Oral and maxillofacial tumor surgery is characterized by complex anatomical structures, extensive surgical trauma, and high demands for postoperative functional reconstruction. Perioperative complications and functional impairments significantly affect patients’ recovery process, quality of life, and long-term prognosis. Enhanced recovery after surgery (ERAS), grounded in evidence-based medicine, optimizes perioperative management through multidisciplinary collaboration and demonstrates substantial application potential in oral and maxillofacial surgery. Multiple prospective studies have confirmed that standardized airway management, goal-directed fluid and temperature management, and specialized ward-based care can shorten hospital stays, facilitate early enteral nutrition and ambulation, and reduce intensive care unit admission rates and postoperative complications. However, existing ERAS studies mainly focus on traditional clinical outcomes, with insufficient attention paid to functional recovery specific to patients with oral and maxillofacial tumors after surgery, including speech, swallowing, mastication, facial expression, and psychosocial function. Based on the structure-process-outcome quality evaluation model, this review summarizes the implementation pathways and evaluation framework of ERAS in oral and maxillofacial tumor surgery. Furthermore, integrating current international evidence and a large cohort study from our team evaluating a delayed extubation strategy in patients undergoing free flap reconstruction, we demonstrate that perioperative management aligned with ERAS principles can significantly shorten hospital stays, reduce postoperative complications, and decrease medical costs while maintaining safety. Future efforts should focus on specialized pathways for oral and maxillofacial surgery, strengthening long-term functional and quality-of-life follow-up, and exploring digital and precision rehabilitation tools to promote the transition of ERAS toward a comprehensive recovery model emphasizing functional restoration and social reintegration.

Objective To investigate the value of constructing a risk prediction model of brain metastasis in lung cancer based on clinical-CT imaging.Methods The clinical and CT imaging data of 208 patients with lung cancer confirmed by surgical pathology or puncture biopsy were analyzed retrospectively,including 98 patients in the metastasis group and 110 patients in the non-metastasis group.Univariable and binary logistic regression analyses were performed between the two groups,and the clinical,CT imaging,and clinical-CT imaging models were constructed according to the selected independent risk factors.Prediction model performance was eval-uated with receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA).Results Multivariate analysis showed that T stage,pathological type,radiotherapy and chemotherapy,surgery,long diameter(LD),short diameter(SD),minimum CT value(CTmin)were the independent risk factors for predicting brain metastasis in lung cancer(P<0.05).The area under the curve(AUC)of clinical,CT imaging and clinical-CT imaging models were 0.925,0.764,0.941,respectively.DeLong test analysis showed that the AUC of clinical-CT imaging model,clinical model and CT imaging model was statistical difference(Z=2.093,5.777,all P<0.05).The calibration curve suggested a good fit of the clinical-CT imaging model.The DCA suggested that the clinical-CT imaging model demonstrates good clinical benefits.Conclusion The clinical-CT imaging model can effectively predict the occurrence of brain metastasis in lung cancer,which is helpful to guide the development of accurate diagnosis and treatment plan.

Objective:To evaluate serum 25-hydroxyvitamin D 3 [25(OH)D 3] as a potential biomarker for amyotrophic lateral sclerosis (ALS) severity and to identify risk factors influencing ALS prognosis. Methods:This study included 217 ALS patients hospitalized at the Department of Neurology, First Medical Center, Chinese PLA General Hospital, between October 2018 and October 2021, who met the revised El Escorial diagnostic criteria. A cross-sectional analysis assessed differences in clinical indicators-including the ALS Functional Rating Scale-Revised (ALSFRS-R) and forced vital capacity percentage (FVC%)-across different serum 25(OH)D 3 levels. The correlation between 25(OH)D 3 levels and individual ALSFRS-R components was also examined. Conduct a prospective cohort study to identify independent risk factors affecting the survival time of ALS patients. Results:Among three groups categorized by serum 25(OH)D 3 levels, there were significant differences in the proportion of males ( χ2=10.51, P<0.05). Serum 25(OH)D 3 levels correlated positively with lower limb function scores in the ALSFRS-R ( r=0.05, P<0.05), but they were not identified as an independent risk factor for survival ( HR=0.98, 95% CI 0.93-1.04, P>0.05). In contrast, delayed diagnosis( HR=0.94, 95% CI 0.89-0.99, P<0.05) and reduced FVC%( HR=0.94, 95% CI 0.97-0.99, P<0.05) were independent predictors of shorter survival. Conclusion:Serum 25(OH)D 3 levels differ by gender distribution and may be linked to better lower limb function in ALS patients. However, their role in prolonging survival remains uncertain.

