Head and neck squamous cell carcinoma(HNSCC)is the most common type of head and neck cancer,and its treatment prognosis remains suboptimal.Although the survival of HNSCC patients has improved with the widespread use of anti-epidermal growth factor receptor(EGFR)monoclonal antibodies and immune checkpoint inhibitors(ICIs),there is still significant room for further improvement.Recent studies have suggested that the combination of anti-EGFR monoclonal antibodies and ICIs offers promising efficacy and safety,earning recommendations from authoritative guidelines such as the National Comprehensive Cancer Network(NCCN)and the Chinese Society of Clinical Oncology(CSCO).However,the application of this combination therapy is still in the early exploratory stage,numerous questions regarding the standardized clinical use of this combination therapy remain unanswered,including the mechanisms of synergy associated with the combination treatment,its therapeutic value in different patient populations,and safety considerations.Committee of Head and Neck Cancer,Chinese Society of Clinical Oncology organized an expert panel to develop"Expert consensus on the combination of anti-EGFR monoclonal antibodies and immune checkpoint inhibitors in the treatment of head and neck squamous cell carcinoma(2025 edition)",based on evidence-based medicine and clinical practice exploration through multiple rounds of discussions.This consensus addressed the mechanisms of the combination of anti-EGFR monoclonal antibodies and ICIs,stratified treatment approaches,applications in special populations,and safety considerations.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2025CN666.It is hoped that this consensus will provide clearer and more practical guidance for clinicians,further promoting the rational application of this combination therapy in clinical practice and offering more treatment options for HNSCC patients.

ObjectiveTo investigate the relationship between the composition of traditional Chinese medicine (TCM) and depression/anxiety/sleep disturbances (D/A/S) in patients with chronic pain.MethodsThis cross-sectional study was conducted at 13 tertiary hospitals across China, enrolling patients who experienced chronic pain between November 2023 and May 2024. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Pittsburgh Sleep Quality Index, and TCM constitution categories were used to assess the patients. The association between the TCM constitution and the D/A/S ratio was analyzed using multivariable logistic regression.ResultsA total of 1107 patients (63.2% women) were analyzed. Compared with those with a balanced constitution, patients who had qi-deficiency and yin-deficiency were at a higher risk of depression. Qi-deficiency and yin-deficiency were associated with anxiety. Sleep disturbances were common in patients with qi-deficiency constitution (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.42–3.81), yang-deficiency constitution (OR: 1.94, 95% CI: 1.26–2.98), yin-deficiency constitution (OR: 2.03, 95% CI: 1.24–3.32), blood stasis constitution (OR: 2.07, 95% CI: 1.01–4.22), and qi-stagnation constitution (OR: 2.66, 95% CI: 1.35–5.25).ConclusionIn patients with chronic pain, specific TCM constitutions may be associated with D/A/S. Further longitudinal studies are needed to clarify the potential causal relationships between TCM constitution types and these conditions.

Objective To explore the value of transvaginal ultrasound parameters combined with clinical features for predicting success pregnancy or not of polycystic ovary syndrome(PCOS)patients with infertility after in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods Totally 348 PCOS patients with infertility were retrospectively analyzed.Patients with presence of a gestational sac on ultrasound and did not experience miscarriage within 4 months after IVF/ICSI were classified as success pregnancy(pregnancy group,n=178),while the rest 170 patients were enrolled in non-pregnancy group.Univariable and multivariable logistic regression analyses were employed to assess clinical data,IVF/ICSI and transvaginal ultrasound parameters to identify the independent predictors of non-pregnancy in PCOS patients with infertility after IVF/ICSI,and a regression equation was constructed.The predictive efficacy,calibration and clinical value of this model were evaluated.Results Patients'age,duration of infertility,ovulation induction protocol(long protocol),duration of gonadotropin treatment,numbers of antral follicles and dominant follicles,total ovarian area,ovarian medullary area and endometrial thickness showed on transvaginal ultrasound before IVF/ICSI,as well as IVF with 2 pronuclei(IVF 2PN)and ICSI with 2 pronuclei(ICSI 2PN)or not were all independent predictors of success pregnancy or not in PCOS patients with infertility after IVF/ICSI(all P＜0.05).The area under the curve of the regression model was 0.771,and its predicted probabilities correlated with actual probabilities.Decision curve analysis indicated that the regression model had good clinical benefit.Conclusion Transvaginal ultrasound parameters combined with clinical features could effectively predict success pregnancy or not in PCOS patients with infertility after IVF/ICSI.

