1.Expert consensus on neoadjuvant PD-1 inhibitors for locally advanced oral squamous cell carcinoma (2026)
LI Jinsong ; LIAO Guiqing ; LI Longjiang ; ZHANG Chenping ; SHANG Chenping ; ZHANG Jie ; ZHONG Laiping ; LIU Bing ; CHEN Gang ; WEI Jianhua ; JI Tong ; LI Chunjie ; LIN Lisong ; REN Guoxin ; LI Yi ; SHANG Wei ; HAN Bing ; JIANG Canhua ; ZHANG Sheng ; SONG Ming ; LIU Xuekui ; WANG Anxun ; LIU Shuguang ; CHEN Zhanhong ; WANG Youyuan ; LIN Zhaoyu ; LI Haigang ; DUAN Xiaohui ; YE Ling ; ZHENG Jun ; WANG Jun ; LV Xiaozhi ; ZHU Lijun ; CAO Haotian
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(2):105-118
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.
2.Value of ultra-high-resolution photon-counting detector CT in improving neurovascular image quality
Guang YAO ; Jun LI ; Junli REN ; Xing LIU ; Lichen REN ; Yiran WANG ; Xiaolei ZHANG ; Jiawei LIU ; Jianbo GAO ; Yonggao ZHANG
Chinese Journal of Radiology 2025;59(12):1353-1360
Methods:This study was a cross-sectional study. A prospective cohort study enrolled 42 patients with clinically suspected acute cerebrovascular disease and those undergoing follow-up examinations after intracranial vascular stenting at the First Affiliated Hospital of Zhengzhou University from June 2024 to May 2025. All patients underwent UHR PCD-CT examinations of the head and neck. Reconstructions were performed based on raw data, yielding conventional standard resolution (SR group) reconstructions and UHR images reconstructed using four distinct convolution kernels (Hv40, Hv48, Hv56, Hv64) in separate groups (Hv40 UHR group, Hv48 UHR group, Hv56 UHR group, Hv64 UHR group). Regions of interest were selected in the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, posterior communicating artery, and anterior communicating artery. CT values and standard deviation (SD) values were measured for each artery, and signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Additionally, the sharpness of the vessel edges and the full-width-half-maximum (FWHM) of each artery were measured. One-way analysis of variance or the nonparametric Kruskal-Wallis test was used to compare the subjective and objective image quality metrics across the five groups. Pairwise comparisons were performed using the LSD test or Dunn method.Results:Statistically significant differences were observed in the overall comparison of vascular imaging SD, SNR, CNR, vascular edge sharpness, and FWHM among the SR group, Hv40 UHR group, Hv48 UHR group, Hv56 UHR group, and Hv64 UHR group ( P<0.05). No statistically significant differences in CT values were found ( P>0.05). Pairwise comparisons revealed statistically significant differences between all groups ( P<0.05), except that no significant differences were observed in image SD, SNR, CNR, vascular edge sharpness, or FWHM between the Hv56 UHR and Hv64 UHR groups ( P>0.05). Conclusions:UHR PCD-CT provides better image quality for neurovascular imaging. For the display of small intracranial vessels, the Hv64 provides sharper vessel walls and better subjective image quality compared to the less sharp convolutional cores.Objective:To explore the value of ultra-high resolution (UHR) photon-counting detector CT (PCD-CT) to improve the quality of neurovascular images.
3.The development, reform and system construction of organ transplantation in China
Jun REN ; Zepeng LI ; Wujun XUE
Chinese Journal of Organ Transplantation 2025;46(6):397-402
After more than sixty years of exploration and practice, China has established an organ donation and transplantation system with distinctive Chinese characteristics, achieving a leapfrog development from technology introduction to independent innovation. Through systematic reforms such as formulating and improving legal regulations including the Regulation on Human Organ Donation and Transplantation, optimizing the China Organ Transplant Response System (COTRS), and comprehensively implementing voluntary citizen donation, the number of organ donations and transplantations in China has ranked among the top in the world. However, challenges remain, including a relatively low donation rate, regional disparities, and insufficient public awareness. In the future, efforts should focus on building a four-level coordinated organ donation management system at the provincial, municipal, county/district, and medical institution levels, strengthening the organic connection between primary healthcare networks and Organ Procurement Organization (OPO). Through systematic measures such as improving public education and awareness systems, optimizing the allocation of medical resources, and refining organizational structures, China aims to continuously increase the organ donation rate and promote the high-quality development of its organ transplantation, thereby contributing Chinese wisdom and solutions to the global progress of organ transplantation.