Objectives:To analyze whether there is a causal relationship between plasma proteins and the risk of coronary atherosclerosis(CAS)based on a two-sample Mendelian randomization(MR)analysis and to identify potential therapeutic targets for CAS.Methods:Single nucleotide polymorphisms(SNP)associated with plasma proteins from the UK Biobank Pharmacoproteomics Program(UKB-PPP)database were used as instrumental variables and outcome data were obtained from genome-wide association study databases.The Wald ratio method and inverse variance weighted(IVW)method in two-sample MR were employed as the primary approaches to assess the causal relationship between plasma proteins and CAS.Colocalization analysis was conducted as a sensitivity analysis to ensure the robustness of the MR findings.Results:A total of 132 plasma proteins were found to have causal associations with an increased risk of CAS.Colocalization analysis revealed that 12 plasma proteins shared genetic variants with CAS.Among them,Proprotein convertase subtilise/kexin type 9(PCSK9)(OR=1.23,95%CI:1.15-1.32,P<0.01)and neurocan(NCAN)(OR=1.35,95%CI:1.21-1.52,P<0.01)exhibited posterior probability of hypothesis4(PPH4)values<0.80 in the colocalization analysis,indicating strong support for colocalization and suggesting their potential as primary plasma protein drug targets for CAS.Conclusions:PCSK9 is associated with an increased risk of CAS and is confirmed as a therapeutic target for CAS.NCAN emerges as another potential therapeutic target for CAS.

The study and control of elemental impurities are crucial for ensuring the quality and safety of drugs.The ICH has published the Q3D guideline as a globally harmonised approach for the research and control of elemental impurities in drugs.In accordance with the requirements of the ICH Q3D guideline for risk assessment and control of elemental impurities,how to carry out the development and validation of detecting methods for elemental impurities is important to analysts.In this research,the key points of ICP-AES and ICP-MS method development are summarized,including the determination of the types and limits of the elements to be measured,the selection of pretreatment methods,interferences and corrections;the validation requirements for the two methods in ICH Q2(R2)and different pharmacopoeial general rules are analyzed,and the evaluation methods of each validation experiments are compared in detail.This paper can provide a reference for the development and validation of detecting methods for elemental impurities,and research ideas for related research workers.

Inverse Compton scattering X-rays are commonly generated by the collision of the incident relativistic high-energy electrons with the low-energy photons of laser pulses. Compared with the X-rays from bremsstrahlung radiation, which are often used in clinical settings, inverse Compton X-rays have unique advantages in radiological diagnosis and treatment due to their distinctive physical properties. In these years, the demand of precision radiotherapy technology has been increasingly emphasized. Inverse Compton X-rays may provide such a promising path for the development of precision radiotherapy. However, only a few facilities worldwide can achieve the generation of inverse Compton X-rays, and relevant studies in the field of radiation therapy are also in the exploratory stage. In this article, recent research progress at home and abroad were reviewed to introduce the ways of inverse Compton X-rays generation as well as their characteristics and advantages in radiation physics, aiming to provide reference for evaluating their application values and prospects in radiation therapy.

Objective:To compare the uncertainty of dose calibration systems between EBT4 and EBT3 films, and to evaluate the effectiveness and accuracy of EBT4 films in radiotherapy dose measurements.Methods:EBT4 and EBT3 films were irradiated with clinical 6 MV photon beams at doses ranging from 0 to 1,600 MU. Films were scanned after resting for 0 and 24 h to establish dose calibration functions based on net optical density. The dose uncertainties introduced by function fitting, dose resolution, film non-uniformity, scan repeatability, and scanner non-uniformity during calibration of the two films were obtained through experimental tests and mathematical calculations. Independent-sample t-tests were used to compare differences in fitting uncertainty and dose resolution between the two films, while homogeneity of variance tests were used to compare differences in film non-uniformity and scan repeatability. The combined total uncertainty was then calculated and compared. Finally, the total combined uncertainty was calculated by integrating all individual sources of uncertainty and compared between the two films. Results:Within the absorbed dose range of 1-12 Gy, EBT4 films exhibited significantly lower dose uncertainties from function fitting and dose resolution than EBT3 films at the same standing time ( P<0.01). No significant differences were observed between the two films in terms of non-uniformity and scan repeatability ( P>0.05). The total dose uncertainties of EBT4 and EBT3 films at 0 h standing were 5.65% and 7.87%, respectively, while the total uncertainties at 24 h standing were 4.73% and 6.33%, respectively. Overall, the dose calibration system of EBT4 films demonstrated consistently lower total uncertainty. Conclusion:Under identical conditions, EBT4 films demonstrate superior and more stable dose uncertainty compared with EBT3 films, thereby meeting the clinical requirements for radiation dose measurements with higher precision.

