In recent years, immunotherapy represented by immune checkpoint inhibitors has made important breakthroughs in the treatment of various malignant tumors. At present, immune checkpoint inhibitors have been widely used in patients with metastatic and recurrent advanced head and neck squamous cell carcinoma (HNSCC). Biomarkers play an important role in predicting the efficacy of immunotherapy for HNSCC. The biomarkers that can predict immunotherapy effect of patients with HNSCC mainly include programmed-death receptor ligand 1, tumor mutation load, human papillomavirus, and immune cell related indicators. This article reviews the predictive markers of immunotherapy for HNSCC and the current research situation. The further understanding of the predictive markers can help to accurately screen out the patients receiving the immunotherapy and to improve the prognosis of patients.

Artificial intelligence (AI) technology enhances the function of acupuncture clinical decision support system (CDSS) by promoting the accuracy of its diagnosis, assisting the formulation of personalized therapeutic regimen, and realizing the scientific and precise evaluation of its therapeutic effect. This paper deeply analyzes the unique advantages of AI-based acupuncture CDSS, including the intelligence and high efficiency. Besides, it points out the challenges of data security, the lack of model interpretation and the complexity of interdisciplinary cooperation in the development of acupuncture CDSS. With the continuous development and improvement of AI technology, acupuncture CDSS is expected to play a more important role in the fields of personalized medicine, telemedicine and disease prevention, and to further advance the efficiency and effect of acupuncture treatment, drive the modernization of acupuncture, and enhance its position and influence in the global healthcare system.
Humans ; Acupuncture Therapy ; Artificial Intelligence ; Decision Support Systems, Clinical

The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

Objective To analyze the research literature on fire needling therapy published on China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),and China Science and Technology Journal Database(VIP)in the last 20 years,and to explore the current status and the hotspots of the research,thus to summarize and analyze the spectrum of the dominant diseases and technological transformations of fire needling therapy.Methods CiteSpace and VOSviewer were applied to analyze the keywords,authors and institutions,to draw the scientific knowledge map,and to summarize the disease spectrum.Results A total of 4 226 literature were included,from 2000 to 2023,the number of publications on fire needling therapy research showed an increasing trend,with each of the four periods showing its own characteristics of the times.The"filiform fire needling"and"pricking of fire needling"were widely used as acupuncture tools and acupuncture techniques in the studies,the emergence of high-frequency disease keywords such as"shingles""vitiligo"and"acne"indicates that research on the treatment of skin diseases with fire needling has attracted much attention.The disease spectrum of fire needling therapy was enlarged,involving a total of 356 diseases distributed in 20 disease systems.Conclusion Skin diseases and arthralgia became the dominant diseases of fire needling therapy,the rise of research hot words such as"acne vulgaris""vitiligo""stroke""chronic eczema""filiform fire needling"and"Lingnan fire needling"indicates that fire needling therapy is developing towards research standardization,theoretical diversification and disease diversification.

The classic principles of oncological surgery were accepted based the procedures from radical surgery for breast cancer described by Halsted in 1894, which can be summarized as tumor en bolc resection, clean surgical margin, regional lymph nodes dissection, and tumor-free technique. The classic principles of oncological surgery are the cornerstone of cancer surgical treatment and have significantly promoted the development of oncological surgery. The minimally invasive surgery is the trend of contemporary oncological surgery for the characteristics of minimal invasion, better tissue identification, precise manipulation, and fast postoperative recovery. Head and neck cancers are usually related to the upper aerodigestive tract, as well as important nerves and blood vessels in head and neck. The anatomical structures of the relative organs are intricate and delicate, and their functions are crucial. Therefore, there is an urgent need for minimally invasive surgical techniques. However, the head and neck cancers which are larger or located in some special sites such as the skull base have to be removed by piecemeal resection in minimally invasive surgery. The piecemeal resection of tumor increases the risks of tumor positive surgical margins and tumor implantation metastasis. The goal of radical surgery for cancers is to completely remove the tumor and obtain a really clean surgical margin. If head and neck cancer is indication for radical surgery, appropriate operative manipulation (en bloc or piecemeal resection) is able to achieve the goal of radical surgery. Giving attention to both the advantages of the principles of oncological surgery and minimally invasive surgical techniques benefits more patients with head and neck cancers from better survival rate and minor invasive morbidities.