4.Consistent observation of cardiac output in severe patients monitored continuously by LiDCO and PiCCO
Yaqi XU ; Yongyi CHEN ; Dezhi REN ; Chen LI ; Jun DUAN
Journal of Chinese Physician 2025;27(3):373-376
Objective:To investigate whether continuous cardiac output (CO) parameters obtained by LiDCO in hemodynamic monitoring of severe patients are consistent with pulse index continuous cardiac output (PiCCO).Methods:From May 18, 2024 to January 10, 2025, 12 critically ill patients who were monitored by PiCCO in the Intensive Care Unit Department of China-Japan Friendship Hospital were prospectively collected. The PiCCO and LiDCO systems were simultaneously connected to the same critically ill patient, injected with ice saline for external calibration, and the average of paired continuous CO measurements were collected. Bland-Altman was used to analyze whether the two were consistent, and Spearman was used to analyze the correlation between norepinephrine dosage and bias.Results:In the data series of 70 pairs, the CO measured by PiCCO was 5.55±1.74, and the CO measured by LiDCO was 4.40(2.90, 6.50), with a bias of 0.52(95% CI: 0.07-0.96) and an upper limit of agreement of 4.2(95% CI: 3.4-4.9), the lower limit of the conformance limit was -3.1(95% CI: -3.9 to -2.4), and the percentage error was 66%, exceeding the clinically acceptable 45%. In the data series where norepinephrine was continuously pumped at the time of data collection, there was a moderate positive correlation between norepinephrine dosage and absolute bias ( r=0.47, P<0.05). There were statistically significant differences in absolute values of bias between groups defined as 0.5 μg/(kg·min) and 1 μg/(kg·min) ( P<0.05). Conclusions:There is no clinically acceptable consistency between LiDCO and PiCCO for continuous CO monitoring in severe patients, and the size of bias may be related to the dosage of norepinephrine.
5.Differentiated effects of personal medical account reforms in the outpatient mutual-aid security mecha-nism of employee basic medical insurance on satisfaction levels across different income groups
Yaqin REN ; Jun LIU ; Jizhi LI
Modern Hospital 2025;25(5):673-678
The article summarizes the differentiated effects of personal account reform on the satisfaction of different in-come groups in the reform of medical insurance outpatient mutual aid.This reform has significantly improved the mutual aid pro-tection offered by medical insurance funds through comprehensive measures such as adjusting the personal account accounting method,promoting coordination of medical treatment in different places,strengthening guidance for first visits at the grassroots level,and expanding the coverage of outpatient coordination.Satisfaction levels varied significantly across income groups,with high-income groups expressing lower satisfaction due to reduced personal account accumulation.The satisfaction of the middle-in-come group increased due to the reduced burden of outpatient expenses.While low-income groups benefited from higher reim-bursement rates,the satisfaction of the above groups was moderated by limited primary care capacity.Interdisciplinary research suggested that differences in economic utility,psychological expectations,and perceptions of social justice are the root causes of differences in satisfaction among different income groups.In the future,it is advisable to fully rely on the big data of medical in-surance electronic vouchers,conduct long-term queue research,construct innovative theoretical models,and establish regional collaborative policy frameworks.This article employed AI-driven predictive modelling to assess policy responsiveness under var-ying scenarios and explored the localization of advanced foreign models,and constructed a three-tier system of"basic protection+differentiated supplements+commercial insurance",so as to promote the precise and sustainable development of the medical in-surance system.