Objective To investigate the relationship between serum IL-8,homocysteine(Hey),C-reactive protein(CRP)levels and severity of coronary lesions in patients with coronary heart disease(CHD)complicated by chronic heart failure(CHF),as well as their prognostic value.Methods A total of 118 elderly eligible patients admitted to our hospital from January 2023 to September 2024 were prospectively recruited,and according to their Gensini score,they were divided into mild,moderate and severe stenosis groups(45,50 and 23 cases,respectively).Accord-ing to the clinical outcomes after follow-up,they were divided into a good prognosis group(82 cases)and a poor prognosis group(36 cases).The serum levels of IL-8,Hcy and CRP were com-pared among the three groups of different stenosis,and Pearson correlation analysis was used to examine the relationship between the three indicators and the severity of coronary lesions.Cox regression analysis was performed to identify factors influencing poor prognosis in patients with CHD and CHF,and receiver ROC curve analysis was conducted to assess the diagnostic value of serum IL-8,Hey,and CRP levels in predicting prognosis.Results The serum levels of IL-8,Hey and CRP were gradually decreased in the severe,moderate and mild stenosis groups in turn,with statistical significances(P＜0.05).Pearson correlation analysis indicated that serum IL-8,Hcy,and CRP levels were positively correlated with the severity of coronary lesions in the patients with CHD and CHF(r=0.364,0.355,0.372,P＜0.01).Significant differences were found in age,NT-proBNP,D-D,IL-8,Hcy,and CRP levels between the good and poor prognosis groups(P＜0.05).Cox regression analysis revealed that age,NT-proBNP,D-D,IL-8,Hcy,and CRP were influencing factors for poor prognosis in patients with CHD and CHF(P＜0.05).ROC curve ana-lysis showed that the AUC value of IL-8,Hey,CRP,and their combination in predicting prognosis was 0.698,0.714,0.723 and 0.899,respectively.Conclusion In the patients with CHD and CHF,serum IL-8,Hcy,and CRP levels are associated with the severity of coronary lesion and prognosis.Moreover,combining these three indicators has significant diagnostic value for predicting patient outcomes.

Objective:To analyze the efficacy of high disinsertion of the levator palpebrae superioris muscle combined with conjoint fascial sheath (CFS) fixation for the treatment of moderate to severe ptosis.Methods:A retrospective study included 20 patients with moderate to severe ptosis treated at the First Affiliated Hospital of Xinxiang Medical University from June 2022 to June 2023. Participants were divided into two groups based on surgical technique. Traditional group [9 patients (16 eyes), 3 males and 6 females, aged 5-32 (18.2±7.1) years]: were treated with standard surgical approach involving levator palpebrae superioris muscle separation starting from the tarsal plate margin combined with CFS fixation. Modified group [11 patients (16 eyes), 5 males and 6 females, aged 6-28 (17.5±6.3) years]: were treated with modified technique utilizing high disinsertion of the levator palpebrae superioris muscle combined with CFS fixation. Outcomes including CFS exposure time, postoperative edema resolution time, complications, and patient satisfaction were compared between the two groups.Results:The CFS exposure time in the traditional group lasted for (37.5±3.0) min, which was significantly longer than that in the modified group of (23.9±1.8) min ( P<0.001). Postoperative edema resolution time in the traditional group was (16.4±1.4) days, which was also longer than that in the modified group of (7.0±0.6) days ( P<0.001). Transient lagophthalmos occurred in all patients postoperatively. The traditional group exhibited 3 cases of mild conjunctival prolapse and 3 cases of chemosis, while the modified group had 1 case of mild conjunctival prolapse and 1 case of chemosis. Patient satisfaction rates were 15/16 eyes in the modified group and 12/16 eyes in the traditional group. Conclusion:The modified technique involving high disinsertion of the levator palpebrae superioris muscle combined with CFS fixation demonstrates superior effectiveness in correcting moderate to severe ptosis.

With the continuous development of genomics and precision medicine,targeted therapy and immunotherapy targeting biomarkers have ush-ered in a new era of anti-tumor therapy.However,due to the heterogeneity of tumor cells and the variability of tumor microenvironment,there are still significant differences in response to the same drug even in patient populations with the same bio-marker enrichment.By combining omics data with drug sensitivity algorithms,the response of anti-tu-mor drugs can be predicted and transformed into personalized diagnosis and treatment strategies re-quired for precision medicine,which is expected to improve the effectiveness of anti-tumor drugs in clinical treatment.Currently,machine learning is one of the commonly used modeling algorithms for predicting the response of anti-tumor drugs.How-ever,due to differences in input data and algorithm construction methods,there is currently a lack of comprehensive literature review in this field.There-fore,this article provides a review of machine learning algorithms for predicting anti-tumor drug responses,summarizing publicly available cell ge-nome characterization datasets,machine learning algorithms,and evaluation indicators in drug re-sponse prediction,as well as the current situation and challenges faced in clinical applications,in or-der to provide methodological references for the main research problems and potential solutions of machine learning algorithms in the field of drug re-sponse prediction.