2 years, respectively. The median age of dust handling was 3.3 years, 22.0 years and 23.2 years, respectively. The age of onset of coal workers' pneumoconiosis was higher than that of silicosis and other pneumoconiosis (H=72.547, P<0.05), and the age of dust exposure of silicosis was shorter than that of coal workers' pneumoconiosis and other pneumoconiosis (H=10.453, P<0.05). Conclusion The current situation of pneumoconiosis in Zigong City is still severe, with obvious clustering in disease types and industries. Prevention and treatment of pneumoconiosis in key industries should be further strengthened to protect the health rights and interests of workers.

OBJECTIVE To establish the fingerprint of Gegenqinlian tablets and determine the content of eleven components(3’-hydroxy puerarin, puerarin, 3’-methoxy puerarin, daidzin, baicalin, palmatine hydrochloride, berberine hydrochloride, scutellarin, baicalein, ammonium glycyrrhizinate and wogonin) by quantitative analysis of multi-components by single-marker(QAMS).METHODS Ten batches of Gegenqinlian tablets were determined by HPLC and a common fingerprint was established. Baicalin was selected as internal reference. The relative correction factors of the component with 3’-hydroxy puerarin, puerarin, 3’-methoxy puerarin, daidzin, palmatine hydrochloride, berberine hydrochloride, scutellarin, baicalein, ammonium glycyrrhizinate and wogonin were calculated and their contents were calculated. The feasibility and scientificity of QAMS was evaluated by comparison on the results between the measured value and calculation value by external standard method and QAMS. The chromatographic separation was performed on ananalytical column of Waters Xbridge-C18(250 mm× 4.6 mm, 5 μm) with gradient elution, the mobile phase was acetonitrile 0.1% phosphoric acid aqueous solution, at a flow rate of 1.0 mL·min-1. The column temperature was 30 ℃ and the detection wavelength was 260 nm.RESULTS There were 20 peaks in 10 batches of Gegenqinlian tablets and 11 chemical constituents were identified. The similarity of 10 batches of Gegenqinlian tablets was >0.97. The linear range of 3’-hydroxy puerarin, puerarin, 3’-methoxy puerarin, daidzin, baicalin, palmatine hydrochloride, berberine hydrochloride, scutellarin, baicalein, ammonium glycyrrhizinate and wogonin were 0.056 6-2.830 2, 0.241 2-12.058 6, 0.128 0-6.401 0, 0.059 7-2.983 5, 0.242 7-12.134 9, 0.045 7-2.285 7, 0.192 8-9.641 0, 0.043 3-2.167 0, 0.018 0-0.900 2, 0.021 0-1.048 4, 0.011 5-0.575 4 μg (r2= 0.999 6-1.000) respectively. The average recovery were 100.23%, 102.01%, 101.66%, 102.73%, 100.17%, 98.45%, 98.41%, 100.95%, 101.85%, 97.97%, 100.09%(RSD=1.24%-2.57%, n=6) respectively. The relative correction factors of 3’-hydroxy puerarin, puerarin, 3’-methoxy puerarin, daidzin, palmatine hydrochloride, berberine hydrochloride, scutellarin, baicalein, ammonium glycyrrhizinate and wogonin were 0.860 4, 0.605 3, 0.850 9, 0.582 8, 0.557 1, 0.498 6, 0.767 2, 0.652 1, 2.608 1, 0.545 2 respectively. RAD between QAMS method and external standard method were 0.03%-2.12%. CONCLUSION The combination of QAMS and fingerprint can provide reference for the quantitative determination and quality control of Gegenqinlian tablets.