6.Recommendations for the clinical use of anti-amyloid-β monoclonal antibody for Alzheimer's disease(2025)
Nan ZHI ; Jinwen XIAO ; Rujing REN ; Binyin LI ; Jintao WANG ; Jieli GENG ; Wenwei CAO ; Yaying SONG ; Hualong WANG ; Shuguang CHU ; Guoping PENG ; Jun LIU ; Xiaoyun LIU ; Fang YUAN ; Wen WANG ; Ronghua DOU ; Xia LI ; Ling YUE ; Wenshi WEI ; Xiaoling PAN ; Xiangyang ZHU ; Dian HE ; Weinü FAN ; Jingping SHI ; Nan ZHANG ; Hui ZHAO ; Qin CHEN ; Cuibai WEI ; Xiaochun CHEN ; Gang WANG
Journal of Chongqing Medical University 2025;50(9):1133-1140
In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.
7.Prognostic value of preoperative prognostic nutrition index in hypopharyngeal cancer patients based on time-dependent receiver operating characteristic curve
Lina YUAN ; Aobo ZHANG ; Wanxin LI ; Cheng LU ; Jun TIAN ; Shuling REN ; Liangfa LIU ; Yanbo DONG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2025;32(3):143-148
OBJECTIVE To explore the prognostic significance of the prognostic nutrition index(PNI)in patients with hypopharyngeal cancer undergoing surgical treatment.METHODS Clinical and pathological data of 117 patients with hypopharyngeal carcinoma who underwent surgical treatment at the center of Otolaryngology Head and Neck Surgery of Beijing Friendship Hospital,Capital Medical University from May 2014 to June 2022 were collected.The prognostic significance of hematological indicators such as PNI and neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and systemic immune inflammation index(SⅡ)were investigated.The time-dependent receiver operating characteristic(tROC)curves were used to analyze the sensitivity and specificity of various hematological indicators and to determine their optimal cutoffvalues.The Kaplan-Meier method was used to plot the postoperative survival curve,and the Cox regression model was used to analyze the correlation between PNI and overall survival(OS)and disease-free survival(DFS).RESULTS 117 patients were enrolled in this cohort,of which 109 were clinically classified as advanced stage(Ⅲ-Ⅳ).63 cases underwent surgery to preserve laryngeal function.The 5-year OS is 46.07%.According to the analysis of the tROC curve,the optimal cutoffvalue for PNI is 46.75.PNI is correlated with tumor T staging,NLR,PLR,and SⅡ.Kaplan Meier univariate analysis showed that PNI was significantly correlated with OS and DFS(P<0.05).In addition,tumor N-stage,postoperative complications,adverse pathological prognostic factors,NLR,PLR,and SⅡ were all significantly correlated with OS(P<0.05).Tumor N-stage,laryngeal preservation,postoperative complications,NLR,and SⅡ were significantly correlated with DFS(P<0.05).The Cox multivariate analysis results indicated that PNI,tumor N-stage,and postoperative complications were independent factors affecting OS and DFS.CONCLUSION Preoperative PNI,tumor N-stage,and postoperative complications are independent risk factors for OS and DFS in patients with hypopharyngeal carcinoma.PNI,as a prognostic indicator for predicting hypopharyngeal cancer patients,is superior to other hematological indicators.
8.Research Progress of Molecular Probes Driven by Tumor Boundary Imaging
Wen-Zhi REN ; Juan LI ; Jun-Lie YAO ; Jie XING ; Hong-Ying BAO ; Li SUN ; Ai-Guo WU
Chinese Journal of Analytical Chemistry 2025;53(1):14-26
″Boundarics in biomedicine″(or″Biomedical boundarics″)is an emerging frontier interdisciplinary subject that focuses on addressing key scientific issues related to the formation,identification,and evolution of biological boundaries within living organisms.In this field,the study of tumor boundaries is of particular importance.Imaging tumor boundaries not only helps to reveal the molecular mechanisms of tumor boundary evolution and interaction with the microenvironment,tumor invasion and metastasis,but is also crucial for clinical tumor diagnosis,treatment decision-making,efficacy monitoring and prognosis evaluation.Molecular probes,as functional substances that enhance imaging signals,play a crucial role in tumor boundary recognition.In this article,the basic concepts and research significance of boundarics in biomedicine and tumor boundarics in biomedicine were summarized firstly.Then a comprehensive review of the research progress in tumor boundary imaging molecular probes was provided,covering areas such as magnetic imaging,optical imaging,acoustic imaging,nuclear imaging,and multimodal imaging.The strategies to regulate the sensitivity,specificity,and safety of molecular probes through chemical structure modifications,conjugation with targeting ligands,and tumor microenvironment-responsive designs were emphasized.Finally,the research trends of molecular probes for tumor boundary imaging were analyzed,and the challenges faced in this field and the future research directions were discussed.