Objective To explore the value of transvaginal ultrasound parameters combined with clinical features for predicting success pregnancy or not of polycystic ovary syndrome(PCOS)patients with infertility after in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods Totally 348 PCOS patients with infertility were retrospectively analyzed.Patients with presence of a gestational sac on ultrasound and did not experience miscarriage within 4 months after IVF/ICSI were classified as success pregnancy(pregnancy group,n=178),while the rest 170 patients were enrolled in non-pregnancy group.Univariable and multivariable logistic regression analyses were employed to assess clinical data,IVF/ICSI and transvaginal ultrasound parameters to identify the independent predictors of non-pregnancy in PCOS patients with infertility after IVF/ICSI,and a regression equation was constructed.The predictive efficacy,calibration and clinical value of this model were evaluated.Results Patients'age,duration of infertility,ovulation induction protocol(long protocol),duration of gonadotropin treatment,numbers of antral follicles and dominant follicles,total ovarian area,ovarian medullary area and endometrial thickness showed on transvaginal ultrasound before IVF/ICSI,as well as IVF with 2 pronuclei(IVF 2PN)and ICSI with 2 pronuclei(ICSI 2PN)or not were all independent predictors of success pregnancy or not in PCOS patients with infertility after IVF/ICSI(all P＜0.05).The area under the curve of the regression model was 0.771,and its predicted probabilities correlated with actual probabilities.Decision curve analysis indicated that the regression model had good clinical benefit.Conclusion Transvaginal ultrasound parameters combined with clinical features could effectively predict success pregnancy or not in PCOS patients with infertility after IVF/ICSI.

Head and neck squamous cell carcinoma(HNSCC)is the most common type of head and neck cancer,and its treatment prognosis remains suboptimal.Although the survival of HNSCC patients has improved with the widespread use of anti-epidermal growth factor receptor(EGFR)monoclonal antibodies and immune checkpoint inhibitors(ICIs),there is still significant room for further improvement.Recent studies have suggested that the combination of anti-EGFR monoclonal antibodies and ICIs offers promising efficacy and safety,earning recommendations from authoritative guidelines such as the National Comprehensive Cancer Network(NCCN)and the Chinese Society of Clinical Oncology(CSCO).However,the application of this combination therapy is still in the early exploratory stage,numerous questions regarding the standardized clinical use of this combination therapy remain unanswered,including the mechanisms of synergy associated with the combination treatment,its therapeutic value in different patient populations,and safety considerations.Committee of Head and Neck Cancer,Chinese Society of Clinical Oncology organized an expert panel to develop"Expert consensus on the combination of anti-EGFR monoclonal antibodies and immune checkpoint inhibitors in the treatment of head and neck squamous cell carcinoma(2025 edition)",based on evidence-based medicine and clinical practice exploration through multiple rounds of discussions.This consensus addressed the mechanisms of the combination of anti-EGFR monoclonal antibodies and ICIs,stratified treatment approaches,applications in special populations,and safety considerations.The consensus has been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2025CN666.It is hoped that this consensus will provide clearer and more practical guidance for clinicians,further promoting the rational application of this combination therapy in clinical practice and offering more treatment options for HNSCC patients.

