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 explore the effect of remote ischemic preconditioning (RIPC) on preoperative heart rate variability in patients with heart valves. Methods Patients scheduled to undergo on-pump cardiac valve surgery in the Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, between January and July 2022 were initially enrolled. Eligible patients were randomly assigned at a 1 : 1 ratio to either the RIPC group or the control group. Relevant indicators of heart rate variability [standard deviation of NN interval (SDNN), standard deviation of mean value of NN interval in every five minutes (SDANN), mean square root of difference between consecutive NN intervals (RMSSD), percentage of adjacent RR interval>50 ms (PNN50), low frequency (LF) component, high frequency (HF) component and LF/HF] at 8 hours in the morning on the surgical day between two groups were compared. Results A total of 118 patients were initially assessed. After screening, 58 patients were excluded, and 60 patients provided written informed consent and were enrolled in the trial, with 30 allocated to the RIPC group and 30 to the control group. Seven patients in the control group and 5 patients in the RIPC group were subsequently excluded due to missing heart rate variability data resulting from cancelled operations. Finally, 23 patients in the control group and 25 patients in the RIPC group were included in the analysis. There was no statistical difference in baseline characteristics between the two groups, and there was no significant difference in heart rate variability 24 hours before intervention (P>0.05). After the intervention measures were taken, the comparison of the results of heart rate variability at 8 hours on the day of operation showed that SDNN and SDANN of patients in the RIPC group were higher than those in the control group, with statistical differences (P<0.05). Conclusion RIPC can stabilize the preoperative heart rate variability of patients undergoing cardiac valve surgery.

Objective To compare the mid- and long-term clinical results of mitral valve plasty (MVP) and mitral valve replacement (MVR) in the treatment of functional mitral regurgitation (FMR). Methods Patients with FMR who underwent surgical treatment in the Department of Cardiovascular Surgery of the General Hospital of Northern Theater Command from 2012 to 2021 were collected. The patients who underwent MVP were divided into a MVP group, and those who underwent MVR into a MVR group. The clinical data and mid-term follow-up efficacy of two groups were compared. Results Finally 236 patients were included. There were 100 patients in the MVP group, including 53 males and 47 females, with an average age of (61.80±8.03) years. There were 136 patients in the MVR group, including 72 males and 64 females, with an average age of (61.29±8.97) years. There was no statistical difference in baseline data between the two groups (P＞0.05). There was no statistical difference between the two groups in the extracorporeal circulation time, aortic occlusion time, postoperative hospital and ICU stay, intraoperative blood loss, or hospitalization death (P＞0.05), but the time of mechanical ventilation in the MVP group was significantly shorter than that in the MVR group (P=0.022). The total follow-up rate was 100.0%, the longest follow-up was 10 years, and the average follow-up time was (3.60±2.55) years. There were statistical differences in the left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter and cardiac function between the two groups compared with those before surgery (P<0.05). The postoperative left ventricular ejection fraction in the MVP group was statistically higher than that before surgery (P=0.002), but there was no statistical difference in the MVR group before and after surgery (P=0.658). The left atrial diameter in the MVP group was reduced compared with the MVR group (P=0.026). The recurrence rate of mitral regurgitation in the MVP group was higher than that in the MVR group, and the difference was statistically significant (10.0% vs. 1.5%, P=0.003). There were 14 deaths in the MVP group and 19 in the MVR group. The cumulative survival rate (P=0.605) and cardiovascular events-free survival rate (P=0.875) were not statistically significant between the two groups by Kaplan-Meier survival analysis. Conclusion The safety, and mid- and long-term clinical efficacy of MVP in the treatment of FMR patients are better than MVR, and the left atrial and left ventricular diameters are statistically reduced, and cardiac function is statistically improved. However, the surgeon needs to be well aware of the indications for the MVP procedure to reduce the rate of mitral regurgitation recurrence.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Group C rotavirus（RVC）is one of the important etiological agents responsible for human rotavirus gastroenteritis（RVGE）. Although its overall detection rate has shown a declining trend in recent years，sporadic outbreaks continue to be reported，highlighting its potential public health threat. RVC infections predominantly occur in preschool children，adolescents，and adults，typically presenting with mild to moderate diarrhea. While most cases are sporadic，cluster outbreaks can also occur. At present，fundamental research on RVC remains limited，particularly regarding its transmission and pathogenesis. Nevertheless，emerging evidence suggests that interspecies transmission may represent a key route of human infection. This review provides a comprehensive overview of current research on RVC-associated gastroenteritis，with a particular focus on its virological characteristics，epidemiological patterns，clinical manifestations，and preventive and control strategies. It aims to offer a theoretical foundation and practical reference for future studies and public health interventions targeting RVC.

