Objective:To investigate the incidence,clinical characteristics,and complications of Torque teno virus(TTV)in children after hematopoietic stem cell transplantation(HSCT).Methods:A total of 40 children with hematological diseases who underwent HSCT were selected,and metagenomic next-generation sequencing(mNGS)technology was used to detect the gene sequences of pathogenic microorganisms in the blood.Combined with clinical data,the characteristics of TTV infection were analyzed.Results:Among the 40 pediatric patients post-HSCT,the TTV positive rate was 42.5％(17/40).There were no statistically significant differences between the TTV-positive group and the TTV-negative group in sex,age,white blood cell count(WBC),red blood cell count(RBC),hemoglobin,platelet count,neutrophil count,lymphocyte count,and high-sensitivity C-reactive protein(all P＞0.05).The incidence of TTV infection was significantly higher in children who underwent haploidentical HSCT and in those with bone marrow stem cells(BMSC)as the transplant source(P＜0.05).However,there were no significant differences in the TTV infection rate among patients with different disease types,different HLA matching statuses,or different engraftment times of neutrophils and platelets(all P＞0.05).Among 17 children infected with TTV,13(76.5％)had co-infections with other viruses,mainly including cytomegalovirus(58.8％,10/17),human polyomavirus(41.2％,7/17),and Epstein-Barr virus(17.6％,3/17).In children with TTV infection,the most common complications were sepsis(82.4％),graft-versus-host disease(GVHD)(70.6％),pulmonary infection(41.2％),and hemorrhagic cystitis(17.6％).The incidence of GVHD in the TTV-positive group was significantly higher than that in the TTV-negative group(P＜0.05).Conclusion:TTV infection is common in children undergoing HSCT,and it is prone to be complicated with cytomegalovirus infection and GVHD,which has an important influence on the clinical outcomes.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To analyze the nutritional development status and trends of preschool children aged 3-6 in Changping District,Beijing.Methods:The physical examination informations of preschool children aged 3-6 from over 180 kindergartens who participated in physical examinations in Maternal and Child Health Care Hospital of Changping District from 2021 to 2023 were collected retrospectively.The malnutrition,vision examination and dental caries of children with different ages across these years were compared.Results:A total of 135 215 children underwent physical examinations from 2021 to 2023,with 43 098 cases in 2021,45 985 cases in 2022,and 46 132 cases in 2023.Among them,there were 601 cases (0.44%) of malnutrition (including underweight,stunted growth,and wasting),and 13 512 cases (9.99%) of excessive nutrition (including overweight and obesity).The prevalence rates of overweight were 7.19%,5.56%,and 5.28% for the years 2021,2022,and 2023,respectively,with the highest rate in 2021; the obesity rates were 4.41%,3.79%,and 3.85% for the same years,also with the highest rate in 2021.The differences were statistically significant ( P<0.05).The analysis of overweight and obese children of different ages in 2021 showed that the highest rate of overweight was in 3-year-olds (8.33%, P<0.05),and the highest rate of obesity was in 6-year-olds (6.19%, P<0.05).The detection rates of dental caries were 51.97%,39.14%,and 49.68%; the total caries treatment rates were 39.39%,43.09%,and 47.34%,showing an increasing trend,with statistically significant differences ( P<0.05).From 2021 to 2023,the detection rates of vision abnormalities among children aged 4 to 6 were 4.93%,3.74%,and 3.71%,respectively; the vision correction rates were 68.71%,76.51%,and 86.27%,showing an increasing trend over the years,with statistically significant differences ( P<0.05). Conclusion:The issues of overweight/obesity,dental caries,and vision abnormalities remain significant among children aged 3-6 in Changping District,Beijing.There is a need for continued attention to the physical examinations of preschool children and to further strengthen the prevention and control of common diseases in preschoolers to ensure their healthy growth.

