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 current status of work readiness and its influencing factors among patients returning to work after lung cancer surgery. Methods A retrospective study was conducted on young and middle-aged postoperative lung cancer patients who were treated at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to September 2023 and returned to their jobs. Data were collected through a general information questionnaire, readiness for return-to-work scale (RRTW), general self-efficacy scale (GSES), and simplified coping style questionnaire (SCSQ). Univariate and multivariate logistic regression analyses were used to explore the factors affecting the work readiness of patients returning to work. Results A total of 219 patients were included, with 59 males and 160 females aged 18-60 years. Among the postoperative lung cancer patients returning to work, 73.1% were in the active maintenance stage of return-to-work readiness with a RRTW score of (17.59±1.48) points, and 26.9% were in the uncertain maintenance stage with a RRTW score of (16.22±1.50) points. Multivariate logistic regression analysis showed that patients aged≤30 years (OR=52.381), employees of enterprises and institutions (OR=7.682), agricultural, pastoral, fishery, forestry laborers (OR=15.665), positive coping (OR=5.043), those with higher self-efficacy (OR=1.157) and engaged in physically demanding work (OR=2.449) had higher return-to-work readiness, while patients with≥2 children (OR=0.055), self-payment (OR=0.044), and those working more than 40 hours per week (OR=0.122) had lower return-to-work readiness. Conclusion The return-to-work readiness of young and middle-aged postoperative lung cancer patients needs to be improved, and occupation, job nature, main coping styles, general self-efficacy and other factors are associated with return-to-work readiness.

Objective To investigate the current situation of career growth of public hospital managers and analyse its influencing factors,in order to provide a reference basis for promoting the level of career growth of hospital managers.Methods A convenient sampling method was applied to select 276 managers from nine public secondary and tertiary public hospitals in Hubei Province as the respondents,and a General Information Questionnaire,Career Growth Scale,and Person-organisation Fit scale were used to conduct the survey.Descriptive statistics,ANOVA,Pearson correlation analysis,and multiple linear regression were used to complete the analysis of the current status of career growth and influencing factors.Results The overall score of hospital managers'career growth is 3.29±0.79;person-organisation fit scores were positively correlated with hospital managers'career growth scores(P＜0.05).Multiple linear regression results showed that the type of hospital,the gender,whether or not they were both hospi-tal functionaries and clinical operations personnel,and the person-organisation fit were the major factors influencing the career growth of hospital managers the(P＜0.05).Conclusion The career growth of hospital managers is general-ly at an intermediate level and is affected by a variety of factors.Hospitals should pay attention to the individual characteristics and job requirements of managers,and improve career growth by completing the performance evalua-tion system,creating a good and fair organisational atmosphere,and easing career promotion stress.

Objective:To explore the efficacy and safety of B-Raf proto-oncogene, serine/threonine kinase (BRAF) inhibitor and epidermal growth factor receptor (EGFR) inhibitor combined with immune checkpoint inhibitor in microsatellite stable (MSS) BRAF V600E metastatic colorectal cancer (mCRC) patients.Methods:The data and outcomes of mCRC patients with MSS BRAF V600E who received BRAF inhibitor, EGFR inhibitor combined with immune checkpoint inhibitor in Tianjin Medical University Cancer Hospital from May 2022 to April 2024 were retrospectively collected.Results:A total of 12 mCRC patients were included in this study, the objective response rate was 50.0%, the disease control rate was 66.7%, and the median disease control time of patients who achieved objective response was 8.0 months. The median progression-free survival was 6.8 months and the median overall survival was 8.4 months. Overall adverse reactions were controllable, the most common treatment-related adverse events were fatigue (8 cases), fever (5 cases), and rash (4 cases). There were no grade 4 adverse event, serious adverse event, and treatment-related death.Conclusion:BRAF inhibitor and EGFR inhibitor combined with immune checkpoint inhibitor show good efficacy and controllable safety in BRAF V600E mCRC patients.