Objective:To investigate the clinicopathological features, immunophenotype, molecular characteristics, and differential diagnosis of primary intracranial DICER1-mutant sarcoma in order to better understand this tumor type.Methods:A retrospective analysis was conducted on 7 cases of primary intracranial DICER1-mutant sarcoma diagnosed in the Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China between 2021 and 2023 using next-generation sequencing. At the same time, 10 gliosarcomas, 4 intracranial FET::CREB fusion-positive mesenchymal tumors, 4 malignant meningiomas, 3 malignant solitary fibrous tumors, 3 malignant peripheral nerve sheath tumors, 3 synovial sarcomas and 3 rhabdomyosarcomas (total 30 cases) were selected as control.Results:Among the 7 patients with primary intracranial DICER1-mutant sarcoma, 6 were male and 1 was female, aged 10-32 years (median, 23 years). The tissue morphology was predominantly spindle or pleomorphic sarcoma-like, with 6 cases exhibiting eosinophilic globules, and 3 cases showing rhabdomyoblastic or rhabdomyosarcoma-like cell differentiation. Immunohistochemistry revealed focal desmin expression in 3 cases (3/7), ATRX loss in 3 cases (3/7), and p53 mutant pattern in 4 cases (4/7). Additionally, 4 cases (4/7) showed focal or diffuse SALL4 expression, whereas the control cases (30 cases) did not exhibit SALL4 protein expression, suggesting that SALL4 may possess certain auxiliary diagnostic value. Next-generation sequencing confirmed that all 7 cases of primary intracranial DICER1-mutant sarcoma harbored mutations in the DICER1 gene, with 5 cases having the mutation site at p.E1813D. Until May 2024, all 7 patients were alive.Conclusions:Primary intracranial DICER1-mutant sarcoma is a rare tumor. Understanding its morphological characteristics, immunohistochemical and molecular markers and differential diagnosis is crucial to avoid misdiagnosis and to improve diagnostic accuracy of this tumor.

Objective: To investigate the relationship between breakfast eating frequency and health-risk behavior of high school students in Chongqing, and provide a reference for conducting students to get a good habit of eating breakfast everyday. Methods: A total of 3 283 high school students in Chongqing were selected to participate in a questionnarie by using convenience sampling method. Logistic regression analysis were condueted to analyze the influences made by the unhealty eating behaviors on eating frequency of breakfast. Results: There were 2 064(69.2%) students eating breakfast everyday, 1 219(37.1%) students having no breakfast or eating breakfast sometimes. There were significant differences between different gender, grade, native place, drinking energy drink, smoking, drinking alcohol, gambling, internet addiction students rate of unhealthy breakfast eating frequency(χ2=6.80, 53.97, 8.10, 23.79, 7.89, 16.31, 3.93, 17.96, P<0.05), the males (36.1%) was beyond the females(33.3%), the energy drink drinkers(41.2%) was beyond the non-drinkers(31.7%), the smokers (40.9%) was beyond the non-smokers(34.4%), the alcohol drinkers(40.3%) was beyond the non-drinkers(33.3%), the gamblers(39.7%) was beyond the non-gamblers(34.3%), those having internet addictions (40.0%) was beyond those having no addictions(33.0%). Drinking energy drink(OR=1.32, 95%CI=1.12-1.55), drinking alcohol(OR=1.24, 95%CI=1.02-1.51), internet addiction(OR=1.42, 95%CI=1.19-1.68) were positively correlated with unhealthy breakfast eating frequency of high school students(P<0.05). Conclusion Social, families and schools should strengthen the guidance of high school students to develop the habit of eating breakfast every day, and advoid the clustering of skipping breakfast and health-risk behaviors.

Since the outbreak of COVID-19, several prevention and control measures have been successively promulgated in Wuhan. To name a few, setup of designated hospitals for severe COVID-19 patients is key to enforcing the policy of pooling patients, experts, resources and standardizing treatment. These efforts contribute decisively to improving the cure rate and reducing the mortality of COVID-19. As one of the designated hospitals composed of multiple medical teams, Wuhan Union Hospital put in place a joint working mode for treating severe COVID-19 patients, and found solutions to the main problems and difficulties in management. Its experiences provide references for the operation of joint medical institutions in emergency.

