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 introduce the causes of accidents and the diagnosis and treatment of two patients with radiation-induced skin injury admitted to our hospital in 2023, and to provide a reference for the clinical treatment of subsequent radiation-induced skin injury. Methods The clinical treatment process of two patients with acute skin injury caused by external radiation exposure were summarized and analyzed. Results The exposure history of the two patients was reconstructed, the flaw detection scenario was simulated, the biological dose and hand skin exposure dose were estimated, and the infrared thermal imaging device was used for dynamic monitoring. A comprehensive analysis was conducted based on clinical manifestations and other data. The diagnosis of “Xie” was excessive exposure combined with acute radiation-induced skin injury on both hands (Grade IV for the right hand palm, index finger, and middle finger and Grade II for the left hand little finger). The diagnosis of “Hao” was acute radiation-induced skin injury on both hands (Grade I). The two patients received different clinical treatment measures: “Xie” was treated with both local and systemic therapies, while “Hao” was mainly treated with systemic therapy. Conclusion After systematic and effective treatment, the radiation-induced skin injuries healed in both patients.

[摘 要] 目的：探讨蟾毒灵（BU）对肿瘤相关巨噬细胞（TAM）介导的结直肠癌（CRC）细胞程序性死亡蛋白-配体1（PD-L1）表达的调控作用及其分子机制。方法：采用HCT116细胞与THP-1来源巨噬细胞构建体外共培养体系。佛波酯（PMA）诱导THP-1细胞分化为M0型巨噬细胞，进一步以HCT116细胞条件培养基（CM）刺激形成TAM样细胞。流式细胞术检测CD11b、CD206表达，以评价巨噬细胞极化水平；RT-qPCR及WB法检测TGF-β、IL-10、STAT3/p-STAT3及PD-L1表达变化；慢病毒转染构建STAT3敲低细胞系HCT116sh-STAT3，结合BU干预验证STAT3/PD-L1信号通路作用。结果：HCT116细胞CM可诱导巨噬细胞向M2表型极化，表现为CD11b⁺CD206⁺细胞比例升高（P < 0.01）及TGF-β、IL-10表达增加（均P < 0.001）。TAM条件培养基可显著促进HCT116细胞STAT3磷酸化（P < 0.001）并上调PD-L1 mRNA及蛋白表达水平（P < 0.001或P < 0.01）。BU干预后，TAM介导的STAT3磷酸化水平明显下降，PD-L1表达同步下调（均P < 0.01）。STAT3敲低可降低PD-L1表达，其作用趋势与BU一致。结论：BU可通过抑制TAM介导的STAT3信号激活，下调CRC细胞PD-L1表达，提示其在肿瘤免疫微环境调控中具有潜在的应用价值。

Sichuan Province is a hilly schistosomiasis-endemic province in China with the highest endemicity and largest coverage. During the period of more than 70 years of integrated control, there are five distinct phases of schistosomiasis control in Sichuan Province, including baseline investigation, Oncomelania hupensis snail control, chemotherapy for both humans and livestock, management of source of Schistosoma japonicum infections, and sustained control and intensified surveillance and early warning, and a package of key interventions are implemented, including environmental modification, snail control with chemical treatment, large-scale chemotherapy for humans and livestock, management of source of S. japonicum infections, intensified integrated control, establishment of an early warning and surveillance system. As a result, schistosomiasis has been eliminated across all 63 disease-endemic counties (cities, districts) in Sichuan Province by June 2025. Government-led multi-sectoral collaborations, science and technology-supported precision control strategies, and a sustainable control model tailored to the ecological and socio-economic conditions in endemic regions are essential to achieving the target of schistosomiasis elimination in Sichuan Province.

This paper systematically analyzes schistosomiasis transmission risks during the elimination stage and reviews the evolution of the schistosomiasis surveillance system in China from a One Health perspective, with a special emphasis on schistosomiasis surveillance and response practices during the elimination stage from a One Health perspective. These practices include precise screening of human schistosomiasis under low-endemicity conditions, systematic monitoring of schistosomiasis in domestic and wild animals, ecological management of Oncomelania snails, and information-coordinated responses. Nevertheless, the current surveillance and response system for schistosomiasis suffers from challenges of insufficient cross-sectoral coordination and complex external environments, which constrain precise schistosomiasis surveillance and response in China. Therefore, it is urgently necessary to integrate coordination mechanisms, empower the surveillance system with technological innovation, improve capacity building, and actively promote diverse social participation in the One Health framework, so as to consolidate current schistosomiasis control achievements and achieve the target for schistosomiasis elimination across China, which may provide a replicable technical model for global zoonoses control.

