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.

Objective To evaluate the value of left ventricular(LV)systolic function impairment in patients with different activity levels of systemic lupus erythematosus(SLE)by applying automatic myocardial motion quantification(aCMQ)technique,and to explore the correlation between left ventricular strain parameters and clinical laboratory indexes,systemic lupus erythematosus disease activity index(SLEDAI).Methods A total of 80 patients diagnosed with SLE from November 2023 to August 2024 in the First Afticiated Hospital of Jinzhou Medical University were selected and divided into two groups:40 cases with SLEDAI＜10points were in mild lupus group,34 cases with SLEDAI ≥ 10points were in moderately severe lupus group.Forty healthy volunteers for physical examination at the same time were randomly selected as control group,relevant parameters were obtained by conventional echocardiography and aCMQ technique respectively.Results aCMQ technique related parameters were compared,and the differences in left ventricular global longitudinal strain(LVGLS),apical two-chamber longitudinal strain(AP2LS),apical three-chamber longitudinal strain(AP3LS),and apical four-chamber longitudinal strain(AP4LS)were statistically significant in all three groups(P＜0.05).The differences in left ventricular global circumferential strain(LVGCS)in lupus moderate-severe group were statistically significant when compared with other two groups(P＜0.05),Pearson correlation analysis showed LVGLS,AP2LS,AP3LS,AP4LS and LVGCS were positively correlated with complement 3 and complement 4,and negatively correlated with anticardiolipin antibody(ACA)IgA,IgG,IgM,and sedimentation,and ultrasensitive C-reactive protein,and the SLEDAI was correlated with LVGLS,AP2LS,AP3LS,AP4LS were negatively correlated,and there was no significant correlation with LVGCS.Conclusion aCMQ technique can detect changes in LV systolic function in SLE patients at an early stage,and the impairment of LV systolic function is more severe with higher disease activity.Better correlation between LV strain parameters and clinical laboratory indexes and SLED AI may help to better assess cardiac involvement in SLE patients.

Objective To explore the barriers of implementing collaborative chronic wound management within medical consortium and provide references for ensuring continuous care for chronic wound patients.Methods Using purposive and snowball sampling methods,14 specialist nurses participating in chronic wound collaborative management across medical consortium in 7 provinces/municipalities(Beijing,Shanghai,Zhejiang,Sichuan,etc.)were selected for semi-structured interviews between December 2023 and January 2024.Data were analyzed via content analysis.Results Totally 4 themes and 8 subthemes were identified,including management and organizational level(the management system needs improvement;the function of medical information mutual recognition has not been fully realized),resource and technology level(there are insufficient nursing resources at the grassroots hospitals;the specialized nursing capabilities of wound nurses at grassroots hospitals need to be enhanced),patient and demand level(patients' trust is insufficient;patients' concepts are rigid),information technology and support level(the informatization construction of grassroots hospitals lags behind;the intelligence of information systems is insufficient).Conclusion Wound specialist nurses encounter various difficulties when participating in the coordinated management of chronic wounds within the medical consortium.The management and organizational system constraints hinder the effectiveness of the nursing coordination;the resource and technology gap affects the implementation of graded wound care in the region;the lack of patient trust and misconceptions intensify the resistance to coordination;the lagging in information technology construction limits the innovative development of nursing coordination.

Objective To explore the effects of Jingling Oral Liquid(mainly composed of Polygoni Multiflori Radix,Polygonati Rhizoma,Platycladi Semen,Nelumbinis Semen,Ligustri Lucidi Fructus,Poria,and Lilii Bulbus)as an adjunctive therapy on cognitive,motor,and social abilities in children with global developmental delay(GDD).Methods A total of 120 children with GDD who visited the Department of Neurological Rehabilitation at Hebei Children's Hospital from July 2021 to November 2023 were selected as the study subjects.The children were randomly divided into a control group and a trial group using a random number table,with 60 children in each group.The control group received conventional comprehensive rehabilitation training,while the trial group received Jingling Oral Liquid as an adjunctive therapy in addition to the control group's treatment.The treatment course lasted 12 weeks.Before and after treatment,the changes in Gesell Developmental Scale(GDS)scores,Peabody Developmental Motor Scales(PDMS)scores,motor function scores,and language ability scores in both groups were observed to evaluate the cognitive,motor,and social abilities of the children.Results(1)After treatment,the scores of all dimensions of the GDS,including adaption,developmental quotient of fine motor,language developmental quotient,and personal-social developmental quotient,were significantly increased in both groups compared to those before treatment(P＜0.01),and the improvement of GDS scores in the trial group was significantly superior to that in the control group(P＜0.01).(2)After treatment,the scores of all dimensions of the PDMS,including fine developmental quotient score,standardized score of visual-motor integration,and standardized score of grasping,were significantly increased in both groups compared to those before treatment(P＜0.01),and the improvement of PDMS scores in the trial group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the scores of motor function indicators of fine motor quotient(FMQ),gross motor quotient(GMQ),and total motor quotient(TMQ)were significantly increased in both groups compared to those before treatment(P＜0.01),and the improvement of motor function scores in the trial group was significantly superior to that in the control group(P＜0.01).(4)After treatment,the language ability scores were significantly increased in both groups compared to those before treatment(P＜0.01),and the improvement of language ability scores in the trial group was significantly superior to that in the control group(P＜0.01).Conclusion The combination of Jingling Oral Liquid with conventional comprehensive rehabilitation training can effectively improve the cognitive,motor,and social abilities of children with GDD.

