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.

With the continuous improving of CT software and hardware,clinical applications of cardiovascular CT gradually extended,shifting from traditional anatomical analysis to functional assessment,providing significant value for full-process management of cardiovascular disease in the past 40 years.Uptill now,large-scale clinical trials,mainly focused on cardiovascular CT constantly emerged,providing evidences for diagnosis,risk stratification and prognosis prediction of cardiovascular diseases.The technological developments,clinical application progressed in the past 40 years and future development trend of cardiovascular CT were reviewed in this article.

Microbial communities such as those residing in the human gut are highly diverse and complex, and many with important implications for health and diseases. The effects and functions of these microbial communities are determined not only by their species compositions and diversities but also by the dynamic intra- and inter-cellular states at the transcriptional level. Powerful and scalable technologies capable of acquiring single-microbe-resolution RNA sequencing information in order to achieve a comprehensive understanding of complex microbial communities together with their hosts are therefore utterly needed. Here we report the development and utilization of a droplet-based smRNA-seq (single-microbe RNA sequencing) method capable of identifying large species varieties in human samples, which we name smRandom-seq2. Together with a triple-module computational pipeline designed for the bacteria and bacteriophage sequencing data by smRandom-seq2 in four human gut samples, we established a single-cell level bacterial transcriptional landscape of human gut microbiome, which included 29,742 single microbes and 329 unique species. Distinct adaptive response states among species in Prevotella and Roseburia genera and intrinsic adaptive strategy heterogeneity in Phascolarctobacterium succinatutens were uncovered. Additionally, we identified hundreds of novel host-phage transcriptional activity associations in the human gut microbiome. Our results indicated that smRandom-seq2 is a high-throughput and high-resolution smRNA-seq technique that is highly adaptable to complex microbial communities in real-world situations and promises new perspectives in the understanding of human microbiomes.
Humans ; Gastrointestinal Microbiome/genetics* ; Bacteriophages/physiology* ; High-Throughput Nucleotide Sequencing ; Sequence Analysis, RNA/methods* ; Bacteria/virology*

Objective:To explore the distribution of TCM syndromes in ulcerative colitis (UC) and their relationship with the characteristics colonoscopy mucosal and histological grading.Methods:A retrospective analysis was conducted on the TCM syndrome classification, colonoscopy mucosal images, and histological grading of 303 UC patients at Henan Provincial Traditional Chinese Medicine Hospital from January 2023 to January 2024. The characteristics and correlation of colonoscopy mucosal images and histological grading in UC patients with different TCM syndrome types was explored.Results:The top three TCM syndrome types of UC patients were large intestine damp-heat syndrome (24.75%), spleen-qi deficiency syndrome (21.12%) and liver-stagnation and spleen-deficiency syndrome (19.80%). Compared with the syndrome of spleen deficiency and dampness accumulation, heat and toxin exuberance, cold and heat mixed syndrome, liver stagnation and spleen deficiency syndrome, spleen and kidney yang deficiency syndrome, spleen qi deficiency syndrome, yin and blood deficiency syndrome, blood stasis and intestinal collateral syndrome, patients with colonic damp-heat syndrome type Ⅰ accounted for the highest proportion ( χ2=12.79, 16.24, 4.26, 16.54, 11.53, 14.16, 7.75, 10.91, P<0.05). The proportion of type Ⅲ patients was the lowest ( χ2=30.57, 33.59, 12.71, 23.63, 7.90, 19.88, 18.31, 17.31, P<0.05). Among the patients with different TCM syndrome types, the proportion of large intestine damp-heat syndrome in histological grade Ⅳ was the highest (66.67%), the proportion of blood stasis and intestinal meridian syndrome in histological grade Ⅲ was the highest (53.33%), the proportion of liver stagnation and spleen deficiency syndrome in histological grade Ⅱ was the highest (50.00%), and the proportion of spleen and kidney yang deficiency syndrome in histological grade Ⅰ was the highest (40.00%). Spearman correlation analysis showed that the large intestine damp-heat syndrome was significantly correlated with the characteristics of colonoscopy mucosal image and histological grade ( r=-0.563, 0.612, respectively, all P<0.001). The syndrome of spleen deficiency and dampness accumulation, heat and toxin exuberance, yin and blood deficiency, blood stasis and intestinal collateral were significantly positively correlated with the characteristics of colonoscopy mucosa ( r=0.373, 0.342, 0.263, 0.331, all P<0.05). The syndrome of liver stagnation and spleen deficiency and spleen and kidney yang deficiency were significantly negatively correlated with histological grade ( r=-0.417, -0.425, all P<0.01). Conclusions:The main TCM syndromes are large intestine damp-heat syndrome, spleen-qi deficiency syndrome and liver-qi deficiency syndrome, which are significantly correlated with the mucosal features and histological grade of colonoscopy. Colonoscopy and histophiologic examination can be used as objective indicators for TCM syndrome differentiation.

The mortality and disability rates of intracranial aneurysm(IA)remain extremely high.CT angiography(CTA)has been widely used for first-line examination of IA,yet with limited diagnostic accuracy and time-consuming procedures.Artificial intelligence(AI)developed continuously in recent years,which could help to improve the accuracy of diagnosing IA and predicting its rupture.The research progresses of AI in CT A evaluating IA were reviewed in this article.