In recent years, the field of cardiovascular surgery has undergone revolutionary changes and made rapid progress in various aspects, bringing more hope and possibilities for the health and well-being of patients. The constant emergence of new technologies brings new opportunities and hope, as well as constant challenges to past concepts. This article aims to provide a comprehensive overview of the latest developments in cardiovascular surgery in recent years, especially since 2023. It introduces cutting-edge knowledge and technologies in the field of cardiovascular surgery, including lifelong management of aortic valve disease, artificial valves, mitral valves, treatment options for hypertrophic obstructive cardiomyopathy, heart transplantation, left ventricular assist, coronary artery surgery, cardiac structural interventions for chronic heart failure, aortic dissection, and comprehensive surgical treatment of atrial fibrillation. It also analyzes and explores future development directions in depth, aiming to provide useful references and inspiration for cardiovascular doctors and jointly promote the continuous progress of cardiovascular surgery in China.

Objective To investigate the bidirectional causal relationship between different subtypes of endometriosis and female infertility using Mendelian randomization(MR).Methods A two-sample MR analysis was performed on the data sourced from publicly available genome-wide association study(GWAS)of endometriosis and infertility.For each subtype of endometriosis,instrumental variables(IVs)satisfying MR assumptions were selected,with inverse variance weighting(IVW)as primary method.Sensitivity analyses,including Cochran's Q test,MR-Egger regression,and leave-one-out analysis,were conducted to verify the robustness of the results.Statistical significance was set at P<0.01(Bonferroni correction),and P<0.05 was considered as suggestive significance.Results Among different locations of endometriosis,ovary(IVW:OR=1.26,95％CI:1.17～1.35,P<0.001),pelvic peritoneum(IVW:OR=1.26,95％CI:1.20～1.33,P<0.001),rectovaginal septum(IVW:OR=1.11,95％CI:1.06～1.16,P<0.001),adenomyosis(IVW:OR=1.16,95％CI:1.07～1.25,P<0.001),and other types of endometriosis(IVW:OR=1.10,95％CI:1.03～1.17,P=0.004)were significantly associated with infertility.But no such association was observed in fallopian tube and intestinal endometriosis with infertility(P>0.05).Reverse causality analysis indicated that infertility might lead to fallopian tube endometriosis(IVW:OR=1.46,95％CI:1.11～1.93,P=0.007),and was associated with ovarian(IVW:OR=1.56,95％CI:1.27～1.93,P<0.001),pelvic peritoneal(IVW:OR=1.34,95％CI:1.11～1.62,P=0.003),rectovaginal(IVW:OR=1.46,95％CI:1.11～1.93,P=0.007),and other types of endometriosis(IVW:OR=1.61,95％CI:1.21～2.13,P=0.001).Suggestive significance was observed statistically in infertility promoting adenomyosis(IVW:OR=1.16,95％CI:1.07～1.25,P<0.05).It had not been proven yet that infertility could lead to intestinal endometriosis(P>0.05).Sensitivity analyses confirmed the robustness of the results.Conclusion Bidirectional causal relationships exist between different subtypes of endometriosis and infertility.Our findings based on MR analysis validate the clinical observation that endometriosis can lead to infertility,and we exploratively propose an important conclusion that infertility itself may also induce endometriosis.However,due to limited data,the causal relationships between intestinal/tubal endometriosis and infertility require further investigation.

