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.

Ischemia-reperfusion injury of solid organs is a common complication during transplantation, but its mechanism remains unclear and there are no effective prevention and treatment methods. Rejection is a common immune response of the graft, which is classified into hyperacute rejection, acute rejection and chronic rejection. Rejection and ischemia-reperfusion injury of solid organs may share some common mechanisms, and further research on their correlation may provide strategies for the prevention and treatment of ischemia-reperfusion injury of solid organs. This article mainly reviews the association between rejection and ischemia-reperfusion injury of solid organs.

Objective:To analyze the predictive role of WT1 expression levels pre-and early post-transplantation on relapse and overall survival(OS)in patients with acute myeloid leukemia(AML)undergoing allogeneic hematopoietic stem cell transplantation(allo-HSCT)during their first complete remission(CR1).Methods:A retrospective analysis was conducted on the clinical data of 107 adult AML patients who underwent allo-HSCT during their CR1 at our center between May 2012 and December 2021.The predictive role of bone marrow WT1 expression levels before transplantation and at 3 and 6 months post-transplantation on relapse and OS was explored in combination with relevant clinical factors.Results:The median follow-up time for the 107 patients was 70(range:11-117)months.Among the patients,15 cases died.Kaplan-Meier survial analysis showed that the 3-year overall survival(OS)rate was 85.0％.20 patients experienced relapse,with a median time to relapse of 8(range:0.5-44)months and a l-year cumulative relapse rate of 13.1％.The overall median value of WT1 before transplantation,3 months after transplantation,and 6 months after transplantation was 0.26％(range:0％-23.64％),with an upper quartile value of 0.74％.No statistically significant differences in WT1 expression levels were observed among the pre-transplantation,3-month post-transplantation,and 6-month post-transplantation time points(P=0.227).Univariate analysis showed that patients with WT1 levels＞0.74％at 3 months post-transplantation had a higher 1-year relapse rate(P=0.029)and lower 3-year OS rate(P＜0.001)compared to patients with WT1 levels ≤0.74％.Other significant factors affecting 1-year relapse included stem cell source(P=0.041)and chronic graft-versus-host disease(cGVHD)(P=0.013).For 3-year OS,additional influencing factors were genetic high risk(P=0.048)and stem cell source(P=0.016).Multivariate analysis revealed that WT1 level＞0.74％at 3 months post-transplantation had a trend to affect 1-year relapse rate(HR=3.309,95％CI:0.958-11.431,P=0.058),while the absence of cGVHD was an independent risk factor for 1-year relapse(HR=3.473,95％CI:0.749-16.100,P=0.037).Only WT1 level＞0.74％at 3 months post-transplantation was an independent risk factor for 3-year OS(HR=6.886,95％CI:2.402-19.738,P＜0.001).Conclusion:High WT1 expression level at 3 months post-transplantation in AML patients undergoing allo-HSCT during CR1 affects the 1-year relapse rate and 3-year OS,and is an independent risk factor affecting 3-year OS.These findings suggest that dynamic monitoring of WT1 expression levels has certain value in prognostic assessment of AML patients who received allo-HSCT during CR1.

Objective To compare and analyze the impact of intraocular higher-order aberrations and total ocular higher-order aberrations on visual quality after the implantation of different types of multifocal intraocular lenses(MIOL),in order to provide personalized MIOL selection recommendations for patients.Methods A total of 107 patients(107 eyes)with age-related cataract were selected and divided into the SBL-3,MF15,ZMB00,and Zeiss809 groups based on the type of MIOL implanted.Uncorrected distance visual acuity(UCDVA),best-corrected distance visual acuity(BCDVA),best-corrected near visual acuity(BCNVA),optical parameters and wavefront aberrations were compared 3 months postop-eratively.Results Preoperatively,there were no statistically significant differences in any optical parameters or visual acuity among the four groups(all P＞0.05).At three months postoperatively,there were no significant differences in UCD-VA,BCDVA,BCNVA,corneal aberration,or intraocular spherical aberration among the four groups(all P＞0.05).How-ever,significant differences were observed in the predicted visual acuity at 100％,20％,and 9％contrast(100％VA,20％VA,9％VA),streller ratio(SR),modulation transfer function cutoff frequency(MTF cutoff),intraocular coma,intraocu-lar trefoil,total higher-order aberrations,and the average modulation transfer function height values(MTF AH)of the en-tire eye across various spatial frequencies showed significant differences(all P＜0.05).Pairwise comparisons showed that the ZMB00 and Zeiss809 groups had significantly better 100％VA,20％VA,9％VA,SR,MTF cutoff,and MTF AH,and sig-nificantly lower intraocular coma,intraocular trefoil,and total higher-order aberrations than the SBL-3 group(all P＜0.05).The MF15 group only had significantly lower intraocular trefoil than the SBL-3 group(P＜0.05).Correlation analy-sis results at 3 months postoperatively showed that in the SBL-3 and MF15 groups,UCDVA(logMAR)was positively corre-lated with the objective scattering index and negatively correlated with 100％VA,20％VA,9％VA,SR,and MTF cutoff(all P＜0.05).MTF AH was negatively correlated with intraocular coma and total higher-order aberrations,and positively cor-related with intraocular spherical aberration(all P＜0.05).In the ZMB00 and Zeiss809 groups,MTF AH was negatively cor-related with intraocular coma,intraocular trefoil,and total higher-order aberrations(all P＜0.05),but showed no correla-tion with intraocular spherical aberration(all P＞0.05).Conclusion There are no differences in UCDVA,BCDVA,or BCNVA among patients implanted with the four types of MIOLs,but differences existed in objective visual quality.The ob-jective visual quality of ZMB00 and Zeiss809 is significantly better than that of SBL-3,making them the preferred choices for patients with high-quality visual demands;SBL-3 is suitable for basic demand scenarios;MF15,which is only superior to SBL-3 in terms of intraocular trefoil,can be a compromise option for those sensitive to trefoil aberration.