Objective: To analyze the hepatitis B virus serological markers (HBVM) and abnormal rates of liver function indexes among primary liver cancer (PLC) patients with different HBVM profiles, so as to provide a reference for risk stratification and optimization of diagnosis and treatment strategies for PLC patients. Methods: Patients diagnosed with PLC at Qidong People's Hospital between January 2017 and June 2024 were selected for this study. Basic information such as gender and age was collected through the hospital information management system. Venous blood samples were drawn to test for HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc, as well as ten liver function indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), cholinesterase (CHE), and adenosine deaminase (ADA). Compare the abnormal rates of liver function indexes among the six HBVM profiles: "big three yang" (HBsAg+, HBeAg+, anti-HBc+), "small three yang" (HBsAg+, anti-HBe+, anti-HBc+), triple antibody positive (anti-HBs+, anti-HBe+, anti-HBc+), s/c antibody positive (anti-HBs+, anti-HBc+), e/c antibody positive (anti-HBe+, anti-HBc+), and all negative. Results: A total of 1 434 patients with PLC were enrolled in this study. Among them, 1 043 (72.73%) were males and 391 (27.27%) were females. The median age was 64.00 (interquartile range, 16.00) years. The positive rates for HBsAg, anti-HBs, HBeAg, anti-HBe, and anti-HBc were 51.95%, 29.43%, 10.81%, 60.32%, and 88.42%, respectively. The "big three yang", "small three yang", triple-antibody positive, s/c antibody positive, e/c antibody positive, and all-negative profiles accounted for 85 (5.93%), 491 (34.24%), 170 (11.85%), 148 (10.32%), 100 (6.97%), and 121 (8.44%) cases, respectively. The abnormal rates of ALT among PLC patients with six HBVM profiles were 26.19%, 28.33%, 13.94%, 22.60%, 20.41%, and 14.91%, respectively. The abnormal rates of AST were 33.33%, 36.17%, 23.03%, 24.66%, 22.45%, and 18.42%, respectively. The abnormal rates of LDH were 62.16%, 68.22%, 53.73%, 61.19%, 60.00%, and 68.42%, respectively. The abnormal rates of CHE were 0%, 1.81%, 0%, 2.11%, 2.22%, and 3.88%, respectively. The abnormal rates of ADA were 59.09%, 57.27%, 24.27%, 33.33%, 45.00%, and 37.04%, respectively. These differences were statistically significant (all P<0.05). Conclusions In this study, the HBVM profiles were mainly characterized by "small triple positive" among PLC patients. The significant differences in liver function indexes abnormal rates among PLC patients with six HBVM profiles could reflect the liver injury status.

Objective:To evaluate the application value of interactive learning in enhancing the diagnosis of breast cancer by residents in the department of radiology through training based on the interpretation of breast magnetic resonance imaging (MRI) features by the breast imaging reporting and data system (BI-RADS).Methods:A total of 23 trainees completed BI-RADS standardized reports of 250 cases. These cases were divided into a pre-training group (Group 1) and post-training groups (initial training, Groups 2-4; advanced training, Groups 5-6), forming a total of six groups. The efficacy of interactive learning through course lectures and case-based practice in enhancing their ability in breast cancer diagnosis was analyzed. All trainees generated reports based on the BI-RADS scoring criteria. Interpretation agreement rates, evaluation time, and confidence levels were recorded. SPSS 25.0 was used for independent samples t test, chi-square test, and rank-sum test. Results:During the initial stage of training, the agreement rate of 150 cases reached 80.00%, which was recommended as the endpoint for completion of the initial learning phase. A significant difference existed between Group 4 and Group 1 ( P=0.012) in agreement rate. Statistically significant differences were noted in evaluation time for Groups 5 and 6 before and after advanced training ( P=0.001 and 0.007, respectively). A significant difference in confidence level was observed for Group 5 ( P=0.005). Conclusions:Interactive training based on BI-RADS standardized reporting can improve the diagnosis of breast diseases by residents in the department of radiology, particularly for enhancing the quality of reports for mass-like enhancement breast diseases.

Objective To investigate the relationship between microRNA(miR)-425-5p/patched homolog 1(PTCH1)axis molecules and clinical pathological parameters and prognosis in cancer tissues of primary laryngeal cancer(PLC)patients.Methods 102 PLC patients admitted to Mianyang Central Hospital from March 2020 to March 2021 were selected.The relative expression level of miR-425-5p and PTCH1 positive expression rate in PLC cancer tissues and adjacent normal tissues were compared,and the relationship between miR-425-5p relative expression level,PTCH1 positive expression rate and PLC clinical pathological parameters was analyzed.Kaplan-Meier curve and Log-Rank were used χ2 tests were conducted to analyze the 3-year cumulative survival rate of miR-425-5p and PTCH1 positive/negative expression groups,and COX regression model was used to analyze the influencing factors of PLC prognosis.Results Compared with normal tissue adjacent to cancer,the relative expression level of miR-425-5p in PLC cancer tissue was significantly increased(2.12±0.52 vs 0.98±0.17),and the positive expression rate of PTCH1 was significantly reduced(27.45%vs 61.76%),with statistical significance(t/χ2=21.045,24.302,all P＜0.05).Compared with patients with T1-T2,N0,and high differentiation of tumors,patients with T3-T4,N1-N3,and low differentiation of tumors showed a significant increase in the relative expression of miR-425-5p(t=3.647,2.900,3.029),and a significant decrease in the positive expression rate of PTCH1(χ2=5.842,4.011,5.136),the differences were statistically significance(all P<0.05).The 3-year cumulative survival rate of the miR-425-5p high expression group was 64.52%(20/31),which was significantly lower than that of the low expression group at 84.06%(58/69).The 3-year cumulative survival rate of the PTCH1 high expression group was 80.00%(28/35),which was significantly higher than that of the low expression group at 64.62%(42/65),and the differences were statistically significant(Log-Rank χ2=4.287,4.548,all P<0.05).Elevated T taging,cervical lymph node recurrence,elevated N staging,pharyngeal recurrence,elevated miR-425-5p,and negative PTCH1 expression were risk factors for poor prognosis of PLC(all P<0.05).Conclusion High expression of miR-425-5p and low expression of PTCH1 in cancer tissues of primary laryngeal cancer patients are significantly correlated with elevated T stage,low tumor differentiation,elevated N stage,and low 3-year cumulative survival rate.