Objective To evaluate the left ventricular systolic function of patients with type 2 diabetes mellitus(T2DM)combined with renal insufficiency(CKD)by applying automated myocardial motion quantifica-tion(aCMQ)and to investigate its correlation with clinical biochemical indexes.Methods 80 patients with T2DM were enrolled,divided into DM group(without CKD,n=40)and DN group(with CKD,n=40),and 40 healthy volunteers were selected as the control group.The general clinical data of all subjects were recorded,and routine echocardiography and aCMQ were performed to obtain routine ultrasonographic measurements and aCMQ-related parameters.Results Comparison of aCMQ-related parameters:The differences in LV global longitudinal strain(LVGLS),LV apical 2-chamber longitudinal strain(LVAP2LS),LV apical 3-chamber longitudinal strain(LVAP3LS),and LV apical 4-chamber longitudinal strain(LVAP4LS)among the three groups were all statistically significant(P<0.05).The differences in LV global circumferential strain(LVGCS)between the DN group and the other two groups were statistically significant(P<0.05).The differences in LV short-axis basal segment cyclic strain(LVSAXBCS),LV short-axis middle segment cyclic strain(LVSAXMCS),and LV short-axis apical segment cyclic strain(LVSAXACS)were not statistically significant(P>0.05).LV strain was negatively correlated with Hs-CRP,GA,HbA1c,creatinine,urea,and uric acid,and positively correlated with eGFR.Correlation.High-sensitivity C-reactive protein(Hs-CRP),glycated albumin(GA)and eGFR showed good correlation with LV strain parameters.Conclusion The aCMQ technique can detect the deterioration of left ventricular function in patients with type 2 diabetes mellitus combined with renal insufficiency at an early stage,and the correlation between left ventricular strain parameters and hs-CRP,GA and eGFR can help to better assess their cardiac involvement.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.

Objective To explore the barriers of implementing collaborative chronic wound management within medical consortium and provide references for ensuring continuous care for chronic wound patients.Methods Using purposive and snowball sampling methods,14 specialist nurses participating in chronic wound collaborative management across medical consortium in 7 provinces/municipalities(Beijing,Shanghai,Zhejiang,Sichuan,etc.)were selected for semi-structured interviews between December 2023 and January 2024.Data were analyzed via content analysis.Results Totally 4 themes and 8 subthemes were identified,including management and organizational level(the management system needs improvement;the function of medical information mutual recognition has not been fully realized),resource and technology level(there are insufficient nursing resources at the grassroots hospitals;the specialized nursing capabilities of wound nurses at grassroots hospitals need to be enhanced),patient and demand level(patients' trust is insufficient;patients' concepts are rigid),information technology and support level(the informatization construction of grassroots hospitals lags behind;the intelligence of information systems is insufficient).Conclusion Wound specialist nurses encounter various difficulties when participating in the coordinated management of chronic wounds within the medical consortium.The management and organizational system constraints hinder the effectiveness of the nursing coordination;the resource and technology gap affects the implementation of graded wound care in the region;the lack of patient trust and misconceptions intensify the resistance to coordination;the lagging in information technology construction limits the innovative development of nursing coordination.