Objective:To investigate the clinical application effect of absorbable plates in the treatment of children with craniosynostosis.Methods:Retrospective analysis was performed on the clinical data of patients with congenital craniosynostosis who were treated in the Department of Burns and Plastic Surgery, Children’s Hospital of Nanjing Medical University from January 2019 to October 2022. Preoperatively, three dimensional CT scan of the skull was performed in order to make a frontal and orbital model. All patients underwent traditional fronto-orbital reconstruction with skull flaps. With the assistance of the frontal and orbital model, the skull flap were rotated and shaped, and then absorbable plates and screws were used for internal fixation under direct vision. Postoperative follow-up observations were conducted on the complications such as infection, incision dehiscence, foreign body reactions of absorbable plates, and the stability of the skull flap.Results:A total of 12 patients were enrolled, 9 males and 3 females, aged 3-17 months, with an average of 11.3 months. There were 7 cases of unilateral coronal craniosynostosis, 3 cases of unilateral coronal craniosynostosis, and 2 cases of Apert syndrome. All cases underwent operation uneventfully, the operation time was 2.8-4.5 hours with an average of 3.6 hours. Follow-up ranged from 13 to 32 months (average, 24.5 months). One patient experienced incision dehiscence 45 days after surgery, which healed after conservative management. The remaining patients had no infections, hematomas, or other complications. All patients had visible and palpable raised masses at the site of absorbable plate implantation in 3-5 months after surgery, which gradually resolved in 10-15 months after surgery.The head shape of patients with craniosynostosis had been significantly improved after surgery, and follow-up CT scans of the skull revealed no displacement of the skull flaps and good osteogenesis.Conclusion:The use of absorbable plates for internal fixation in children with craniosynostosis can achieve stable fixation effects with few complications, and is worthy of clinical promotion and application.

In the mid-20th century,internal mammary artery(IMA)ligation attracted attention for improving myocardial ischemia survival and relieving angina symptoms in animals,but was eliminated after sham-operation trials confirmed that its efficacy stemmed from a placebo effect.Recent advances in interventional techniques have led to the revival of distal IMA blockade,which has been shown to improve myocardial perfusion by modulating collateral circulation.Randomized controlled trials further showed that angina relief was significantly better in the blockade group than in the sham-operated group,especially in right coronary artery(RCA)and left anterior descending(LAD)lesions,but not in the ileocecal branch due to the lack of IMA collateral connections.Anatomy suggests that the internal mammary artery forms a natural collateral pathway to the RCA/LAD via the pericardial phrenic artery,which is the anatomic basis for its efficacy.Current technical limitations include incomplete occlusion,device-related complications,and insufficient evidence of long-term prognosis.Future studies are needed to optimize the design of occlusion devices,explore combined therapeutic strategies,and conduct controlled studies with conventional revascularization techniques.In this review,we systematically review the 100-year evolution of IMA occlusion,the paradigm shift from surgical ligation to precision intervention,analyze its anatomical and hemodynamic mechanisms,integrate evidence-based evidence and propose screening criteria for indications,and provide a new pathway for individualized treatment of high-risk patients who cannot tolerate coronary artery bypass grafting/percutaneous coronary intervention.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

In the mid-20th century,internal mammary artery(IMA)ligation attracted attention for improving myocardial ischemia survival and relieving angina symptoms in animals,but was eliminated after sham-operation trials confirmed that its efficacy stemmed from a placebo effect.Recent advances in interventional techniques have led to the revival of distal IMA blockade,which has been shown to improve myocardial perfusion by modulating collateral circulation.Randomized controlled trials further showed that angina relief was significantly better in the blockade group than in the sham-operated group,especially in right coronary artery(RCA)and left anterior descending(LAD)lesions,but not in the ileocecal branch due to the lack of IMA collateral connections.Anatomy suggests that the internal mammary artery forms a natural collateral pathway to the RCA/LAD via the pericardial phrenic artery,which is the anatomic basis for its efficacy.Current technical limitations include incomplete occlusion,device-related complications,and insufficient evidence of long-term prognosis.Future studies are needed to optimize the design of occlusion devices,explore combined therapeutic strategies,and conduct controlled studies with conventional revascularization techniques.In this review,we systematically review the 100-year evolution of IMA occlusion,the paradigm shift from surgical ligation to precision intervention,analyze its anatomical and hemodynamic mechanisms,integrate evidence-based evidence and propose screening criteria for indications,and provide a new pathway for individualized treatment of high-risk patients who cannot tolerate coronary artery bypass grafting/percutaneous coronary intervention.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

