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 compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Recently, the World Health Organization (WHO) R&D Blueprint for Epidemics released the 2024 priority pathogen list. Over 200 scientists around the world evaluated the evidences of transmissions, virulences of 1 652 pathogens and the availability of medical countermeasures in two years. Finally, 33 pathogens that could potentially cause the next pandemic were included in the priority pathogen list. This list introduces the scientific framework of "family-priority pathogen-prototype pathogen", emphasizing the importance of studying entire pathogen family rather than specific pathogen. The list can be used to guide and coordinate the research and development of medical countermeasures, including vaccine, blood product, antibody, antimicrobial or antiviral drug, diagnostic test, and personal protective equipment, thereby improving the global rapid response to unknown infectious disease threats. This article summarizes the scientific background and main contents of the WHO priority pathogen list and the enlightenment for pandemic preparedness in the development of medical countermeasures in China to provide reference for the disease prevention and control in China.

Recently, the World Health Organization (WHO) R&D Blueprint for Epidemics released the 2024 priority pathogen list. Over 200 scientists around the world evaluated the evidences of transmissions, virulences of 1 652 pathogens and the availability of medical countermeasures in two years. Finally, 33 pathogens that could potentially cause the next pandemic were included in the priority pathogen list. This list introduces the scientific framework of "family-priority pathogen-prototype pathogen", emphasizing the importance of studying entire pathogen family rather than specific pathogen. The list can be used to guide and coordinate the research and development of medical countermeasures, including vaccine, blood product, antibody, antimicrobial or antiviral drug, diagnostic test, and personal protective equipment, thereby improving the global rapid response to unknown infectious disease threats. This article summarizes the scientific background and main contents of the WHO priority pathogen list and the enlightenment for pandemic preparedness in the development of medical countermeasures in China to provide reference for the disease prevention and control in China.

Coptis chinensis Franch. and Panax ginseng C. A. Mey. are traditional herbal medicines with millennia of documented use and broad therapeutic applications, including anti-diabetic properties. However, the synergistic effect of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng on type 2 diabetes mellitus (T2DM) and its underlying mechanism remain unclear. The research demonstrated that the optimal ratio of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng was 4∶1, exhibiting maximal efficacy in improving insulin resistance and gluconeogenesis in primary mouse hepatocytes. This combination demonstrated significant synergistic effects in improving glucose tolerance, reducing fasting blood glucose (FBG), the weight ratio of epididymal white adipose tissue (eWAT), and the homeostasis model assessment of insulin resistance (HOMA-IR) in leptin receptor-deficient (db/db) mice. Subsequently, a T2DM liver-specific network was constructed based on RNA sequencing (RNA-seq) experiments and public databases by integrating transcriptional properties of disease-associated proteins and protein-protein interactions (PPIs). The network recovery index (NRI) score of the combined treatment group with a 4∶1 ratio exceeded that of groups treated with individual components. The research identified that activated adenosine 5'-monophosphate-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC) signaling in the liver played a crucial role in the synergistic treatment of T2DM, as verified by western blot experiment in db/db mice. These findings demonstrate that the 4∶1 combination of total alkaloids from Coptis chinensis and total ginsenosides from Panax ginseng significantly improves insulin resistance and glucose and lipid metabolism disorders in db/db mice, surpassing the efficacy of individual treatments. The synergistic mechanism correlates with enhanced AMPK/ACC signaling pathway activity.
Animals ; Panax/chemistry* ; Ginsenosides/administration & dosage* ; Diabetes Mellitus, Type 2/metabolism* ; Mice ; Male ; Alkaloids/pharmacology* ; Coptis/chemistry* ; Drug Synergism ; Insulin Resistance ; Mice, Inbred C57BL ; Humans ; Transcriptome/drug effects* ; Blood Glucose/metabolism* ; Hypoglycemic Agents/administration & dosage* ; Drugs, Chinese Herbal/administration & dosage* ; Hepatocytes/metabolism*