The main tasks of artificial intelligence(AI)for intracranial aneurysms included automated detection,rupture risk assessment,and prognosis assessment.Effective application of AI technology could improve efficiency of detecting intracranial aneurysm and enhance the ability of risk stratification.The current status and challenges of clinical application of AI in intracranial aneurysms were reviewed in this article.

Objective To investigate the value of morphological and hemodynamic parameters of CT angiography(CTA)for predicting recurrence of intracranial aneurysms(IA)after endovascular embolization.Methods Totally 205 patients with ruptured IA who underwent endovascular embolization were retrospectively collected and divided into recurrence group(n=35)and non-recurrence group(n=170)according to follow-up results after embolization.The morphological and hemodynamic parameters of IA in CTA before treatment were compared between groups.Variance inflation factor(VIF)was used to explore whether there was collinearity between morphological and hemodynamic parameters,and those without collinearity were included in univariate and multivariate logistic regression analysis to screen predictors of recurrence of IA after endovascular embolization.Two prediction models were constructed based on morphological parameters(model 1)and combination with hemodynamic parameters(model 2).Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of models.Results The maximum diameter,aneurysm neck width,maximum height,maximum vertical height and size ratio(SR)of IA in recurrence group were all higher than those in non-recurrence group(all P＜0.05),while gradient oscillatory number(GON)in recurrence group was lower than that in non-recurrence group(P＜0.05).The neck width,SR,pressure at IA neck plane,intra-aneurysm time-averaged wall shear stress(TAWSS),oscillatory shear index(OSI)and GON had no significant collinearity(all VIF＜10),among which the neck width,SR and TAWSS were all independent predictors(all P＜0.05).AUC of model 1 and model 2 for predicting recurrence of IA after endovascular embolization was 0.668 and 0.723,respectively,which of model 2 was higher than which of model 1(integrated discrimination improvement index was 0.055,P=0.025).Conclusion CTA morphological parameters combined with hemodynamic parameters of IA could be used to predict its recurrence after endovascular embolization.

As a pivotal noninvasive diagnostic tool of coronary artery disease,coronary CT angiography(CCTA)has achieved remarkable advancements over the past four decades.From early electron beam CT to contemporary photon counting detector CT,CCTA technology has undergone continuous innovation,and its clinical applications expanded from pure anatomical assessment to a multidimensional comprehensive evaluation integrating anatomy,function and histology.The technological evolution clinical application status and future development directions of CCTA were reviewed in this article.

With the continuous improving of CT software and hardware,clinical applications of cardiovascular CT gradually extended,shifting from traditional anatomical analysis to functional assessment,providing significant value for full-process management of cardiovascular disease in the past 40 years.Uptill now,large-scale clinical trials,mainly focused on cardiovascular CT constantly emerged,providing evidences for diagnosis,risk stratification and prognosis prediction of cardiovascular diseases.The technological developments,clinical application progressed in the past 40 years and future development trend of cardiovascular CT were reviewed in this article.

Objective:To investigate the correlation between peri-coronary fat attenuation index (FAI) and plaque formation in patients with myocardial bridge (MB) of the left anterior descending artery (LAD) using coronary computed tomography angiography (CCTA) and to develop an optimal predictive model to explore the potential application of FAI in the primary prevention of MB related atherosclerosis.Methods:In this retrospective study, prediction models associated with perivascular fat inflammation were developed and validated using both logistic regression and machine learning (ML) algorithm. A training dataset was collected from 253 patients who underwent ≥2 coronary computed tomography angiography (CCTA) with ≥3 months intervals from one tertiary hospital from January 2007 to April 2021 and had baseline CCTA showing no plaques in LAD MB. The median follow-up time was 3.2 years. According to the same criteria, a total of 75 LAD MB patients from four other hospitals were included to form an independent external validation dataset, with a median follow-up time of 1.8 years. Receiver operating characteristic (ROC) curve analysis with integrated discrimination improvement (IDI) and category net reclassification index (NRI) were used to compare the performance of the predictive models.Results:62 patients (24.5%) in the training dataset had proximal plaque formation in LAD MB, while 22 patients (29.3%) in the external validation dataset had plaque formation during the follow-up period. Baseline FAI within the longitudinal distance equal to 30 mm proximal to the MB entrance was an independent predictor ( OR=1.068, P=0.046). According to the model results, ROC curves were plotted. The AUC of Model 1 was 0.822, and the AUCs of Model 2 and 1 were 0.821 and 0.591 in the training dataset. After the DeLong test, the AUC of Model 1 was superior to that of Model 2 ( Z=2.839, P=0.005) and Model 1 ( Z=6.124, P<0.001). These findings were further validated in the external validation dataset, where ML-model 3 yielded the best predictive performance, outperforming the logistic regression-based Model 2 (categorical NRI=0.359, P=0.048; IDI=0.108, P=0.046). Conclusion:FAI measured within the 30 mm proximal to the entrance of MBs due to its prone to plaque development is an independent predictor for atherosclerotic plaque formation. The ML-prediction model based on a decision tree algorithm combines FAI, MB anatomical features, and patient risk factors, which is beneficial for patients undergoing routine CCTA examination to identify inflamed coronary arteries in advance and guide the clinical adoption of more targeted preventive treatment, including anti-inflammatory treatment.