Objective:To analyze the relationship between the optimal surgical margin value and clinical prognosis of transoral robotic surgery（TORS） in treating human papillomavirus（HPV） -positive oropharyngeal squamous cell carcinoma. Methods:A single-center, prospective, observational cohort study was conducted, enrolling patients with early and moderated stage（≤T3 stage） oropharyngeal carcinoma undergoing TORS between July 2020 and April 2024. The proposed optimal surgical margin cutoff value for TORS was set as 2 mm. The primary objectives were to evaluate the optimal clear margin for TORS and its association with overall survival（OS） and progression-free survival（PFS）. Logistic regression was used to analyze correlations between surgical margins and clinical variables, while Cox regression models assessed the impact of surgical margins on OS and PFS. Results:A total of 90 patients（60 males, 66.7%） were included, all had squamous cell carcinoma, with a mean age of 58.0±9.0 years（range: 39-84 years） old. The 1, 2 and 3-year OS rates were 92.3%, 89.9% and 85.0%, respectively, while the 1, 2 and 3-year PFS rates were all 90.1%. For surgical margins ≤2 mm, the 1, 2 and 3-year OS rates were 80.8%, 69.3% and 69.3%, respectively, and PFS rates were 77.9% across three time points. For surgical margins>2 mm, the 1, 2 and 3-year OS rates were 96.5%, 96.5% and 90.6%, respectively, with PFS rates of 94.6%. Logistic regression showed no correlation between surgical margins and tumor type, T/N stage, smoking, alcohol use, or gender（P>0.05）. Cox analysis identified surgical margins>2 mm as a significant factor improving PFS（HR=0.14, 95%CI 0.02-0.90, P=0.038）. Conclusion:This systematic analysis suggests setting a 2 mm and longer as clear surgical margin for TORS. Margins>2 mm are associated with superior postoperative PFS rate and prolonged PFS time in HPV-positive oropharyngeal carcinoma patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Carcinoma, Squamous Cell/virology* ; Human Papillomavirus Viruses/isolation & purification* ; Margins of Excision ; Oropharyngeal Neoplasms/virology* ; Papillomavirus Infections/virology* ; Prognosis ; Prospective Studies ; Robotic Surgical Procedures/methods*

The medicinal history of Zanthoxyli Radix is long,and it is recorded in the Shen Nong Ben Cao Jing under the name of Manjiao.Modern pharmacological research has proven that Zanthoxyli Radix has anti-tumor,antibacterial,antioxidant,and hemostatic effects.This article reviewed the pharmacological effects of Zanthoxyli Radix based on its functional indications.Based on the basic requirements of TCM quality markers(Q-markers),this article predicted and analyzed the Q-markers of Zanthoxyli Radix from the perspectives of plant phylogeny and chemical component specificity,chemical component and pharmacological correlation,and chemical component testability.It is proposed to select alkaloids,flavonoids,and lignans as the Q-markers for the general classification of Zanthoxyli Radix.The candidate components for Q-marker were identified,including chloramphenicol,white croaker alkaloid,magnolian alkaloid,taro alkaloid,vanillin,hesperidin,L-sesamin and L-asarone,providing a reference for further research on the quality standards of Zanthoxyli Radix.

Objective To explore the application effect of volunteer service in the practical teaching of Traditional Chi-nese Pediatrics.Methods In 2023,80 undergraduate interns from the 2021 cohort at Yunnan University of Traditional Chinese Medicine,who were shadowing in the pediatrics department of a traditional Chinese medicine hospital in Yunnan,were randomly selected as research subjects.They were divided into an experimental group and a control group.The experimental group received teaching through a combination of volunteer service and traditional teaching methods,while the control group was taught using tra-ditional classroom methods.Results The experimental group scored significantly higher than the control group in clinical skills assessments,Mini-CEX scores,subject recognition evaluations,and teaching satisfaction,with statistically significant differences(P＜0.05).Conclusion The use of volunteer service in the practical teaching of Traditional Chinese Pediatrics is highly feasi-ble and can significantly enhance students'clinical practice abilities,stimulate their enthusiasm for learning,foster independent thinking,and improve their overall clinical competencies.