Objective To design a training device of the flight crew for plateau normobaric low-oxygen acclimatization so as to enhance the flight crew's ability to adapt to the low oxygen environment after rushing into the plateau and reduce the incidence of acute plateau reaction.Methods The training device comprised a plateau environment simulation controller,a multimodal physiological acquisition system and hypoxia exercise training evaluation software.The plateau environment simulation controller was composed of an environment monitor for plateau acclimatization,two composite sensor sets,a control valve and an alarm device;the multimodal physiological acquisition system was made up of 20 groups of vital signs acquisi-tion devices,with a wearable dynamic ECG and respiration recorder,a wrist oximeter and an arm sphygmomano-meter included in each group.The hypoxia exercise training evaluation software was developed with a B/S architecture,Java language and JetBrains 2020.3.Results The training device proved to have the simulation altitude ranging from 0 to 6 000 m and facilitated simultaneous training of 20 persons for normobaric low-oxygen acclimatization,screening for hypoxia endurance,real-time monitoring of physiological parameters and assessment of training effect,with none of the trainees having acute plateau reaction.Conclusion The training device assists the flight crew for plateau normobaric low-oxygen acclimatization,and can be used for acclimatization training before plateau missions.[Chinese Medical Equipment Journal,2025,46(8):18-24]

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting the clinical and pathological features of prostate cancer(PCa).Methods We recruited 47 patients who underwent bpMRI combined with IVIM-DWI in our hospital from July 2022 to October 2023 and pathologically confirmed with PCa.Among these cases,20 were transitional zone PCa(TZ-PCa),and 27 were peripheral zone PCa(PZ-PCa).According to the International Society of Urological Pathology(ISUP)risk grades,the patients were divided into high-risk group(ISUP≥3)and low-risk group(ISUP≤2).Differences in the risk levels between TZ-PCa group and PZ-PCa group were compared.Factors including age,total prostate-specific antigen(tPSA),diffusion coefficient(D)value,pseudo diffusion coefficient(D*)value,perfusion fraction(F)value,and apparent diffusion coefficient(ADC)as independent variables were compared between the two groups.Binary logistic regression analysis was further used to identify the factors associated with high or low risk of PCa.Receiver operation characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of PSA,D value,anatomical zones,and the combined model of PSA+D value+anatomical zones in predicting the risk level of PCa.Results The risk level was higher in PZ-PCa group than in TZ-PCa group(P=0.015).Binary logistic regression analysis showed that the tPSA level in the high-risk group of PCa was higher than that in the low-risk group(OR=1.026,95％CI:1.004-1.049,P=0.014),but the Dmean value was lower than that in the low-risk group(OR=0.993,95％CI:0.987-0.999,P=0.034).PCa in the high-risk group was more distributed in the peripheral zone(OR=5.250,95％CI:1.468-18.772,P=0.023).The diagnostic efficacy of the combined model(AUC=0.887,95％CI:0.787-0.987)was higher than that of tPSA,Dmean,or anatomical partitioning alone(P=0.001,0.043,and 0.003,respectively).Conclusion PZ-PCa has a higher risk level than TZ-PCa.Combining bpMRI localization of anatomical zones with PSA and D value provides the highest efficacy in predicting the risk level of PCa,which can potentially support the development of precise and personalized clinical diagnosis and treatment strategies for PCa.

Inspection,the foremost of the four diagnostic methods in traditional Chinese medicine(TCM),refers to a clinical approach involving observation of the body's overall condition and specific regions to assess pathological conditions.This method holds an important position in the clinical diagnostic system of TCM.However,traditional inspection is limited by the subjectivity of physician experience and technological means,often resulting in inconsistent and subjective outcomes.With the advancement of science and technology,the generalized inspection diagnosis technology of smart TCM has emerged.This innovative approach integrates classical TCM diagnostic theories with digital-intelligent technologies,enabling accurate collection and intelligent analysis of physiological indicators related to spirit,complexion,physique,and postures.The development of a generalized inspection diagnosis system of smart TCM based on this technology is crucial for promoting the objectivity,precision,and intelligence of TCM diagnosis and treatment.This article proposes that the core feature of the generalized inspection diagnosis system of smart TCM is the analytical logic based on the classic theory of TCM.The framework design of the system can be divided into five modules:data acquisition,data processing,knowledge graph and reasoning,report generation,and report analysis.The limitations and future development trends in data annotation standardization,integration of TCM theory and algorithms are also discussed.The aim is to provide a new paradigm for precise diagnosis in TCM,and advance research and practical implementation of smart TCM generalized inspection.