Objective: To explore the protective effects of anthrahydroquinone-2,6-disulfonate (AH 2 QDS) on the kidneys of paraquat (PQ) poisoned rats via the apelin-APJ pathway. Methods: Male Sprague Dawley rats were divided into four experimental groups: control, PQ, PQ+sivelestat, and PQ+AH 2 QDS. The PQ+sivelestat group served as the positive control group. The model of poisoning was established via intragastric treatment with a 20% PQ pesticide solution at 200 mg/kg. Two hours after poisoning, the PQ+sivelestat group was treated with sivelestat, while the PQ+AH 2 QDS group was given AH 2 QDS. Six rats were selected from each group on the first, third, and seventh days after poisoning and dissected after anesthesia. The PQ content of the kidneys was measured using the sodium disulfite method. Hematoxylin-eosin staining of renal tissues was performed to detect pathological changes. Apelin expression in the renal tissues was detected using immunofluorescence. Western blotting was used to detect the expression levels of the following proteins in the kidney tissues: IL-6, TNF-α, apelin-APJ (the apelin-Angiotensin receptor), NF-κB p65, caspase-1, caspase-8, glucose-regulated protein 78 (GRP78), and the C/EBP homologous protein (CHOP). In in vitro study, a PQ toxicity model was established using human tubular epithelial cells treated with standard PQ. Twenty-four hours after poisoning, sivelestat and AH 2 QDS were administered. The levels of oxidative stress in human renal tubular epithelial cells were assessed using a reactive oxygen species fluorescence probe. Results: The PQ content in the kidney tissues of the PQ group was higher than that of the PQ+AH 2 QDS group. Hematoxylin-eosin staining showed extensive hemorrhage and congestion in the renal parenchyma of the PQ group. Vacuolar degeneration of the renal tubule epithelial cells, deposition of crescent-like red staining material in renal follicles, infiltration by a few inflammatory cells, and a small number of cast formation were also observed. However, these pathological changes were less severe in the PQ+sivelestat group and the PQ+AH 2 QDS group (P<0.05). On the third day after poisoning, immunofluorescence assay showed that the level of apelin in the renal tissues was significantly higher in the PQ+AH 2 QDS group than in the PQ group. Western blotting analysis results showed that IL-6, TNF-α, NF-κB p65, caspase-1, caspase-8, GRP78, and CHOP protein levels in the PQ group were higher than in the PQ+AH 2 QDS group (P<0.05). The expression of apelin-APJ proteins in the PQ+AH 2 QDS group was higher than in the PQ+sivelestat and PQ groups (P<0.05); this difference was significant on Day 3 and Day 7. The level of oxidative stress in the renal tubular epithelial cells of the PQ+AH 2 QDS group and the PQ+sivelestat group was significantly lower than in the PQ group (P<0.05). Conclusions: This study confirms that AH 2 QDS has a protective effect on PQ-poisoned kidneys and its positive effect is superior to that of sivelestat. The mechanism of the protective effects of AH 2 QDS may be linked to reduction in cellular oxidative stress, PQ content of renal tissue, inflammatory injury, endoplasmic reticulum stress, and apoptosis. AH 2 QDS may play a role in the treatment of PQ poisoning by upregulating the expression of the apelin-APJ.

Objective    To characterize surgical outcomes of supra-cardiac total anomalous pulmonary venous connection (TAPVC), investigate risk factors for postoperative death, and explore informed LASSO machine learning methods to solve "small sample size problem" in research of rare congenital heart diseases. Methods    A retrospective analysis of 241 patients with supra-cardiac TAPVC who underwent surgical repair in Guangdong Provincial People&#39;s Hospital from 2009 to 2019 was conducted, including 179 males and 62 females with a median surgical age of 71 (33, 232) d. Detailed clinical data of the postoperative death-related factors were extracted. Univariable Cox proportional hazard models were used to initially screen potential risk factors for postoperative death. Factors with P鈮?.05 were retained. To solve the limitation of small sample size and the "P>n" problem, we proposed a novel LASSO method for conducting multivariable Cox regression analysis that was capable of bringing in findings of related studies to improve analysis power and to reduce false-negative findings. Results 聽 聽Univariable Cox analyses showed several potential clinical risk factors, among which highly significant factors (P<0.001) included: surgical weight鈮?.5 kg (HR=16.00), main pulmonary artery diameter (HR=0.78), prolonged cardiopulmonary bypass time (HR=1.21), aortic block time (HR=1.28), and postoperative ventilator-assisted time (HR=1.13/d). LASSO multivariable analysis revealed that independent risk factors for postoperative death included cardiopulmonary bypass time (aHR=1.308/30 min), age (aHR=0.898), postoperative ventilator-assisted time (aHR=1.023/d), weight鈮?.5 kg (aHR=2.545), right vertical venous return (aHR=1.977), preoperative pulmonary venous obstruction (aHR=1.633) and emergency surgery (aHR=1.383). Conclusion 聽 聽Our proposed informed LASSO method can use previous studies&#39; results to improve the power of analysis and effectively solve the "P>n" and small sample size limitation. Cardiopulmonary bypass time, surgical age, postoperative ventilator-assisted time, weight, right vertical venous return, preoperative pulmonary venous obstruction, and emergency surgery are risk factors for postoperative death of supra-cardiac TAPVC.

Objective    To review the characteristics of patients who underwent atrioventricular septal defects (AVSD) repair with prosthetic valve ring implantation in our hospital, and to analyze the safety and effectiveness of this intervention. Methods    The clinical data of all patients diagnosed with AVSD who received surgery repair and prosthetic valve ring implantation from January 1, 2018 to July 12, 2020 in Guangdong Provincial People&#39;s Hospital were collected and analyzed. There were 22 patients with 9 males and 13 females at a median age of 35.00 (14.10, 53.00) years. There were 9 (40.9%) patients with prosthetic half or full rings placed on the left atrioventricular valve and 18 (81.8%) patients with prosthetic half or full rings placed on the right atrioventricular valve. Results    The median postoperative hospital stay was 7.00 (6.00, 8.80) d, and the postoperative mechanically assisted ventilation time was 11.00 (6.25, 19.00) h. There were 2 (9.1%) patients of moderate or higher postoperative atrioventricular valve regurgitation, 1 on the left and 1 on the right. There was one patient (4.5%) of the postoperative residual septal defect. There was no left ventricular inflow or outflow tract obstruction and no postoperative residual atrial septal defect during the follow-up of 152.00 (124.00, 1 030.00) d. Conclusion    Implantation of a prosthetic ring is safe and effective in patients with AVSD, and the structural strength of  the ring may be improved after the implantation. The physiological development of the AVSD annulus after prosthetic ring implantation and the results of long-term follow-up needs further attention.

