Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

OBJECTIVE To investigate the impact of perilla alcohol on pulmonary vascular remod-eling in hypoxia-induced pulmonary hypertension(HPH)rats and to assess its regulatory effects on the angiotensin-converting enzyme 2(ACE2)-angiotensin(1-7)[Ang(1-7)]-mas proto-oncogene receptor(Mas)and ACE-angiotensinⅡ(AngⅡ)-angiotensin type 1 receptor(AT1R)axes.METHODS An HPH rat model was established by keeping them in a hypobaric chamber that simulated an altitude of 5 000 m for 28 d.Male SD rats were randomly divided into the control group,hypoxia group,hypoxia+sildenafil group(ig administration of 30 mg·kg-1),and hypoxia+perillyl alcohol groups(ig administration of 25,50 and 100 mg·kg-1 respectively).After 28 d,the levels of glutamic-oxaloacetic transaminase(GOT),glutamic-pyruvic transaminase(GPT),and blood urea nitrogen(BUN)in rat serum were measured to evaluate the toxic effects of perillyl alcohol on rat organs.Mean pulmonary artery pressure(mPAP)was measured via right ventricular catheterization.HE staining was used to observe the patho morphological changes of pulmonary vessels in HPH rats and measure the percentages of the vascularwall area[WA(%)],wall thickness[WT(%)],lumen area[LA(%)].The right ventricular hypertrophy level and α-smooth muscle actin(α-SMA)expression level were detected by immunohistochemistry and immunofluorescence.Western blotting was used to detect the protein expression levels of α-SMA,ACE,AT1R,AngⅡ,ACE2 and Mas in lung tissues of rats.Enzyme-linked immunosorbent assay(ELISA)was employed to mea-sure the content of Ang(1-7)in lung tissues.RESULTS Compared with the control group,the serum levels of GOT,GPT and BUN in the hypoxia group rats were significantly increased,but were signifi-cantly decreased by perillyl alcohol and sildenafil intervention.Compared with the control group,mPAP,WA(%),WT(%),right ventricular inner diameter(RVID),right ventricular free wall thickness(RVFWT)and fibrosis levels were significantly increased in the hypoxia group,while LA(%)was signifi-cantly decreased.Besides,the protein expression levels of α-SMA,ACE,AT1R and AngⅡ in lung tissues were significantly elevated while those of ACE2 and Mas,as well as Ang(1-7)content were signifi-cantly decreased in hypoxia group compared to the control group.Following intervention with perillyl alcohol and sildenafil,the protein expression levels of ACE and AngⅡin lung tissues of HPH rats were significantly decreased compared to the model group while those of ACE2 and Mas receptor,along with the content of Ang(1-7),were significantly increased.Perillyl alcohol significantly reduced the protein expression level of AT1R while sildenafil had no significant effect.CONCLUSION Perillyl alcohol can lower mPAP levels by improving pulmonary vascular remodeling and reducing pulmonary vascular fibrosis in HPH rats.The mechanism may be related to the regulatory effects on the ACE-AngⅡ-AT1R and ACE2-Ang(1-7)-Mas axes.