Objective To analyze the interspecies differences in virulence of different carbapenem-resistant Enterobacterales(CREb)strains and provide a theoretical basis for understanding the pathogenic mechanisms of CREb and for guiding individualized treatment strategies.Methods A total of nine CREb clinical isolates collected between 2013 and 2022 were included,representing five species:Enterobacter cloacae(E.cloacae),Enterobacter hormaechei(E.hormaechei),Enterobacter kobei(E.kobei),Enterobacter asburiae(E.asburiae),and Enterobacter chuandaensis(E.chuandaensis).Whole-genome sequencing was performed to characterize virulence gene profiles.Phenotypic assays included growth curve analysis,biofilm formation assessment,serum bactericidal assays,and Galleria mellonella infection models to evaluate virulence-related traits.Results Virulence gene analysis revealed that motility-related factors were the most abundant(16 to 20 per strain),followed by nutrition/metabolism-related factors(10 to 12 per strain),while invasion-related genes were rare,with the ibeB gene detected in only two E.asburiae strains.The strains of the same species shared similar viru-lence gene profiles,and E.chuandaensis harbored the fewest virulence genes.In vitro growth assays showed that E.hormaechei and E.cloacae had the fastest growth rates,while E.chuandaensis and E.kobei exhibited slower growth,and E.asburiae displayed the slo-west growth.Biofilm assays indicated that E.hormaechei and E.cloacae had the strongest biofilm-forming capacity,while E.kobei had the weakest.In serum bactericidal assays,E.hormaechei and E.cloacae showed high survival rates(＞70%),whereas the survival rate of E.chuandaensis was less than 1%.In the Galleria mellonella model,E.asburiae and E.cloacae exhibited marked dose-dependent virulence,whereas the remaining strains showed reduced virulence.Conclusion Different CREb species exhibit significant variation in virulence gene content and phenotypic traits.The pathogenic potential of CREb may provide fundamental data to inform strategies for prevention and treatment of CREb infection.

To construct a recombinant fowl adenovirus 4(FAdV-4)expressing the Cap protein of goose astrovirus genotype 2(GoAstV-2),the expression cassette of Cap gene was inserted into the natural 1 966 bp deletion region of the FAdV-4 genome in the infectious clone p15A-cm-FAdV4-HNJZ.The resulted recombinant plasmid p15A-cm-FAdV4-HNJZ-Cap/GoAstV-2 was linearized with restriction enzyme and transfected into chicken hepatoma cell line(LMH)to rescue the recombinant FAdV-4 expressing the Cap protein of GoAstV-2,rF Ad V4-Cap/GoAstV-2.After 15 passages in LMH cells,the recombinant rFAdV4-Cap/GoAstV-2 was identified by PCR using primers flanking the insertion site of the Cap gene expression cassette and using viral genome DNA extracted from rFAdV4-Cap/GoAstV-2 infected LMH cells as template.LMH cells were in-fected with 15th passage rFAdV4-Cap/GoAstV-2 and indirect immunofluorescence was performed with a polyclonal antibody against Cap protein as the primary antibody.Western blot was carried out with lysates of rFAdV4-Cap/GoAstV-2 infected LMH cells.The in vitro replication dynamic of the 15th passage of the rFAdV4-Cap/GoAstV-2 was also investigated in LMH cells.The results demonstrated that the Cap gene of GoAstV-2 was presented in the genome of the recombinant vi-rus rF AdV4-Cap/Go Ast V-2,and could be expressed stably.The prepared recombinant virus in this study will lay a foundation for developing inactivated bivalent vaccine candidate against co-in-fection of FAdV-4 and GoAstV-2 in goose.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