9.Development of A High-performance Rectangular Ion Trap for Multi-reflection Time-of-Flight Mass Spectrometer
Xiao-Xia CHEN ; Yi REN ; Qi HUANG ; Da-Jun XIANG ; Chang-Wei LI ; Yi HONG ; Lei LI ; Zheng-Xu HUANG ; Mei LI ; Jing-Wei XU ; Zhen ZHOU
Chinese Journal of Analytical Chemistry 2025;53(1):38-46
As a new generation of time-of-flight mass spectrometry,multiple-reflection time-of-flight mass spectrometry(MR-TOF-MS)has been increasingly applied in the fields such as nuclear physics,chemistry,and biology due to its ultra-high resolution and rapid analysis capabilities.However,the analytical performance of MR-TOF-MS largely depends on the ion bunch state entering the mass analyzer.In this study,a rectangular ion trap(RIT)was developed,designed and processed using printed circuit board technology,as an ion accumulating and focusing device for MR-TOF mass analyzer.Compared to traditional ion traps composed of two sets of planar electrodes,this RIT had higher voltage utilization efficiency,resulting in more efficient ion collection and focusing.The ions were cooled to a sufficiently small bunch for precise mass measurement with MR-TOF-MS mass spectrometry in only 1 ms of cooling time in the RIT,then orthogonally ejected to the MR-TOF mass spectrometer for mass analysis.Experimental results indicated that the working cycle,ion flux,and ion focusing state of the RIT fully met the requirements of the MR-TOF mass analyzer.When coupled with the MR-TOF mass analyzer,the RIT enabled MR-TOF-MS to achieve a mass resolution of 1.5×105.
10.Automatic Discrimination Method for Detection of Mineral Oil Based on Multiple Second-order Difference Quotient Filtering
Juan REN ; Bing-Ning LI ; Ling-Ling LIU ; Ting CHEN ; Qing-Jun LIU ; Yan-Wen WU
Chinese Journal of Analytical Chemistry 2025;53(1):104-114
Mineral oil contaminants composed of saturated hydrocarbons(MOSH)and aromatic hydrocarbons(MOAH)are commonly found in edible oils and related processed foods.Currently,the analysis of mineral oils primarily employs the liquid chromatography-gas chromatography-flame ionization detector(LC-GC-FID)method.Liquid chromatography is used to purify and separate MOSH and MOAH from interfering substances,and the interface technology transfers MOSH or MOAH into different GC channels for quantitative analysis.The MOSH and MOAH chromatograms typically exhibit an irregular hump shape,with sharp peaks above the hump representing natural hydrocarbon interferences,which usually do not affect the identification of the hump profile.However,when the purification of interferences is incomplete,they can form one or more gaps above the hump,interfering with the accurate judgment and delineation of the hump profile,and leading to poor reproducibility of analysis results of mineral oil.In this study,an algorithm that mimicked the manual drawing of the hump shape or contour was proposed for automatically determining the mineral oil hump contour(i.e.,the lower envelope line).The algorithm used a multiple second-order difference quotient filtering method to identify and remove the gaps above the hump.The method involved first searching and determining the lowest value of the mineral oil hump,which was the valley point sequence,and then applying second-order difference quotient filtering to the valley point sequence.Compared to the hump,the second-order difference quotient of sharp peaks was a significantly larger negative value.By filtering out the points in the valley point sequence with larger negative second-order difference quotients(or multiple second-order difference quotients),the sharp peaks above the hump were removed.To verify the accuracy of the algorithm,42 different types of samples,including edible oils and milk powders were analyzed,using both the automatic algorithm and manual methods.The results showed that there were no significant differences in the detected mineral oil contents between these two methods.


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