OBJECTIVE To investigate the impact of perilla alcohol on pulmonary vascular remod-eling in hypoxia-induced pulmonary hypertension(HPH)rats and to assess its regulatory effects on the angiotensin-converting enzyme 2(ACE2)-angiotensin(1-7)[Ang(1-7)]-mas proto-oncogene receptor(Mas)and ACE-angiotensinⅡ(AngⅡ)-angiotensin type 1 receptor(AT1R)axes.METHODS An HPH rat model was established by keeping them in a hypobaric chamber that simulated an altitude of 5 000 m for 28 d.Male SD rats were randomly divided into the control group,hypoxia group,hypoxia+sildenafil group(ig administration of 30 mg·kg-1),and hypoxia+perillyl alcohol groups(ig administration of 25,50 and 100 mg·kg-1 respectively).After 28 d,the levels of glutamic-oxaloacetic transaminase(GOT),glutamic-pyruvic transaminase(GPT),and blood urea nitrogen(BUN)in rat serum were measured to evaluate the toxic effects of perillyl alcohol on rat organs.Mean pulmonary artery pressure(mPAP)was measured via right ventricular catheterization.HE staining was used to observe the patho morphological changes of pulmonary vessels in HPH rats and measure the percentages of the vascularwall area[WA(%)],wall thickness[WT(%)],lumen area[LA(%)].The right ventricular hypertrophy level and α-smooth muscle actin(α-SMA)expression level were detected by immunohistochemistry and immunofluorescence.Western blotting was used to detect the protein expression levels of α-SMA,ACE,AT1R,AngⅡ,ACE2 and Mas in lung tissues of rats.Enzyme-linked immunosorbent assay(ELISA)was employed to mea-sure the content of Ang(1-7)in lung tissues.RESULTS Compared with the control group,the serum levels of GOT,GPT and BUN in the hypoxia group rats were significantly increased,but were signifi-cantly decreased by perillyl alcohol and sildenafil intervention.Compared with the control group,mPAP,WA(%),WT(%),right ventricular inner diameter(RVID),right ventricular free wall thickness(RVFWT)and fibrosis levels were significantly increased in the hypoxia group,while LA(%)was signifi-cantly decreased.Besides,the protein expression levels of α-SMA,ACE,AT1R and AngⅡ in lung tissues were significantly elevated while those of ACE2 and Mas,as well as Ang(1-7)content were signifi-cantly decreased in hypoxia group compared to the control group.Following intervention with perillyl alcohol and sildenafil,the protein expression levels of ACE and AngⅡin lung tissues of HPH rats were significantly decreased compared to the model group while those of ACE2 and Mas receptor,along with the content of Ang(1-7),were significantly increased.Perillyl alcohol significantly reduced the protein expression level of AT1R while sildenafil had no significant effect.CONCLUSION Perillyl alcohol can lower mPAP levels by improving pulmonary vascular remodeling and reducing pulmonary vascular fibrosis in HPH rats.The mechanism may be related to the regulatory effects on the ACE-AngⅡ-AT1R and ACE2-Ang(1-7)-Mas axes.

Background and Aims:Iliac vein compression syndrome (IVCS) is a major cause of acute lower extremity deep vein thrombosis (DVT). Without timely treatment,it can lead to thrombus detachment,resulting in pulmonary embolism and increased mortality risk. Percutaneous mechanical thrombectomy,particularly using the AngioJet thrombectomy system,is a widely used thrombectomy method. The combination of AngioJet thrombectomy with iliac vein stent placement provides a novel treatment option for DVT associated with IVCS. This study was performed to evaluate the efficacy and safety of AngioJet thrombectomy combined with iliac vein stent placement in treating DVT with IVCS.Methods:The clinical data of 120 patients with DVT and IVCS treated between April 2019 and October 2022 were retrospectively analyzed. Sixty patients underwent AngioJet thrombectomy combined with iliac vein stent placement (observation group),while another 60 patients received catheter-directed thrombolysis (CDT) combined with stent placement (control group). The clinical efficacy,outcomes (thrombus clearance grade,thrombolysis duration,venous patency score,hospitalization duration,urokinase dosage,thigh circumference difference,and calf circumference difference),Villalta scores at various time points before and after treatment,and adverse events (chest tightness,mild pulmonary embolism,bleeding at the catheter insertion site,and mild renal function impairment) were compared between the two groups.Results:The overall efficacy rate in the observation group was significantly higher than that in the control group (98.33％ vs. 86.67％,P=0.015). While there was no significant difference in thrombus clearance grade between the two groups (P>0.05),the observation group had significantly shorter thrombolysis duration,lower urokinase dosage,and shorter hospitalization time compared to the control group (all P<0.05). Before treatment,there were no significant differences in thigh circumference difference,calf circumference difference,or venous patency score between the two groups (all P>0.05). After treatment,the observation group had significantly better venous patency score and smaller thigh and calf circumference differences than the control group (all P<0.05). There was no significant difference in Villalta score between the two groups before treatment (P>0.05). Post-treatment Villalta scores showed a significant decreasing trend over time in both groups compared to pre-treatment scores (all P<0.05),but there were no statistically significant differences in Villalta scores between the two groups at 1,6,and 12 months after treatment (all P>0.05). The total incidence of adverse events was not significantly different between the two groups (10.00％ vs. 3.33％,P=0.143).Conclusion:The use of AngioJet thrombectomy combined with iliac vein stent placement for the treatment of lower extremity DVT with IVCS can shorten thrombolysis and hospitalization duration,reduce thrombolytic drug dosage,and achieve better and safer outcomes,making it worthy of clinical application.

