In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for clinical practice.

Oropharyngeal squamous cell carcinoma(OPSCC)is a malignant tumor originating from the squamous epithelium of the oro-pharyngeal mucosa,accounting for more than 90％of oropharyngeal malignancies.In recent years,human papillomavirus(HPV)infec-tion has become one of the primary etiological factors of oropharyngeal squamous carcinoma.The incidence of HPV-associated oropharyn-geal squamous carcinoma has been rising annually,with a noticeable trend toward younger populations,posing a significant threat to hu-man health.Due to the distinct biological behavior and clinical characteristics of HPV-associated oropharyngeal squamous carcinoma com-pared to its non-HPV-related counterpart,the diagnostic and treatment strategies for oropharyngeal squamous carcinoma have undergone substantial changes.Prevention and screening for oropharyngeal squamous carcinoma are of critical importance.The diagnostic and treat-ment process involves multi-disciplinary collaboration,including oral and maxillofacial surgery,otolaryngology,head and neck surgery,oncology,radiology and pathology.Based on evidence from clinical practice,a comprehensive,integrated diagnostic and therapeutic ap-proach has been established,centered around the concept of"prevention,screening,diagnosis,treatment,and rehabilitation",covering the entire patient lifecycle and providing a valuable reference for 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.

Reduced or interrupted blood flow is an important pathological and physiological process in femoral head necrosis,so understanding the blood flow of the femoral head can help better understand the progression of femoral head necrosis.With the continuous development and improvement of imaging technology,the technical methods for detecting the blood flow of the femoral head are gradually being widely applied,allowing clinical physicians to better understand the blood flow situation of patients with femoral head necrosis.However,at present,the prognosis prediction of femoral head necrosis still mainly revolves around factors such as the area and angle of femoral head necrosis.Therefore,this article explores imaging techniques covering studies such as femoral head vascular imaging or blood flow perfusion parameters,summarizes their application research progress in femoral head necrosis blood flow assessment,and aims to provide more objective basis for exploring the prevention and prognosis of femoral head necrosis from the perspective of femoral head blood flow.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

The multidisciplinary diagnosis and treatment (MDT) mode plays a positive role in diagnosing and treating difficult and complicated diseases, improving service quality, and promoting the construction of an integrated medical system. In March 2023, Zhejiang Provincial People′s Hospital had launched the " 6 New" MDT management practice to further improve the hospital′s inpatient MDT service level, including new concepts, new architectures, new standards, new processes, new models, and new quality control. This practice had improved the quality and efficiency of MDT management and promoted interdisciplinary integration by strengthening top-level design, establishing MDT leadership and quality control teams, developing relevant standards and specifications, enhancing the level of information management throughout the entire process, implementing diversified MDT models, and implementing quality control measures. As of July 2024, the hospital had established 80 MDT teams covering 30 clinical departments, conduct 120 MDT discussions for hospitalized cases per month, and with the continuous promotion of inpatient MDT work, the number of MDT teams and cases continued to increase. This practice had achieved good results and could provide references for other public hospitals in China to improve the level of inpatient MDT services.

Objective:To investigate the relationship between terminal soft tissue infection of the diabetic foot and glucose and lipid metabolism as well as inflammatory factors.Methods:A total of 126 patients with diabetes mellitus combined with foot-soft tissue infections, who hospitalized in our hospital from March 2018 to February 2023 were divided into mild group (46 cases), moderate group (43 cases) and severe infections group (37 cases) according to the degree of foot-soft tissue infection before treatment. The glucose and lipid metabolism and inflammatory factors of patients among the different groups were compared, and the effects of glycolysis and lipid metabolism and inflammatory factors on the soft tissue infection at the end of diabetic foot were analyzed by logistic regression analysis. Patients were treated with antimicrobial therapy and other treatments. After 2 weeks of anti-infective treatment, if three consecutive cultures of secretions were negative for bacteria, antibiotic therapy was discontinued and glucose-lipid metabolism and inflammatory factors after treatment were compared. Patients were followed up for 1 year, and the changes in glucose-lipid metabolism and inflammatory factors were observed in toe or limb amputations group ( n=38) and non-toe or limb amputations group ( n=88). Results:Before treatment, the levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), free fatty acids (FFA), fasting plasma glucose (FPG), fasting insulin (FINS), glycosylated hemoglobin typeA1c (HbA 1c), vascular cell adhesion molecule-1 (VCAM-1), C reactive protein (CRP,) tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in the mild group were significantly lower than those in the moderate and severe group, and the adiponectin (APN) level was significantly higher than that in the moderate and severe group (all P<0.05). Logistic regression analysis showed that FFA, FPG, FINS, APN, VCAM-1, CRP, TNF-α and IL-6 were risk factors of terminal soft tissue infection ( P<0.05). After treatment, the levels of TC, LDL-C, FFA, FPG, FINS, HbA1c, VCAM-1, CRP, TNF-α and IL-6 were significantly decreased, and the APN was significantly increased (all P<0.05). The levels of TC, LDL-C, FFA, FPG, FINS, HbA1c, VCAM-1, CRP, TNF-α, and IL-6 were significantly higher in the toe/limb amputation group than in the non-toe/limb amputation group, and the APN levels were significantly lower in the toe/limb amputation group than in the non-toe/limb amputation group (all P<0.05). Conclusion:There is a close relationship between glucose and lipid metabolism, inflammatory factors and terminal soft tissue infection of the diabetic foot.