Objective: To improve the efficiency and standardization of preoperative anemia diagnosis and treatment by establishing a systematic intelligent management platform for preoperative anemia. Methods: A multidisciplinary collaborative model was adopted to develop a preoperative anemia management system that integrates intelligent early warning, standardized treatment pathways, and quality control. The system utilizes natural language processing technology to automatically capture laboratory data and establish evidence-based medical decision support functions. A pre-post study design was employed to compare changes in preoperative anemia screening rates, preoperative anemia intervention rates, reasonable use of iron supplements, and perioperative red blood cell transfusion rates before and after system implementation. Results: After system implementation, the standardization of anemia diagnosis and treatment significantly improved: 1) Screening effectiveness: The anemia screening rate increased to 50.00% (an increase of 27.24%); 2) Intervention effectiveness: The anemia treatment rate rose to 56.30% (an increase of 14.02%); 3) Treatment standardization: The reasonable use rate of iron supplements increased to 55.33% (an increase of 21.02%); the red blood cell transfusion rate decreased to 18.29% (a decrease of 4.07%), and the amount of red blood cell transfusions was reduced by 291 units. Conclusion: This system achieves full-process management of preoperative anemia through information technology, significantly enhancing the standardization of diagnosis and treatment as well as intervention effectiveness, providing an effective solution for perioperative anemia management.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To compare the dosimetric disparities among static intensity-modulated radiotherapy(IMRT),volumetric modulated arc therapy(VMAT),and tomotherapy(TOMO)techniques in cervical cancer radiotherapy for providing data support for clinical decision-making scheme of radiotherapy.Methods The clinical data of 19 cervical cancer patients,treated at the Affiliated Cancer Hospital and Institute of Guangzhou Medical University from February to May in 2024,were analyzed.Three plans were devised for each case using IMRT,VMAT,and TOMO techniques,followed by dosimetric evaluation in terms of various metrics such as dose volume parameters of the target areas as well as organs-at-risk(OAR),conformity index(CI),homogeneity index(HI),and delivery time.Results All 3 plans met the clinical prescription requirements for the target areas.Compared with static IMRT and VMAT,TOMO had significantly lower Dmean and Dmaxof PCTV and PGTVnd.For OAR,TOMO demonstrated significant advantages over IMRT and VMAT in the Dmean of the bladder,the Dmean,Dmax,V30,V40of the rectum,the Dmean,Dmax,V20,V30of left and right femoral heads,and the Dmean,V20,V50of the pelvis(P<0.05).In addition,the TOMO group showed significantly higher CI for both PCTV and PGTVnd as compared with IMRT and VMAT groups,and lower PGTVnd HI than IMRT group(all P<0.05).Although there was trivial difference among 3 groups in term of PCTV HI,TOMO group performed slightly better than the other two groups.Notably,VMAT technique had the shortest treatment time.Conclusion In various treatment modalities for cervical cancer,TOMO is superior to IMRT and VMAT in terms of target dose coverage,OAR dose distribution,CI,and HI.However,VMAT has the highest efficiency.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To generate a stable kidney-specific deletion of augmenter of liver regeneration(ALR)mice and provide an animal model for further studying the biological function of ALR in the kidney.In addition,we further explored the effect of ALR on renal tubulointerstitial fibrosis.Methods Mating and identification of ALRflox/+/Ggt1-Cre mice with ALRflox/flox mice was carried out,and the ALRflox/flox/Ggt1-Cre mice were screened.Mating and identification of ALRflox/flox/Ggt1-Cre mice with ALRflox/flox mice were carried out,and screening the ALRflox/flox/Ggt1-Cre mice was performed.The ALRflox/flox/Ggt1-Cre mouse was a kidney-specific ALR knockout mouse and the ALRflox/flox mouse was a control mouse.The mouse genotypes were identified by PCR;the expression of ALR protein and mRNA levels in mouse liver were detected by Western blotting and real-time PCR;ALR expression in mouse kidney was detected by immunofluorescence.The kidney tissue morphology of the mouse kidney was observed using hematoxylin-eosin staining,periodic acid Schiff's reaction and Masson stain.Flow cytometry,immunohistochemistry,immunofluorescence and real time PCR analyses were used to determine macrophage phenotype.Results PCR results indicate that mouse genotypes are consistent with ALRflox/flox/Ggt1-Cre.Compared with ALRflox/flox mice,ALRflox/flox/Ggt1-Cre mice showed lower levels of ALR mRNA and protein,more interstitial inflammatory cells in kidney tissue,broken basement membrane of the renal tubules,the brush-border damage and significant interstitial fibrosis.After the kidney-specific ALR gene was knocked out,macrophages infiltrated the kidney tissue o and the polarization process of macrophages from M1 to M2 was reduced.Conclusion In this study,the kidney-specific deletion of ALR mouse was successfully constructed using the Cre/Loxp technology,which providing an important animal model for further study of the role of ALR genes.And ALR deficiency promotes renal fibrosis in physiological conditions.