Objective To explore the effectiveness of a double preemptive analgesia protocol in the perioperative period for adolescents undergoing arthroscopic medial patellofemoral ligament(MPFL)re-construction.Methods Totally 104 adolescents with recurrent patellar dislocation and undergoing ar-throscopic MPFL reconstruction between April 2023 and November 2023 were analyzed retrospectively.Among them,47 were selected into a double preemptive analgesia(DPA)group,while the rest 57 were chosen into the control group.DPA group received preemptive analgesia on the days before and of the surgery,and the control group was given traditional perioperative and individualized postopera-tive analgesia.The Numerical Rating Scale(NRS)pain scores were recorded for both groups at admis-sion,right after returning to the ward postoperatively,at 6,12,24 and 48 hours after operation post-operatively,as well as at the time of the first attempt to bear weight.The time and frequency of res-cue analgesia,the time to the first straight leg raise,and the time to first bearing weight were record-ed for both groups.Moreover,adverse reactions were observed,and patient satisfaction scores were col-lected from family members before their discharge.Results There was no significant difference in pain scores between the two groups at admission.However,from 6 to 48 hours postoperatively,the NRS pain scores of DPA group were significantly lower than the control group at the same time points(P＜0.05).Moreover,compared with the control group,DPA group had significantly fewer times of rescue analgesia,higher patient satisfaction,and earlier time for first straight leg raise(P＜0.05).There were no severe postoperative complications in either DPA group or the control.However,mild adverse reac-tions occurred in 7(14.8％)of the DPA group and 8(14.1％)of the control group,mainly nausea,which mostly appeared on the day of surgery and improved without special treatment on the same day.Conclusions The double preemptive analgesia protocol can effectively reduce postoperative pain in ado-lescents undergoing arthroscopic MPFL reconstruction,accelerate postoperative recovery,enhance the confidence of adolescents and their families in rehabilitation,and improve satisfaction,providing a ref-erence for future clinical practice.

Objective To explore the effectiveness of a double preemptive analgesia protocol in the perioperative period for adolescents undergoing arthroscopic medial patellofemoral ligament(MPFL)re-construction.Methods Totally 104 adolescents with recurrent patellar dislocation and undergoing ar-throscopic MPFL reconstruction between April 2023 and November 2023 were analyzed retrospectively.Among them,47 were selected into a double preemptive analgesia(DPA)group,while the rest 57 were chosen into the control group.DPA group received preemptive analgesia on the days before and of the surgery,and the control group was given traditional perioperative and individualized postopera-tive analgesia.The Numerical Rating Scale(NRS)pain scores were recorded for both groups at admis-sion,right after returning to the ward postoperatively,at 6,12,24 and 48 hours after operation post-operatively,as well as at the time of the first attempt to bear weight.The time and frequency of res-cue analgesia,the time to the first straight leg raise,and the time to first bearing weight were record-ed for both groups.Moreover,adverse reactions were observed,and patient satisfaction scores were col-lected from family members before their discharge.Results There was no significant difference in pain scores between the two groups at admission.However,from 6 to 48 hours postoperatively,the NRS pain scores of DPA group were significantly lower than the control group at the same time points(P＜0.05).Moreover,compared with the control group,DPA group had significantly fewer times of rescue analgesia,higher patient satisfaction,and earlier time for first straight leg raise(P＜0.05).There were no severe postoperative complications in either DPA group or the control.However,mild adverse reac-tions occurred in 7(14.8％)of the DPA group and 8(14.1％)of the control group,mainly nausea,which mostly appeared on the day of surgery and improved without special treatment on the same day.Conclusions The double preemptive analgesia protocol can effectively reduce postoperative pain in ado-lescents undergoing arthroscopic MPFL reconstruction,accelerate postoperative recovery,enhance the confidence of adolescents and their families in rehabilitation,and improve satisfaction,providing a ref-erence for future clinical practice.