Reduced or interrupted blood flow is an important pathological and physiological process in femoral head necrosis,so understanding the blood flow of the femoral head can help better understand the progression of femoral head necrosis.With the continuous development and improvement of imaging technology,the technical methods for detecting the blood flow of the femoral head are gradually being widely applied,allowing clinical physicians to better understand the blood flow situation of patients with femoral head necrosis.However,at present,the prognosis prediction of femoral head necrosis still mainly revolves around factors such as the area and angle of femoral head necrosis.Therefore,this article explores imaging techniques covering studies such as femoral head vascular imaging or blood flow perfusion parameters,summarizes their application research progress in femoral head necrosis blood flow assessment,and aims to provide more objective basis for exploring the prevention and prognosis of femoral head necrosis from the perspective of femoral head blood flow.

The activation of the sirtuin1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase 1 (HO-1) pathway has been shown to mitigate oxidative stress-induced apoptosis and mitochondrial damage by reducing reactive oxygen species (ROS) levels. Clinical trials have demonstrated that Zhongfeng Xingnao Liquid (ZFXN) ameliorates post-stroke cognitive impairment (PSCI). However, the underlying mechanism, particularly whether it involves protecting mitochondria and inhibiting apoptosis through the SIRT1/Nrf2/HO-1 pathway, remains unclear. This study employed an oxygen-glucose deprivation (OGD) cell model using SH-SY5Y cells and induced PSCI in rats through modified bilateral carotid artery ligation (2VO). The effects of ZFXN on learning and memory, neuroprotective activity, mitochondrial function, oxidative stress, and the SIRT1/Nrf2/HO-1 pathway were evaluated both in vivo and in vitro. Results indicated that ZFXN significantly increased the B-cell lymphoma 2 (Bcl2)/Bcl2-associated X (Bax) ratio, reduced terminal deoxynucleotidyl transferase-mediated dUTP nick-end-labeling (TUNEL)⁺ cells, and markedly improved cognition, synaptic plasticity, and neuronal function in the hippocampus and cortex. Furthermore, ZFXN exhibited potent antioxidant activity, evidenced by decreased ROS and malondialdehyde (MDA) content and increased superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels. ZFXN also demonstrated considerable enhancement of mitochondrial membrane potential (MMP), Tom20 fluorescence intensity, adenosine triphosphate (ATP) and energy charge (EC) levels, and mitochondrial complex I and III activity, thereby inhibiting mitochondrial damage. Additionally, ZFXN significantly increased SIRT1 activity and elevated SIRT1, nuclear Nrf2, and HO-1 levels. Notably, these effects were substantially counteracted when SIRT1 was suppressed by the inhibitor EX-527 in vitro. In conclusion, ZFXN alleviates PSCI by activating the SIRT1/Nrf2/HO-1 pathway and preventing mitochondrial damage.
Sirtuin 1/genetics* ; Animals ; NF-E2-Related Factor 2/genetics* ; Cognitive Dysfunction/genetics* ; Male ; Rats, Sprague-Dawley ; Rats ; Humans ; Signal Transduction/drug effects* ; Drugs, Chinese Herbal/administration & dosage* ; Heme Oxygenase-1/genetics* ; Stroke/complications* ; Oxidative Stress/drug effects* ; Apoptosis/drug effects* ; Mitochondria/metabolism* ; Reactive Oxygen Species/metabolism* ; Neuroprotective Agents