With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

OBJECTIVE: This study investigated the association between household chemical use and respiratory disease (RD) in older Chinese adults. METHODS: The data were from the 2018 China Longitudinal Health and Longevity Survey (CLHLS) database, which included 12,866 participants aged ≥ 65 years. The prevalence of RD was based on self-reported medical history, and patients were divided into diseased and non-diseased groups. The frequency of household chemical usage was divided into four categories, and a total score for eight household chemical usage categories was constructed. Binary logistic regression was used to determine the relationship between the frequency of household chemical use and RD, and a restricted cubic spline was used to determine the dose-response association. RESULT: After adjusting for all covariates, regular use of repellents [odds ratios ( OR) = 1.28, 95% CI 1.06-1.55] and oil removers ( OR = 1.28, 95% CI 1.03-1.58) were associated with RD. There was a dose-response association between the total score of household chemicals usage and RD risk ( P non-linearity > 0.05, P for trend < 0.01). Using patients with the total score below 9 as a reference, the OR for patients with the total score ranging from 25 to 32 is 2.33 (95% CI 1.25-4.09). CONCLUSION Regular use of repellents and oil removers increased the risk of RD, and the dose-dependent relationship was also observed.
Humans ; China/epidemiology* ; Aged ; Male ; Female ; Respiratory Tract Diseases/chemically induced* ; Aged, 80 and over ; Household Products/adverse effects* ; Prevalence

Objective:To compare the value of Caprini, Padua and Autar risk assessment models in the risk assessment of venous thromboembolism in hospitalized stroke patients.Methods:A retrospective case-control study were used to collect hospitalized stroke patients in the neurology department of Xiangya Hospital from January 1, 2018 to June 30, 2020. 75 patients with venous thromboembolism (VTE) were VTE group and 75 patients without VTE were control group. The risk of thrombosis was assessed by Caprini risk assessment model, Padua risk assessment model and Autar risk assessment model respectively. The predictive value of each model on the risk of VTE formation in stroke patients was analyzed by receiver operating characteristic (ROC) curve and area under the curve (AUC).Results:The areas under the curve of Caprini, Padua and Autar risk assessment models for predicting the risk of VTE formation in stroke patients were 0.768±0.039, 0.746±0.040 and 0.710±0.042 respectively. The sensitivity, specificity and accuracy were 81.3%, 61.3%, 71.3%(Caprini), 72.0%, 72.0%, 72.0%(Padua), 66.7%, 68.0% and 67.3%(Autar) respectively. There was no significant difference in the prediction value of the three models on the formation risk of stroke VTE (all P>0.05). The technique for order preference by similarity to ideal solution (TOPSIS) method was used to comprehensively evaluate the AUC, sensitivity, specificity and accuracy of the three risk assessment models. Padua risk assessment model was the best, followed by Caprini risk assessment model and Autar risk assessment model. Conclusions:The Caprini, Padua, and Autar risk assessment scales can well predict the risk of VTE in stroke patients. The Caprini scale has the highest sensitivity and the Padua scale has the highest specificity. There is no significant difference in the predictive value of the three scales. Comprehensive evaluation of predictive value: Padua risk assessment scale is the best.

Objective:To observe the efficacy of trigeminal nerve microvascular decompression in the treatment of elderly trigeminal neuralgia.Methods:A total of 96 elderly patients with trigeminal neuralgia admitted to our hospital from January 2015 to June 2016 were selected.48 patients were treated with percutaneous trigeminal semilunar ganglion radiofrequency thermocoagulation as a control group, and the other 48 patients were treated with trigeminal nerve microvascular decompression as the observation group.Efficacy indicators of post-operative pain severity scores, severity scores of post-operative complications, a sum of two categories of severity scores, which were compared between the two groups at one month and at 1, 3, 5 years after surgery.Results:One month after the operation, there was no significant differences in pain severity score, surgical complications severity scores, and a sum of two categories severity scores between the two groups of patients(all P>0.05). In the observation group versus the control group, pain severity scores were[(0.55±0.39)scores versus(0.94±0.61)scores, t=7.572, P=0.011 at 1 year after operation], [(0.81±0.61)versus(1.19±0.83)scores, t=7.513, P=0.012 at 3 years after operation]and[(1.13±0.65)and(1.55±0.91)scores, t=7.837, P=0.010 at 5 years after operation]respectively, showing more efficacy in observation group.In the observation group versus the control group, severity scores of surgical complications were[(0.39±0.28)and(0.67±0.49)scores, t=7.290, P=0.014, at 1 year after operation], [(0.65±0.37)and(0.94±0.55)scores, t=7.353, P=0.013 at 3 years after operation]and[(0.80±0.35)and(1.13±0.64)scores, t=7.475, P=0.012 at 5 years after operation], respectively, showing more efficacy in observation group.In the observation group versus the control group, overall efficacy from a sum of the two categories of severity scores were[(0.72±0.35)and(1.33±0.56)scorets, t=7.701, P=0.009 at 1 year after operation], [(1.21±0.49)and(1.78±0.70)scores, t=7.580, P=0.011 at 3 years after operation]and[(1.46±0.55)and(2.24±1.03)scores, t=8.026, P=0.007 at 5 years after operation], respectively, showing more efficacy in observation group.Overall, above three severity scores were lower than in the observation group than in the control group(all P<0.05). Conclusions:For elderly patients with trigeminal neuralgia, trigeminal nerve microvascular decompression has definite efficacy, long duration of pain relief, low incidence of surgical complications, and is safe and reliable, which is worthy of clinical application.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