Cataract surgery is one of the most common ophthalmologic procedures. Advances in technology and medical policies have made it more precise. Residual refractive errors and deviation of target diopters are a main cause of dissatisfaction among patients. Refractive enhancement after cataract surgery can correct or eliminate these errors, improving patients' visual quality of life. There are multiple options for correcting residual refractive errors. The best approach depends on factors like the cause of the error, degrees of residual refractive errors, type of intraocular lens, ocular comorbidities, and patient preference. This paper summarizes the incidence and types of residual refractive errors, advancements in refractive enhancement surgeries, and provides practical solutions for clinical practice.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To evaluate the effects of Modified Wendan Decoction combined with Intestinal Regulation and Mind-Regulating Acupuncture on cognitive,social,and self-care abilities in children with autism spectrum disorder(ASD).Methods A total of 100 children diagnosed with ASD at Anhui Children's Hospital(inpatient and outpatient)from February 2023 to March 2024 were enrolled.The participants were divided into an observation group(n=50)and a control group(n=50)using a random number table.The control group received conventional rehabilitation training and Intestinal Regulation and Mind-Regulating Acupuncture,while the observation group received additional Modified Wendan Decoction.Both groups underwent a 2-month treatment period.Post-treatment assessments included clinical efficacy,changes in Childhood Autism Rating Scale(CARS)scores,Autism Behavior Checklist(ABC)scores,and Autism Treatment Evaluation Checklist(ATEC)scores were observed.Additionally,Social Responsiveness Scale(SRS)and Infant-Junior Middle School Student Social Life Abilities Scale(S-M)scores were compared between groups.Results(1)During the study,1 case was lost to follow-up in the observation group and 2 in the control group,leaving 49 and 48 cases for final analysis,respectively.(2)After treatment,both groups showed significant improvements in CARS,ABC,and ATEC scores(P＜0.05),with the observation group demonstrating superior improvements compared to the control group,the difference being statistically significant(P＜0.05).(3)Similarly,both groups exhibited marked improvements in SRS and S-M scores(P＜0.05),with the observation group outperforming the control group,the difference being statistically significant(P＜0.05).(4)The total effective rate was 81.63％(40/49)in the observation group versus 56.25％(27/48)in the control group,indicating significantly better efficacy in the observation group,the difference being statistically significant(P＜0.05).Conclusion Modified Wendan Decoction combined with Intestinal Regulation and Mind-Regulating Acupuncture significantly improves clinical symptoms and enhances cognitive,social,and self-care abilities in children with ASD,demonstrating notable therapeutic efficacy.

Objective To establish and validate a nomogram model for predicting the risk of new-onset postoperative atrial fibrillation (POAF) after isolated aortic valve replacement (AVR). Methods The clinical data of patients without atrial fibrillation (AF) who underwent isolated AVR in the General Hospital of the Northern Theater of Command from June 2020 to June 2022 were retrospectively collected. Patients with AVR were divided into a POAF group and a non-POAF group according to whether POAF occurred within 7 days after surgery. The preoperative baseline data, blood indexes, color Doppler echocardiography and the heart rate variability (HRV) in 7 days before surgery were analyzed. Logistic regression was used to analyze the preoperative risk factors for POAF and R language was used to construct a nomogram to predict POAF. The results were compared with the established AF model (POAF-AF score). Results A total of 191 patients were enrolled in this study, and 66 (35%) of them developed POAF within 7 days after the surgery. The age of the patients in the POAF group was (60.97±8.41) years and 16 (24%) were female, while the age of the patients in the non-POAF group was (54.65±11.85) years and 59 (47%) were female. Univariate and multivariate logistic regression analysis showed that age, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit and high frequency power were independently associated with POAF after the AVR. The nomogram of POAF was constructed by combining the above independent risk factors. We predicted the area under receiver operating characteristic curve (AUC=0.812) in the nomogram of POAF after simple aortic valve replacement. The model was internally verified by a 10-fold cross-validation resampling (AUC=0.757, Kappa=0.438). Compared with the POAF-AF score, the nomogram had a superior discrimination performance. Conclusion Age, sex, drinking history, chronic obstructive pulmonary disease, plateletocrit, and high frequency power are independent predictors for POAF after isolated AVR. The nomogram can be used as a practical tool to help clinicians predict the probability of individual POAF occurrence and take necessary preventive measures.

Objective To explore the CT and MR features of duodenal stromal tumors(DST).Methods The clinical,imaging and pathological data of patients with pancreaticoduodenal groove(PDG)mass detected by CT and/or MR,and pathologically diagnosed as DST were retrospectively analyzed.All imaging features were analyzed.Results Finally,all 11 patients were included,all of whom presented external mass in descending duodenum with clear boundary.There were 5 patients with irregular mass and 6 patients with circular mass.Two patients showed homogeneous mass on plain CT and MR imaging,while 9 patients presented heterogeneous mass(with varying degrees of calcification,hemorrhage,cystic degeneration,and necrosis),showed heterogeneous density on CT findings or high,low and iso signals on T1WI and T2WI without high signal on diffusion weighted imaging(DWI),and high enhancement on arterial phase,portal venous phase and delayed phase.There were no signs of air accumulation in all masses.Conclusion Stromal tumors commonly present external heterogeneous mass in descending duodenum with clear boundary.Familiarity with its predilection location and corresponding CT and MR findings are helpful for the qualitative diagnosis of DST.