Objective:To explore the prolonged therapeutic regimen for patients with plaque psoriasis, who showed a positive response to 4-week treatment with tazarotene/betamethasone dipropionate cream, but were not completely cured.Methods:A multicenter, randomized, open-labelled, parallel-controlled clinical study was conducted. A total of 232 patients with plaque psoriasis were collected, who showed a positive response to previous 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured with the psoriasis area and severity index[PASI] improvement rate being 50%-90%. At week 5, they were randomly and equally divided into 2 groups: test group receiving treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream once a day, and control group receiving a sequential regimen of 0.05% tazarotene gel on weekdays once a day followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream on weekends once a day. After 2-and 4-week prolonged treatment, the efficacy and safety of the 2 therapeutic regimens were evaluated and compared. Measurement data were compared between 2 groups by using covariance analysis or t test, and enumeration data were compared by using chi-square test. Results:From the 5th to the 8th week, 200 out of the 232 patients completed the treatment. Data collected from 110 patients in the test group and 112 in the control group were enrolled into the full analysis set, and those from both 113 patients in the test group and control group were enrolled into safety analysis set. After consecutive 6-and 8-week treatment, the decline rates of the PASI score were 73.05% ± 16.69% and 78.46% ± 15.40% respectively in the test group, which were significantly higher than those in the control group (66.73% ± 21.77%, 67.02% ± 34.19%, respectively, both P < 0.05) . After 6-week treatment, the proportion of subjects who achieved PASI90 was significantly higher in the test group (14 cases, 12.7%) than in the control group (5 cases, 4.5%, χ2=4.842, P=0.028) ; After 8-week treatment, the proportions of subjects who achieved PASI75 and PASI90 (61.8%, 23.6%, respectively) were significantly higher in the test group than in the control group (48.2%, 12.5%, respectively, both P < 0.05) . During the consecutive 8-week treatment, there was no significant difference in the incidence rate of adverse reactions between the test group (15.0%) and control group (23.9%, χ2=2.822, P=0.093) . Conclusion:For patients who showed a positive response to 4-week treatment with 0.05%/0.05% tazarotene/betamethasone dipropionate cream, but were not completely cured, the continuous use of 0.05%/0.05% tazarotene/betamethasone dipropionate cream for 4 weeks is a superior therapeutic regimen compared with the sequential regimen of 0.05% tazarotene gel followed by 0.05%/0.05% tazarotene/betamethasone dipropionate cream.

Objective To study the effect of paeonol on the proliferation and apoptosis of A375 human melanoma cells and its mechanism.Methods Cell counting kit-8 (CCK8) was used to evaluate the proliferative activity of A375 cells treated with paeonol of 0.5,1,2,4,8 mmol/L for 24,48 and 72 hours respectively.Subsequently,A375 cells were treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours followed by double staining with annexin V and propidium iodide for the detection of cell apoptosis,fluorometric assay for the estimation of caspase 3,caspase 8 and caspase 9 activity,and Western blot for the determination of the levels of p53,nuclear factor-κB proteins and some of their target proteins.The A375 cells receiving no treatment served as the blank control group.Statistical analysis was carried out by t test.Results Within the investigated concentration and time ranges,paeonol significantly inhibited the proliferative activity of A375 cells in a concentration-and timedependent manner.Compared with the blank control group,a significant increase was observed in the early apoptosis rate in A375 cells treated with paeonol of 1.25,2.5 and 5 mmol/L for 24 hours (13.74％-± 1.73％,25.95％ ± 0.57％ and 46.44％ ± 0.81％ vs.3.11％ ± 0.53％,P ＜ 0.05 or 0.01),as well as in the activity of caspase 3,8 and 9 in A375 cells treated with paeonol of 2.5 and 5 mmol/L for 24 hours (P ＜ 0.05 or 0.01).After 24-hour treatment,the protein levels of p53 and Bax were elevated,but those of nuclear factor-κB,Bcl-2 and Bcl-XL were decreased in A375 cells with the increase of paeonol concentration.Conclusions Paeonol can inhibit the proliferation but induce the apoptosis of A375 cells,and the apoptosis-inducing effect may be realized through intrinsic and extrinsic pathways by modulating nuclear factor-κB and p53 genes.

OBJECTIVETo investigate the relationship between occupational stress and depression in migrant workers.

METHODSMigrant workers in the textile industry were selected as subjects, and the self-made Occupational Stress Questionnaire and Self-rating Depression Scale were used to investigate the sex, age, seniority, educational level, and marital status of these subjects. Data analysis was performed by independent-samples t test, analysis of variance, Spearman rank correlation analysis, and stepwise multiple regression analysis.

RESULTSSex, seniority, and educational level were not influential factors for depression scores. The lower age group had a higher moderate depression score than the higher age group; the unmarried group had a higher moderate depression score than the married group. Severe depression was negatively correlated with decision-making power, psychological job demands, social support, and external pay-return, but positively correlated with skills and internal input; moderate depression was positively correlated with psychological job demands and external pay, but negatively correlated with other factors; mild depression was negatively correlated with all factors. The stepwise regression analysis showed that the influential factors for depression included, from major to minor, supervisor support, skills, internal input, and colleague support, according to the standardized regression coefficients; internal input was the contribution factor, and the remaining ones were negative factors.

CONCLUSIONAmong migrant workers, certain mental health problems exist, and occupational stress is associated with depression.

Adolescent ; Adult ; Aged ; Depression ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Diseases ; epidemiology ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Transients and Migrants ; Young Adult

Objective To observe the effects of intravenous injection of fentanyl and tramadol on postoperative analgesia in laparoscopic cholecystectomy of clinical efficacy.Methods 80 cases treated with laparoscopic cholecystectomy were randomly divided into the fentanyl group (group F) and tramadol group (group Q).VAS score,adverse reaction incidence and patient satisfaction,were observed after the administration of 0.5,1,2,4,8,12h.Results In group F after administration of 0.5,1,2h,VAS score was better than that of group Q; group F after administration of the drug 4,8 h VAS score was inferior to group Q;two groups of patients in postoperative 12h VAS scores showed no significant difference in group F;the overall incidence of adverse reactions was higher than that of group Q,patients' satisfaction was higher than that of group Q.Conclusion Intravenous fentanyl in laparoscopic cholecystectomy operation postoperative overall are superior to the analgesic effect of tramadol,with high patient's satisfaction.