Objective To investigate the status and developmental trends of clinical trials for weight control drugs in China,and to provide data support for sponsors,researchers,and regulatory authorities.Methods The drug clinical trial registration and information platform of the National Medical Products Administration was utilized to search for registered clinical trials of weight control drugs from November 2012 to June 2024.The search employed"overweight","obesity",and"weight loss"as keywords.The information collected included project registration time,drug name,dosage form,drug classification,indications,trial staging,study progress,design type,lead unit,and sponsor.Microsoft Office Excel software was employed for data entry,organization,and extraction.Results A total of 95 registered clinical trials of weight control drugs were identified,comprising 40 domestic multicenter trials,47 domestic single-center trials,and 8 international multicenter trials.Regarding trial phasing,46(48.4％)were phase Ⅰ clinical trials,17(17.9％)were phase Ⅱ clinical trials,19(20.0％)were phase Ⅲ clinical trials,and 13(13.7％)were bioequivalence trials.The drug categorization encompassed 22 chemical drugs,20 biological products,and 1 traditional Chinese medicine/natural drug.Concerning drug dosage forms,there were 32 items of injectable dosage forms,8 items of tablets,2 items of capsules,and 1 item of chewable tablets.Conclusions Registered clinical trials for weight-loss medications in China are predominantly concentrated in regions with developed medical resources.Injectable biologics constitute most test drugs,with most drugs in the early stages of research and development.The examination of the safety and efficacy of these drugs remains to be substantiated,and it is anticipated that a considerable period will elapse before their approval and market introduction.

Objective To evaluate the value of left ventricular(LV)systolic function impairment in patients with different activity levels of systemic lupus erythematosus(SLE)by applying automatic myocardial motion quantification(aCMQ)technique,and to explore the correlation between left ventricular strain parameters and clinical laboratory indexes,systemic lupus erythematosus disease activity index(SLEDAI).Methods A total of 80 patients diagnosed with SLE from November 2023 to August 2024 in the First Afticiated Hospital of Jinzhou Medical University were selected and divided into two groups:40 cases with SLEDAI＜10points were in mild lupus group,34 cases with SLEDAI ≥ 10points were in moderately severe lupus group.Forty healthy volunteers for physical examination at the same time were randomly selected as control group,relevant parameters were obtained by conventional echocardiography and aCMQ technique respectively.Results aCMQ technique related parameters were compared,and the differences in left ventricular global longitudinal strain(LVGLS),apical two-chamber longitudinal strain(AP2LS),apical three-chamber longitudinal strain(AP3LS),and apical four-chamber longitudinal strain(AP4LS)were statistically significant in all three groups(P＜0.05).The differences in left ventricular global circumferential strain(LVGCS)in lupus moderate-severe group were statistically significant when compared with other two groups(P＜0.05),Pearson correlation analysis showed LVGLS,AP2LS,AP3LS,AP4LS and LVGCS were positively correlated with complement 3 and complement 4,and negatively correlated with anticardiolipin antibody(ACA)IgA,IgG,IgM,and sedimentation,and ultrasensitive C-reactive protein,and the SLEDAI was correlated with LVGLS,AP2LS,AP3LS,AP4LS were negatively correlated,and there was no significant correlation with LVGCS.Conclusion aCMQ technique can detect changes in LV systolic function in SLE patients at an early stage,and the impairment of LV systolic function is more severe with higher disease activity.Better correlation between LV strain parameters and clinical laboratory indexes and SLED AI may help to better assess cardiac involvement in SLE patients.

Objective To evaluate the left ventricular systolic function of patients with type 2 diabetes mellitus(T2DM)combined with renal insufficiency(CKD)by applying automated myocardial motion quantifica-tion(aCMQ)and to investigate its correlation with clinical biochemical indexes.Methods 80 patients with T2DM were enrolled,divided into DM group(without CKD,n=40)and DN group(with CKD,n=40),and 40 healthy volunteers were selected as the control group.The general clinical data of all subjects were recorded,and routine echocardiography and aCMQ were performed to obtain routine ultrasonographic measurements and aCMQ-related parameters.Results Comparison of aCMQ-related parameters:The differences in LV global longitudinal strain(LVGLS),LV apical 2-chamber longitudinal strain(LVAP2LS),LV apical 3-chamber longitudinal strain(LVAP3LS),and LV apical 4-chamber longitudinal strain(LVAP4LS)among the three groups were all statistically significant(P<0.05).The differences in LV global circumferential strain(LVGCS)between the DN group and the other two groups were statistically significant(P<0.05).The differences in LV short-axis basal segment cyclic strain(LVSAXBCS),LV short-axis middle segment cyclic strain(LVSAXMCS),and LV short-axis apical segment cyclic strain(LVSAXACS)were not statistically significant(P>0.05).LV strain was negatively correlated with Hs-CRP,GA,HbA1c,creatinine,urea,and uric acid,and positively correlated with eGFR.Correlation.High-sensitivity C-reactive protein(Hs-CRP),glycated albumin(GA)and eGFR showed good correlation with LV strain parameters.Conclusion The aCMQ technique can detect the deterioration of left ventricular function in patients with type 2 diabetes mellitus combined with renal insufficiency at an early stage,and the correlation between left ventricular strain parameters and hs-CRP,GA and eGFR can help to better assess their cardiac involvement.