Objective:To investigate analgesic effect of fire needle on postherpetic neuralgia(PHN)rats and its effect on IL-10/β-endorphin(β-EP)signaling pathway.Methods:Forty rats were randomly divided into 4 groups:control group,model group,fire needle group and drug group,with 10 rats in each group.PHN model was constructed by intraperitoneal injection of resin toxin.Af-ter successful modeling,fire needle group was intervened by fire needle at L4～6 Jiaji points,and drug group was intervened by intra-peritoneal injection of gabapentin.Von Frey electronic pain meter was used to measure paw withdrawal mechanical threshold(PW-MT)of rats in each group.Thermal latency of paw withdrawal(PWTL)of rats was measured by thermal radiation stimulator.Prosta-glandin E2(PGE2)and substance P(SP)in dorsal root ganglion tissues,serum IL-6,TNF-α and IL-1β levels were detected by ELI-SA.IL-10 and β-EP protein expressions in spinal cord of rats were detected by Western blot.Results:Compared with control group,PWMT of model group was decreased significantly(P<0.05),PWTL,levels of PGE2 and SP in spinal cord tissue and levels of IL-6,TNF-α and IL-1β in serum were increased significantly(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were decreased significantly(P<0.05).Compared with model group,PWMT of fire needle group and drug group was significantly increased(P<0.05),PWTL,PGE2 and SP in spinal cord tissue and serum IL-6,TNF-α and IL-1β levels were significantly decreased(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were significantly increased(P<0.05).Conclusion:Fire needle can improve pain response of PHN rats and reduce peripheral blood inflammation level,which may be related to activation of IL-10/β-EP signaling pathway.

Objective To explore the relationship between community health follow-up management and the mental health of the long-term care insurance residents,and to provide a basis for the construction of an integrated community home care service mode for disabled elders.Methods The residents were selected through cluster sampling who participated in LTCI home care from Jan 1 to Dec 31,2021.After a year of participation,the subjects'mental health was assessed face-to-face by trained community doctors using the Self-Rating Anxiety Scale and the Self-Rating Depression Scale.By referring to residents'electronic health records combined with on-site questionnaire survey,community doctors collected the demographic information and health follow-up management provided by primary medical and health institutions.The multivariate logistic regression were conducted to evaluate the association between follow-up care and mental health outcomes.Results The study consisted of 399 LTCI-enrolled individuals,57.64%(n=230)received follow-up care by family physicians.The prevalence of anxiety and depression among participants was 19.80%(n=79)and 67.67%(n=270),respectively.Univariate analysis found that community health follow-up management could underscore the potential impact of follow-up care in mitigating anxiety(χ2=38.926,P<0.001)and depression(χ2=14.598,P<0.001)among LTCI enrollees.Multivariate analysis revealed that follow-up care was an independent protective factor against anxiety(adjusted OR=0.351,95%CI:0.176-0.701,P=0.003).However,follow-up care did not significantly impact depression prevalence.Additionally,LTCI grade and education level were also identified factors influencing the mental health of participants(P<0.05).Conclusion Community health service centers provide health follow-up management that plays a positive role in alleviating the anxiety symptoms of disabled residents under long-term care insurance home care.It is an effective way to improve the quality of LTCI home care services.

Objective:To investigate analgesic effect of fire needle on postherpetic neuralgia(PHN)rats and its effect on IL-10/β-endorphin(β-EP)signaling pathway.Methods:Forty rats were randomly divided into 4 groups:control group,model group,fire needle group and drug group,with 10 rats in each group.PHN model was constructed by intraperitoneal injection of resin toxin.Af-ter successful modeling,fire needle group was intervened by fire needle at L4～6 Jiaji points,and drug group was intervened by intra-peritoneal injection of gabapentin.Von Frey electronic pain meter was used to measure paw withdrawal mechanical threshold(PW-MT)of rats in each group.Thermal latency of paw withdrawal(PWTL)of rats was measured by thermal radiation stimulator.Prosta-glandin E2(PGE2)and substance P(SP)in dorsal root ganglion tissues,serum IL-6,TNF-α and IL-1β levels were detected by ELI-SA.IL-10 and β-EP protein expressions in spinal cord of rats were detected by Western blot.Results:Compared with control group,PWMT of model group was decreased significantly(P<0.05),PWTL,levels of PGE2 and SP in spinal cord tissue and levels of IL-6,TNF-α and IL-1β in serum were increased significantly(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were decreased significantly(P<0.05).Compared with model group,PWMT of fire needle group and drug group was significantly increased(P<0.05),PWTL,PGE2 and SP in spinal cord tissue and serum IL-6,TNF-α and IL-1β levels were significantly decreased(P<0.05),IL-10 and β-EP protein expressions in spinal dorsal horn were significantly increased(P<0.05).Conclusion:Fire needle can improve pain response of PHN rats and reduce peripheral blood inflammation level,which may be related to activation of IL-10/β-EP signaling pathway.