Objective To evaluate the mechanism of external branch of the superior laryngeal nerve (EBSLN) injury during thyroid surgery as showed by intraoperative neuromonitoring.Methods 70 patients with 109 nerves at risk were enrolled in this study from March 2011 to October 2011.A positive signal is determined by observing contractions of the cricothyroid muscle.The relationship between EBSLN and the upper pole of the thyroid or the inferior constrictor muscle was studied.Results 108 nerves (99.1％) were located successfully,42 of which were visualized (38.9％).55 nerves (50.9％) crossed the superior thyroid artery more than 1 cm apart,while the other 53 nerves (49.1％) went less than 1 cm including 24 nerves(more than 0.5 cm,less than 1 cm) and 29 nerves (less than 0.5 cm) or coursed below the superior pole of the thyroid.The rate of the latter type was significantly elevated in patients with the top to botton diameter of the gland more than 5 cm.One patient suffered from impairing in the production of high tones postoperatively.Conclusions Intraoperative neuromonitoring is useful and helpful in providing instructive information for operations by locating EBSLN.

Objective To assess the relationship of methylation status of CpG islands in the promoter region of insulin-like growth factor binding protein 7 (IGFBP7) gene with the expression of IGFBP7 gene in human melanoma cell lines and primary melanocytes.Methods Primary melanocytes from human forcskin tissue as well as 4 human melanoma cell lines,including A375,M14,SK-MEL-1 and MV3,were used in this study.Bisulfite sequencing PCR (BSP) was applied to detect the methylation status of 54 CpG sites in the 5'-flanking promoter region of IGFBP7 gene in all of the melanoma cell lines and primary melanocytes.Results As hierarchical cluster analysis showed,IGFBP7-positive cells (including A375,M14 and SK-MEL-1 ) differed significantly from IGFBP7-negative cells (including MV3 cells and primary melanocytes) in the methylation pattern of IGFBP7 gene promoter region.Conclusion The methylation status of CpG island in the promoter region of IGFBP7 gene may be associated with its expression in melanoma cell lines.

ObjectiveTo investigate the protein wasting and energy reserve in chronic renal failure (CRF) patients undergoing maintaining hemodialysis (HD) at different ages.MethodsA total of 129 CRF patients (62 men and 67 women) aged (56.33 ± 14.14) years on HD were enrolled in this study.They were divided into four age groups:below 40,40-69,60-69,and over 70 years.Nutritional status was assessed by body mass index (BMI),normalized protein catabolic rate (nPCR),and biochemical parameters including pre-albumin,cholesterol,and creatinine.Body composition was tested with multi-frequency bioelectric impedance analysis.Meanwhile,83 healthy subjects,matched for age and sex,were enrolled as controls.ResultsBMI showed no significant difference between healthy controls and HD patients.Among HD patients,38％ had an BMI higher than the normal high limit and 6.2％ had a BMI less than 18.5kg/m2 ; patients with a low body weight accounted for 0,6.2％,4.8％,and 11.1％ in the ＜40 years group,40-59 years group,60-69 years group,and above 70 years groups,respectively.nPCR in the above 70 years group was ( 1.46 ±0.28) g/( kg·d),which was significantly lower than that in the 40-59 years group [ (1.54 ±0.28) g/( kg·d) ; P =0.004) ; the serum creatinine in the the above 70 years group was (834.08 ± 184.96) μmol/L,which was significantly lower than that in 40-59 years group [ (976.24 ± 186.86) μmol/l ] ( P=0.037) ; the prealbumin in the the above 70 years group was (272.65 ±79.78) mg/L,which was significantly lower than that in 40-59 year group [ (332.07 ± 73.03 ) mg/L] ( P =0.026).Body cell mass in HD patients was (22.81 ±8.12) kg,which was significantly lower than that in the control group [ (29.95 ±6.73) kg] (P＜0.001) ; furthermore,the lean tissue mass (LTM) [ (40.16±11.90) kg vs.(47.22 ±9.84) kg] and fat [ (17.45± 8.83)vs.(13.66±7.28) kg] were also significantly lower (both P=0.001 ).The lean tissue indicators in the below 40 years group were also significantly lower than those in the healthy controls ( P =0.012).For the fat tissue ingredients,the below 40 years group ( P =0.013 ) and over 70 years group (P =0.039) showed significant differences with the controls,while the 60-69 years group (P =0.191 ) showed no such difference.ConclusionsNutritional status is different among HD patients at different ages.HD patients below 40 years and abover 70 years are more susceptible to malnutrition.Although BMI shows no difference with the normal subjects,protein wasting and increased fat tissue storage do exist in HD patients.The nutrition changes are slightest in 40-59 years old and much severer in over 70 years old patients.