The classic principles of oncological surgery were accepted based the procedures from radical surgery for breast cancer described by Halsted in 1894, which can be summarized as tumor en bolc resection, clean surgical margin, regional lymph nodes dissection, and tumor-free technique. The classic principles of oncological surgery are the cornerstone of cancer surgical treatment and have significantly promoted the development of oncological surgery. The minimally invasive surgery is the trend of contemporary oncological surgery for the characteristics of minimal invasion, better tissue identification, precise manipulation, and fast postoperative recovery. Head and neck cancers are usually related to the upper aerodigestive tract, as well as important nerves and blood vessels in head and neck. The anatomical structures of the relative organs are intricate and delicate, and their functions are crucial. Therefore, there is an urgent need for minimally invasive surgical techniques. However, the head and neck cancers which are larger or located in some special sites such as the skull base have to be removed by piecemeal resection in minimally invasive surgery. The piecemeal resection of tumor increases the risks of tumor positive surgical margins and tumor implantation metastasis. The goal of radical surgery for cancers is to completely remove the tumor and obtain a really clean surgical margin. If head and neck cancer is indication for radical surgery, appropriate operative manipulation (en bloc or piecemeal resection) is able to achieve the goal of radical surgery. Giving attention to both the advantages of the principles of oncological surgery and minimally invasive surgical techniques benefits more patients with head and neck cancers from better survival rate and minor invasive morbidities.

In recent years, immunotherapy represented by immune checkpoint inhibitors has made important breakthroughs in the treatment of various malignant tumors. At present, immune checkpoint inhibitors have been widely used in patients with metastatic and recurrent advanced head and neck squamous cell carcinoma (HNSCC). Biomarkers play an important role in predicting the efficacy of immunotherapy for HNSCC. The biomarkers that can predict immunotherapy effect of patients with HNSCC mainly include programmed-death receptor ligand 1, tumor mutation load, human papillomavirus, and immune cell related indicators. This article reviews the predictive markers of immunotherapy for HNSCC and the current research situation. The further understanding of the predictive markers can help to accurately screen out the patients receiving the immunotherapy and to improve the prognosis of patients.

Objective:To explore the relationship between atherosclerotic index of plasma(AIP)and vulnerable plaque of coronary under computed tomography(CT)based on coronary CT angiography(CCTA).Methods:Data were retrospectively collected on 213 patients with coronary heart disease(CHD)who underwent CCTA examination from January 2021 to February 2024 at the Second Affiliated Hospital of Shenyang Medical College,and they were divided into a vulnerable plaque group(123 cases)and a non-vulnerable plaque group(90 cases)according to whether existed vulnerable plaque of coronary artery.General clinical data such as age,gender,history of smoking,history of alcohol consumption,history of diabetes,and serum indicators such as AIP were collected.The differences in AIP and other factors between the two groups were compared.The independent influencing factors of vulnerable plaque of coronary artery were determined by multifactorial logistic regression analysis,and the predictive value of AIP for vulnerable plaque was assessed by drawing a receiver operating characteristic(ROC)curve.Results:AIP of vulnerable plaque group was 0.22±0.31,which was higher than that 0.05±0.27 of the vulnerable plaque group,and the difference of AIP between two groups was significant(t=4.223,P<0.001).Multifactorial logistic analysis showed there was independent correlation between AIP and vulnerable plaque under CT(OR=7.556,95%CI:2.442～23.385,P=0.002).The ROC curve showed that the best cut-off value of AIP was 0.20 in predicting vulnerable plaque under CT,and the value of area under curve(AUC)was 0.665,and the sensitivity was 55.56%and the specificity was 73.98%.Conclusion:AIP is an independent influencing factor for CHD patients who complicate vulnerable plaques,and it has a certain of predictive value for vulnerable plaques.