Objective:To investigate the effects of sampling methods on pathological assessment of resected non-small cell lung cancer (NSCLC) specimen with tumor maximum diameter >3 cm after neoadjuvant therapy.Methods:NSCLC patients with a large tumor (diameter >3 cm) that were resected after neoadjuvant therapy from June 2020 to July 2023 were retrospectively collected in the Department of Pathology, Shanghai Pulmonary Hospital, Shanghai, China. Sampling methods of the tumor bed were performed in accordance with the international and Chinese experts recommendations for resection specimens following neoadjuvant therapy (recommended sampling method, RSM), and all remaining tumor bed lesions were completely sampled after recommended sampling (complete sampling method, CSM). The difference of pathological response assessment of residual viable tumor (RVT) between RSM and CSM was examined.Results:A total of 90 cases were identified and analyzed, including 39 cases of squamous cell carcinoma and 51 cases of adenocarcinoma, treated with neoadjuvant therapy including chemotherapy in 22 cases (24.4%), targeted therapy in 14 cases (15.6%), and chemoimmunotherapy in 54 cases (60.0%). There were 62 males and 28 females with an average age of (62.7±17.9) years. The average tumor maximum diameter was 4.3 cm (range, 3.1-8.0 cm). The average number of sampled blocks was 8 blocks (range, 5 to 16) and 15 blocks (range, 8 to 36) per case by RSM and CSM, respectively. According to the definition of major pathological response (MPR) in which RVT is ≤10%, the numbers of patients with MPR were 34 cases by RSM and 30 cases by CSM, respectively. Four cases showed inconsistent RVT between the two methods, including one case of squamous cell carcinoma and three cases of adenocarcinoma. The RVT of the four inconsistent cases was 7%, 7%, 5% and 9% (MPR by RSM), and 15%, 15%, 15% and 20% (non-MPR by CSM), respectively. The kappa values of MPR consistency evaluated by the two sampling methods were 0.893 for all cases, 0.906 for squamous cell carcinoma cases and 0.751 for adenocarcinoma cases. According to MPR cut-off of 65% for invasive primary adenocarcinoma, 24 cases and 20 cases achieved MPR by RSM and CSM, respectively. Of the four inconsistent cases, the RVT by RSM was 60% in three cases and 65% in one case (MPR), whereas the RVT by CSM was 70% in three cases and 75% in one case (non-MPR). The kappa value of the two sampling methods was 0.741.Conclusions:There is high consistency between RSM and CSM in the pathological assessment of post-treatment responses in resected NSCLC specimens with tumor maximum diameter larger than 3 cm. When the percentage of RVT cells is close to MPR, re-evaluation of the specimen is required and CSM may be necessary to accurately evaluate the degree of pathological remission, assist in clinical postoperative treatment, and predict patient prognosis.

This study was aimed at understanding the relationships among the drug resistance and genome characteristics of group A Streptococcus in Jiangsu Province.A total of 149 group A Streptococcus strains were collected from hospitals between 2016 and 2023.Thirteen antimicrobial minimal inhibitory concentrations were detected with the micro-dilution broth method.The GAS strains were typed with emm genotyping analysis and whole genome sequencing,to determine the carriage rates of drug resistance genes and the evolutionary relationships among strains.The resistance rates of 149 GAS strains to erythromy-cin,tetracycline,and clindamycin exceeded 90％,whereas the strains showed sensitivity to 8 different antibiotics,including penicillin.Notably,the resistance rates to erythromycin,tetracycline,and clindamycin consistently increased over time.All strains were classified into 9 emm types,among which emm12 accounted for the highest proportion(77/149;51.68％).Signifi-cant statistical differences were observed among emm types,in terms of the drug resistance rate,number of resistant species,and prevalence of drug resistance genes.Furthermore,SNP evolutionary tree analysis revealed 3 distinct clusters within the GAS strains:emm12,emm1,and other emm types.emm 12 and emm1 were the dominant GAS strains in Jiangsu Province.Most isolates were resistant to erythromycin,tetracycline,and clindamycin.Differences in phenotypes and genomic characteris-tics were observed among emm types.