Objective To construct a predictive model for the 3-year recurrence-free survival(RFS)after total endoscopic resection of early and mid-stage esophageal cancer,and to test it,in order to provide decision support for standardized management after total endoscopic resection of early and mid-stage esophageal cancer.Methods A retrospective study was conducted to include 306 patients with early-to-mid stage esophageal cancer who underwent total endoscopic resection in our hospital from January 2018 to December 2020.The patients were divided into a modeling set(n=204)and a validation set(n=102)according to a 2∶1 ratio.Univariate analysis and random forest algorithm were used to screen variables,and Cox regression analysis was used to analyze the factors affecting the 3-year RFS after total endoscopic resection for early-to-mid stage esophageal cancer.The R language was used to construct a nomogram prediction model for model validation,and the receiver operating characteristic curve(ROC curve)was drawn to calculate the area under the curve(AUC).The discrimination of the prediction model was evaluated,and the calibration curve and decision curve(DCA curve)were used to evaluate the predictive performance and clinical applicability of the prediction model.Results Among the 306 patients with early and mid-stage esophageal cancer who underwent total endoscopic resection,18 died 3 years after the operation,55 relapsed,233 achieved RFS,and the 3-year RFS rate was 76.14％.Through univariate and random forest algorithm screening,seven factors were identified as being associated with the RFS of patients three years after surgery.These factors were entered into a Cox regression analysis,and the results showed that positive abdominal lymph nodes,vascular cancer thrombus,clinical stage Ⅲ,gross type of erosion,age ≥ 65 years,and tumor diameter＞3 cm were risk factors for RFS three years after surgery(P＜0.05).Based on this,a nomogram prediction model for RFS three years after full endoscopic resection for early-to-mid stage esophageal cancer was constructed.Internal and external validation showed that the consistency index of the prediction model in the modeling set was 0.881,and the consistency index in the validation set was 0.867.The ROC curve validation showed that the AUC of the prediction model in the modeling set and validation set were 0.855(95％CI:0.778-0.932)and 0.826(95％CI:0.763-0.890),respectively.The DCA curve validation showed that the risk threshold of the modeling set and validation set were 0-0.95 and 0-0.77,respectively,when the model could achieve high net benefits.Conclusion The 3-year RFS after total endoscopic resection for early and middle stage esophageal cancer is related to multiple factors.The nomogram model based on clinical stage Ⅲ,positive abdominal lymph nodes,vascular tumor thrombus,and gross type of erosion has good clinical utility for predicting the 3-year RFS of patients after surgery,and is of guiding significance for medical staff in making decisions about the management of early and middle stage esophageal cancer after surgery.

Objective To investigate the relationship between microRNA(miR)-425-5p/patched homolog 1(PTCH1)axis molecules and clinical pathological parameters and prognosis in cancer tissues of primary laryngeal cancer(PLC)patients.Methods 102 PLC patients admitted to Mianyang Central Hospital from March 2020 to March 2021 were selected.The relative expression level of miR-425-5p and PTCH1 positive expression rate in PLC cancer tissues and adjacent normal tissues were compared,and the relationship between miR-425-5p relative expression level,PTCH1 positive expression rate and PLC clinical pathological parameters was analyzed.Kaplan-Meier curve and Log-Rank were used χ2 tests were conducted to analyze the 3-year cumulative survival rate of miR-425-5p and PTCH1 positive/negative expression groups,and COX regression model was used to analyze the influencing factors of PLC prognosis.Results Compared with normal tissue adjacent to cancer,the relative expression level of miR-425-5p in PLC cancer tissue was significantly increased(2.12±0.52 vs 0.98±0.17),and the positive expression rate of PTCH1 was significantly reduced(27.45%vs 61.76%),with statistical significance(t/χ2=21.045,24.302,all P＜0.05).Compared with patients with T1-T2,N0,and high differentiation of tumors,patients with T3-T4,N1-N3,and low differentiation of tumors showed a significant increase in the relative expression of miR-425-5p(t=3.647,2.900,3.029),and a significant decrease in the positive expression rate of PTCH1(χ2=5.842,4.011,5.136),the differences were statistically significance(all P<0.05).The 3-year cumulative survival rate of the miR-425-5p high expression group was 64.52%(20/31),which was significantly lower than that of the low expression group at 84.06%(58/69).The 3-year cumulative survival rate of the PTCH1 high expression group was 80.00%(28/35),which was significantly higher than that of the low expression group at 64.62%(42/65),and the differences were statistically significant(Log-Rank χ2=4.287,4.548,all P<0.05).Elevated T taging,cervical lymph node recurrence,elevated N staging,pharyngeal recurrence,elevated miR-425-5p,and negative PTCH1 expression were risk factors for poor prognosis of PLC(all P<0.05).Conclusion High expression of miR-425-5p and low expression of PTCH1 in cancer tissues of primary laryngeal cancer patients are significantly correlated with elevated T stage,low tumor differentiation,elevated N stage,and low 3-year cumulative survival rate.