Objective:To compare the efficacy and safety of low-dose and standard-dose radiotherapy (LD-RT vs. SD-RT) in the treatment of oropharyngeal cancer patients with positive human papillomavirus (HPV). Methods:All comparative studies of low-dose versus standard-dose radiotherapy in the treatment of HPV-positive oropharyngeal cancer were searched from PubMed, Web of Science, Cochrane Library, EMbase, Chinese Biomedical Literature Database (CBM), CNKI, Chongqing VIP, and Wanfang databases from January 1, 2000 to February 9, 2023. According to the inclusion and exclusion criteria, the data were strictly screened, and the RevMan 5.4 software was used for meta-analysis.Results:A total of 8 studies were included. The pooled results showed that the overall survival (OS) and progression-free survival (PFS) of patients in the LD-RT group were similar to those in the SD-RT group ( HR=0.83, 95% CI=0.59-1.18, P=0.31; HR=0.97, 95% CI=0.53-1.78, P=0.92), but the rate of percutaneous endoscopic gastrostomy (PEG) insertion was significantly reduced ( RR=0.45, 95% CI=0.28-0.72, P=0.001). Conclusion:LD-RT yields similar efficacy and lower rate of PEG insertion compared with SD-RT in HPV-positive oropharyngeal neoplasm patients.

Objective To investigate the effects of total flavones of Dracocephalum moldavica L.(TFDM)on oxida-tive damage to retinal ganglion cells(RGCs)induced by high glucose(HG)and its mechanism.Methods RGCs of mice were taken as the research subjects.RGCs were inoculated in 24-well plates(with 2.5 × 104 cells in each well)and divided into control group(cultured with medium containing 10％fetal bovine serum for 48 h),HG group(cultured with medium containing 30 mmol·L-1 glucose for 48 h),HG+TFDM-L group(cultured with medium containing 30 mmol·L-1 glucose and 25 mg·L-1 TFDM for 48 h),HG+TFDM-M group(cultured with medium containing 30 mmol·L-1 glucose and 50 mg·L-1 TFDM for 48 h),HG+TFDM-H group(cultured with medium containing 30 mmol·L-1 glucose and 100 mg·L-1 TFDM for 48 h),miR-NC group(transfected with miR-NC and then cultured with medium containing 30 mmol·L-1 glu-cose for 48 h),miR-93-5p group(transfected with miR-93-5p mimics and then cultured with medium containing 30 mmol·L-1 glucose for 48 h),anti-miR-NC group(transfected with anti-miR-NC and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h),and anti-miR-93-5p group(transfected with anti-miR-93-5p and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h).Levels of RGCs oxidative stress indexes in each group were detected according to the kit instructions.The thiobarbituric acid method was used to measure the level of malondialdehyde(MDA),the colorimetric method was adopted to detect the levels of catalase(CAT)and 8-hydroxydeoxyguanosine(8-OHdG),apoptosis rate was detected by flow cytometry,the messenger ribonucleic acid(mR-NA)expressions were analyzed by real-time quantitative polymerase chain reaction,the targeting regulation of miR-93-5p and E2F transcription factor 1(E2F1)were verified by dual luciferase reporter assay,and the protein expressions were de-tected by Western blot.Statistical analysis was conducted on the data of each group.Results In the HG group,the lev-els of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were higher than those in the control group(all P＜0.05);the CAT level and Bcl-2 protein expression were lower than those in the control group(both P＜0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the levels of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were lower than those in the HG group(all P＜0.05);the CAT level and Bcl-2 protein expression were higher than those in the HG group,and those indexes gradually tended to those in the control group with the increase of TFDM concentrations(all P＜0.05).In the HG group,the miR-93-5p expression in RGCs was lower than that in the control group,and the mRNA and protein expressions of E2F1 were higher than those in the control group(all P＜0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the miR-93-5p expression in RGCs was higher than that in the HG group,and the mRNA and protein expressions of E2F1 were lower than those in the HG group(all P＜0.05).The protein expression of E2F1 in RGCs of the miR-93-5p group was lower than that in the miR-NC group,and the protein expression of E2F1 in RGCs of the anti-miR-93-5p group was higher than that in the anti-miR-NC group(both P＜0.05).In the miR-93-5p group,the miR-93-5p expression was higher than that in the miR-NC group,the levels of MDA and 8-OHdG,apoptosis rate,and protein expressions of Bax and E2F1 were lower than those in the miR-NC group,and the CAT level and Bcl-2 protein expression were higher than those in the miR-NC group(all P＜0.05).Con-clusion TFDM can inhibit oxidative stress and cell apoptosis,and then reduce the damage to RGCs induced by HG.The mechanism may involve the regulation of miR-93-5p/E2Fl expression.