A series of 2-(((5-akly/aryl-1-pyrazol-3-yl)methyl)thio)-5-alkyl-6-(cyclohexylmethyl)-pyrimidin-4(3)-ones were synthesized and their anti-HIV-1 activities were evaluated. Most of these compounds were highly active against wild-type (WT) HIV-1 strain (IIIB) with EC values in the range of 0.0038-0.4759 μmol/L. Among those compounds, had an EC value of 3.8 nmol/L and SI (selectivity index) of up to 25,468 indicating excellent activity against WT HIV-1. anti-HIV-1 activity and resistance profile studies suggested that compounds and displayed potential anti-HIV-1 activity against laboratory adapted strains and primary isolated strains including different subtypes and tropism strains (ECs range from 4.3 to 63.6 nmol/L and 18.9-219.3 nmol/L, respectively). On the other hand, it was observed that those two compounds were less effective with EC values of 2.77 and 4.87 μmol/L for HIV-1A (K103N + Y181C). The activity against reverse transcriptase (RT) was also evaluated for those compounds. Both and obtained sub-micromolar IC values showing their potential in RT inhibition. The pharmacokinetics examination in rats indicated that compound has acceptable pharmacokinetic properties and bioavailability. Preliminary structure-activity relationships and molecular modeling studies were also discussed.

Objective: To observe the effects of moxibustion or moxa smoke on serum lipids, aorta and liver pa-thology, and carotid plaque stability in atherosclerosis.Methods: Fifty-four 8-week-old ApoE-/- mice were randomly divided into three groups (untreated, moxibustion, and moxa smoke) and received a high-fat diet. Eighteen wild-type C57BL/6 mice of the same age were used as controls. The intervention (none, moxibustion between the nipples, or 10-15 mg/m3 moxa smoke) was applied to restrained mice 20 min per day, six days per week, for 12 weeks. At the end of the experimental period, we measured serum lipids and apolipoprotein, stained thoracic aortas and livers to observe pathological changes, and used immunohistochemical staining to assess the levels of α-smooth muscle actin, CD68, tumor necrosis factor-α, nuclear transcription factor-kB, and P38 mitogen-activated protein kinase. We also measured the levels of matrix metalloproteinase-2 and 9 and tissue metalloproteinase inhibitor-1. Results: After 12 weeks, lipid metabolism disorder and atherosclerotic plaques were observed in the ApoE-/- mice. Moxibustion or moxa smoke reduced the levels of serum total cholesterol, triglycerides, low density lipoprotein, and very low density lipoprotein but did not affect the levels of high density lipoprotein, apolipoprotein A1, or oxidized low density lipoprotein. Moxibustion or moxa smoke sup-pressed pathological changes in thoracic aortas and livers, increased fiber cap thickness, the fiber cap thickness/intimal medial thickness ratio, and collagen area percentage, and reduced extracellular lipids. Treatment with moxibustion or moxa smoke increasedα-smooth muscle actin and reduced CD68 and the vulnerability index, suppressed tumor necrosis factor-α and nuclear transcription factor-kB expres-sion, and did not affect P38 mitogen-activated protein kinase expression. Treatment lowered the levels of matrix metalloproteinase-2 and 9 and increased those of tissue metalloproteinase inhibitor-1. Conclusion: Moxibustion or moxa smoke exert protective effects in serum lipid profiles and carotid plaque stability in atherosclerotic mice by regulating plaque stability, inflammatory factors, and matrix metalloproteinases.