Background and Aims:Iliac vein compression syndrome (IVCS) is a major cause of acute lower extremity deep vein thrombosis (DVT). Without timely treatment,it can lead to thrombus detachment,resulting in pulmonary embolism and increased mortality risk. Percutaneous mechanical thrombectomy,particularly using the AngioJet thrombectomy system,is a widely used thrombectomy method. The combination of AngioJet thrombectomy with iliac vein stent placement provides a novel treatment option for DVT associated with IVCS. This study was performed to evaluate the efficacy and safety of AngioJet thrombectomy combined with iliac vein stent placement in treating DVT with IVCS.Methods:The clinical data of 120 patients with DVT and IVCS treated between April 2019 and October 2022 were retrospectively analyzed. Sixty patients underwent AngioJet thrombectomy combined with iliac vein stent placement (observation group),while another 60 patients received catheter-directed thrombolysis (CDT) combined with stent placement (control group). The clinical efficacy,outcomes (thrombus clearance grade,thrombolysis duration,venous patency score,hospitalization duration,urokinase dosage,thigh circumference difference,and calf circumference difference),Villalta scores at various time points before and after treatment,and adverse events (chest tightness,mild pulmonary embolism,bleeding at the catheter insertion site,and mild renal function impairment) were compared between the two groups.Results:The overall efficacy rate in the observation group was significantly higher than that in the control group (98.33％ vs. 86.67％,P=0.015). While there was no significant difference in thrombus clearance grade between the two groups (P>0.05),the observation group had significantly shorter thrombolysis duration,lower urokinase dosage,and shorter hospitalization time compared to the control group (all P<0.05). Before treatment,there were no significant differences in thigh circumference difference,calf circumference difference,or venous patency score between the two groups (all P>0.05). After treatment,the observation group had significantly better venous patency score and smaller thigh and calf circumference differences than the control group (all P<0.05). There was no significant difference in Villalta score between the two groups before treatment (P>0.05). Post-treatment Villalta scores showed a significant decreasing trend over time in both groups compared to pre-treatment scores (all P<0.05),but there were no statistically significant differences in Villalta scores between the two groups at 1,6,and 12 months after treatment (all P>0.05). The total incidence of adverse events was not significantly different between the two groups (10.00％ vs. 3.33％,P=0.143).Conclusion:The use of AngioJet thrombectomy combined with iliac vein stent placement for the treatment of lower extremity DVT with IVCS can shorten thrombolysis and hospitalization duration,reduce thrombolytic drug dosage,and achieve better and safer outcomes,making it worthy of clinical application.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

【Objective】 To explore the role of visfatin-nicotinamide phosphoribosyl transferase （Nampt） axis in the progression of epithelial ovarian cancer （EOC） and its effect on the patients’ prognosis. 【Methods】 Immunohistochemical analysis was used to detect the expression of Nampt protein in tissues from epithelial ovarian cancer and normal ovary； ELISA was used to determine the level of visfatin in serum. Then the two were further analyzed to estimate their effects on clinicopathological characteristics and the EOC patients’ overall survival. 【Results】 The mean level of serum visfatin in these EOC patients was significantly elevated compared with that of the patients with benign ovarian tumors and normal population. ROC curve analysis showed that the area under curve （AUC） of serum visfatin for diagnosis of EOC was 0.744， with a cut-off value of 5.95 ng/mL. Serum visfatin of the EOC patients was related to T， N and FIGO stage （P<0.05）， and was positively correlated with CA125 （rs=0.389， P=0.001）. The rate of Nampt positive expression in tissues from EOC was significantly increased and correlated with FIGO stage and serum visfatin （P<0.05）. Nampt protein expression in EOC was positively correlated with serum visfatin level （rs=0.55， P<0.001）. The 1-year， 3-year and 5-year survival rate of these patients with EOC was 98.6%， 74.3% and 34.3%， respectively. Survival analysis demonstrated that the overall survival of these patients was related to T， N， FIGO stage， serum visfatin and Nampt expression in EOC， and both FIGO stage and Nampt expression were independent prognostic factors （P<0.05）. 【Conclusion】 The overall survival of these EOC patients was related to T， N， FIGO stage， serum visfatin and Nampt expression， and FIGO stage and Nampt expression are independent factors predicting the outcome. This highlights that visfatin-Nampt axis promotes the progression of epithelial ovarian cancer and affects the prognosis of EOC patients.