Objective To investigate the effect of the peroxide proliferator-activated receptorgamma (PPAR-γ) agonist rosiglitazone on the motor function recovery of hind limbs in rats with spinal cord injury.Methods Sixty-eight female SD rats were used to establish spinal cord injury model by modified Allen method.(1) Eight rats were randomly divided into negative control group and rosiglitazone group with four rats in each group.The expression of aspartate proteolytic enzyme-1 (caspase-1) in spinal cord of rats 7 days after injury was detected by immunohistochemical staining.(2) Forty-eight rats were randomly divided into negative control group,rosiglitazone group,rosiglitazone + Clostridium chitosans group [nuclear factor kappa B (NF-kappa B) activator],rosiglitazone + monosodium urate group [oligomerization domain-like receptor protein 3 (NLRP3) antagonist],with 12 rats in each group.BBB scores of hindlimb motor function were assessed at 1,3,14,21 and 28 days after injury in each group.The expression of interleukin-1 β (IL-1 β) and tumor necrosis factor-α (TNF-α) in each group was detected by ELISA at 28 days after injury.Microglia were isolated from the spinal cord of 12 rats and cultured for 7 days.They were randomly divided into the following five groups:(1) negative control group:no drug treatment;(2) rosiglitazone group:1 micromol/L rosiglitazone treatment;(3) rosiglitazone + Clostridium chitin group:1 micromol/L rosiglitazone + 20 micromol/L Clostridium chitosporin treatment;(4) Clostridium chitosan treatment Mycoplasma group:20 μ mol/L shell Clostridium treatment;(5) Clostridium chitosanin + MCC950 group [(NLRP3) antagonist]:20 μmol/L Clostridium chitosanin + 100 nmol/L MCC950;Western blot was used to detect the expressions of caspase-1,NF-kappa B and NLRP3 in microglia cells;ELISA was used to detect the expressions of IL-1β and TNF-α in the supernatant of microglia culture.Results Compared with negative control group,caspase-1 expression was decreased in rosiglitazone group in spinal cord injury area [gray matter area:5.1 ± 0.8∶6.9 ± 1.1;white matter area:5.6 ± 0.9 ∶ 7.5 ± 1.1] (P ＜ 0.05).At 28 days after operation,the rosiglitazone group had the highest BBB score [(14.7 ± 1.6) points],and the BBB score of rosiglitazone + Clostridium chitosans group (10.5 ± 2.1) points was superior to that of rosiglitazone + monosodium urate group [(7.2 ± 1.3)points,P ＜ 0.05].The expressions of IL-1β and TNF-α in rosiglitazone + monosodium uric acid group were lower than those in other groups at 28 days after injury (P ＜ 0.05).In vitro,the expressions of caspase-1,NF-kappa B,IL-1β and TNF-α in rosiglitazone group were lower than those in negative control group (P ＜ O.05).The expressions of caspase-1,NLRP3,IL-1β and TNF-α in rosiglitazone + Clostridium chitosani group were higher than those in rosiglitazone group,(P ＜ 0.05).The expressions of caspase-1 and IL-1β were higher than those in Clostridium chitosani + MCC950 group (P ＜0.05),but there was no significant difference in the expression of TNF-α between the two groups (P ＞0.05).Conclusion Rosiglitazone can promote the recovery of hind limb motor function in rats with spinal cord injury by inhibiting the expression of NF-kappa B,thereby reducing the activation of NLRP3 inflammatory bodies in microglia and ultimately inhibiting the occurrence of inflammation.

Objective : The present study observed the clinical effects on reattachment and pulpotomy of young crown-fractured and pulp-exposed permanent incisors. Methods : In a one-year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpotomy and reattachment technique with an enamel-dentin luting agent and composite resin. Results : The number of subsequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow-up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months. Conclusion Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment technique is an effective middle- and short-term method for temporary restoration of young crown-fractured permanent incisors.