Objective To explore the short-term effect of particulate matters with an aerodynamic diameter of less than or equal to 10 μg (PM10) and aerodynamic diameter of less than or equal to 2.5 μg (PM2.5) on cardio-cerebrovascular mortality in Ningbo city.Methods Daily cardiocerebrovascular mortality data from 2011 to 2014 in Ningbo city were collected and the time series study using a semi-parametric generalized additive model were used to evaluate the relationship between the mortality of cardio-cerebrovascular disease and particulate matters after adjustment for the long-term trend of death,weather conditions,"days of the week" and other confounding factors.Results In single-pollutant model,the short-term effects of particulate matter on cardio-cerebrovascular mortality was strongest in lagged 2 days in Ningbo city,and an increase of 10 μg/m3 in moving average concentrations (lagged 2-3 days and lagged 2-4 days) of PM2.5 and PM10 could increase the cardio-cerebrovascular mortality by 0.55％ (0.23％-0.87％) and 0.53％ (0.28％-0.78％),respectively.In multi-pollutant models,PM10 did remain robust after being adjusted for PM2.5 with 0.58％ (0.09％-1.07％) increase in cardio-cerebrovascular mortality.The effect of PM2.5 had no statistical significantce after being adjusted for other co-pollutants.Conclusion These findings suggested that the concentrations of ambient particulate matters were associated with an increased risk of daily cardio-cerebrovascular mortality in Ningbo city.

Objective Through adverse event reporting module in hospital nursing manage-ment system, research group screened out the fall incidence higher departments to explore the effect of workshop mode in tralning nurses' prevention of falls of hospitalized patients. Methods A tralning team was set up under the guidance of hospital nursing department, to determine the content of the project and implementation process. 176 registered nurses were received tralning of fall-prevention by workshop mode, compared the differences in fall prevention knowledge level of nurses before and after tralning. Likert's 5-points were used in the investigation for satisfaction of participants. Results Aver-age score of after tralning was (18.66 ±1.32). The previous increase was (2.42 ±2.06). The differences was statistically significant (P=0.000). The comprehensive evaluation of the tralning mode from the participants was over 92.00%, except for the tralner was 89.77%. Participants were satisfied with the workshop mode . Conclusion Application of workshop in tralning program can improve nurses' knowledge of fall-prevention and guarantee patient safety.

Objective:To investigate the effects of Helicobacter pylori on NLRP3 inflammasomes activation in THP-1 ( human monocytic cell line) -derived macrophages and evaluate the role of ROS.Methods:H.pylori strain SS1 was co-cultured with the THP-1-derived macrophages at a multiplicity of infection (MOI) of 1∶100 based on trial results with different MOIs (ratios of THP-1 cells to bacteria ranging from 1∶25 to 1∶200).The co-culture supernatants and THP-1 cells were collected at various time points (3 h,6 h,12 h,24 h) and cytokine production was quantitated using ELISA analysis.The generation of intracellular ROS was detected by FCM,and the mRNA transcript levels of NLRP3 and caspase-1 were measured by Real-time PCR.Western blot was employed to analyze the expression of active caspase-1 subunit ( p10).Then we observed the inhibitory effects of NAC and siRNA specific for NLRP3 on the ex-pression of NLRP3 inflammasome-related components and the secretion of cytokines induced by H.pylori.Results:We found that H.pylori SS1 induced IL-1βand IL-18 production in human acute monocytic leukemia cell line THP-1 in a time-and dose-dependent manner.We further showed that H.pylori could induce the mRNA expressions of NLRP3 and caspase-1 in THP-1 cells.Moreover, release of IL-1βand IL-18 from H.pylori-infected THP-1 cells was suppressed by the ROS scavenger NAC,which was an agent known to inhibit NLRP3 inflammasome formation.NAC administration also resulted in a significant decrease in the level of H.pylori-induced caspase-1 protein expression in THP-1 cells.Additionally,secretion of IL-1βand IL-18 in response to H.pylori infection was remarkably reduced by NLRP3-siRNA.Conclusion:The induction of IL-1βand IL-18 secretion by H.pylori strain SS1 in THP-1 cells could be mediated through activation of NLRP3 inflammasome via ROS signaling pathway, which may be involved in the host innate immune defence and the pathogenesis of the bacteria.