[Abstract] Objective: To investigate the expression changes of miR-96 in endometrial cancer tissues and cells, and to explore its effect on tumor malignant phenotypes as well as the possible mechanisms. Methods:From April 2016 to December 2018, 76 cases of endometrial cancer tissues from 76 patients who were surgically treated in the Department of Obstetrics and Gynecology of our hospital were selected for this study. qPCR was used to detect the expression of miR-96 in human endometrial cancer tissues and cells, and the correlation between the miR-96 expression and the clinicopathological characteristics of patients was analyzed. miR-96 inhibitor was transfected into human endometrial cancer Ishikawa cells in vitro. After transfection, the expression of miR-96 in Ishikawa cells was detected by qPCR; the tumor biological behaviors of Ishikawa cells were detected by CCK-8 test, Clone formation test, Flow cytometry, Scratch test and Transwell test; and the FOXO1 protein expression in Ishikawa cells was detected by WB. At the same time, Dual luciferase reporter gene assay was used to observe the targeting relationship between miR-96 and FOXO1. Results: The results of qPCR showed that the expression of miR-96 was abnormally high in human endometrial cancer cells (JEC, Ishikawa, HEC-1B) and endometrial cancer tissues (all P<0.01), and the expression of miR-96 was closely related to FIGO stage and lymph node metastasis (all P<0.05). After transfection with miR-96 inhibitor, the expression level of miR-96 in Ishikawa cells decreased significantly (P<0.01), the proliferation activity and clone formation ability decreased significantly (all P<0.01), the apoptotic rate increased significantly (P<0.01), and the scratch healing rate and the number of invasive transmembrane cells decreased significantly (P<0.01). Dual luciferase reporter gene assay showed that miR-96 could directly target FOXO1, and WB showed that miR-96 could negatively regulate FOXO1 protein expression in Ishikawa cells (P<0.01). Conclusion: The expression of miR-96 is abnormally high in endometrial cancer tissues and cells. Inhibiting the expression of miR-96 can inhibit the proliferation, invasion and migration of endometrial cancer cells and promote their apoptosis. The mechanism may be related to the targeted regulation of FOXO1.

AIM:To analyze and compare the influence of different injury sites and injury types on surgical repair of canalicular laceration.

METHODS: A retrospective study was conducted on 87 cases(87 eyes)of traumatic canalicular laceration from January 2016 to August 2017, who were treated with silicone lacrimal drainage tube implantation. Lacrimal irrigation were performed 3mo and 6mo after surgery, and their respective operation results were evaluated. 3mo after surgery, lacrimal drainage tube were removed. Statisical analysis was proceeded on injury types, distances as well as the success rate of lacrimal passage irrigation.

RESULTS: Among the 87 cases of canalicular laceration, 29 eyes(33%)were in the PCL(proximal canalicular laceration)group, 41 eyes(47%)were in the MCL(medial canalicular laceration)group, and 17 eyes(20%)were in the DCL(distal canalicular laceration)group. There were 22 eyes(25%)of lacrimal canaliculi fracture caused by sharp instrument injury, including 18 eyes in the PCL group, 2 eyes in the MCL group and 2 eyes in the DCL group. There were 65 eyes(75%)of lacrimal canaliculi fracture caused by blunt trauma or collision, including 11 eyes in the PCL group, 39 eyes in the MCL group and 15 eyes in the DCL group. Six months after surgery, 72 eyes of lacrimal passage irrigation were successful, including 20 eyes in the PCL group, 36 eyes in the MCL group, and 16 eyes in the DCL group. The success rate of postoperative anatomic reduction in the three groups was 69%、88%、94%, respectively(P=0.047). There were 19 eyes of acute injury and 53 eyes of blunt injury with successful lacrimal duct irrigation respectively. The success rate of anatomical reduction was 86%、82%(P=0.605), respectively.

CONCLUSION: The canalicular laceration closed to lacrimal punctum is more vulnerable to cutting injury, while the canalicular laceration, which is near the lacrimal sac or between the lacrimal sac and center part of lacrimal punctum, can be more likely caused by lacerated wound. The success rate after operation is higher for patients with distal or medial canalicular laceration, and lower for those who with blunt wound location near the lacrimal punctum.