ObjectiveTo evaluate the efficacy and possible mechanism of Wei's Huoxue Tongluo Formula （韦氏活血通络方，WHTF） in treating atrophic-stage non-arteritic anterior ischemic optic neuropathy （NAION） with qi deficiency and blood stasis. MethodsA total of 82 atrophic-stage NAION patients with qi deficiency and blood stasis were randomly divided into a treatment group and a control group， with 41 cases in each group. The treatment group was given oral administration of WHTF twice a day plus acupoint injection of distilled water 2 ml at Taiyang （EX-HN5） once daily， while the control group received injection of compound anisodine injection 2 ml at Taiyang （EX-HN5） once daily and oral administration of WHTF placebo twice a day. Both groups received treatment for a course of 14 days. The best-corrected visual acuity （BCVA）， optic disc perfusion density （PD）， flux index （FI）， macular superficial PD， vascular density （VD）， and traditional Chinese medicine （TCM） syndrome scores were compared between groups before treatment and on day 7 and day 14 of treatment. Additionally， mean defect （MD） and mean sensitivity （MS） of visual fields were measured before treatment and on day 14， along with safety evaluation. ResultsAfter treatment， both groups showed significant improvement in BCVA， visual field MD and MS， and TCM syndrome scores （P＜0.05 or P＜0.01）. On day 14 of treatment， the TCM syndrome score in the treatment group was significantly lower than that in the control group （P＜0.05）. There was no significant improvement in optic disc PD and FI， and macular superficial PD and VD after treatment in either group （P＞0.05） except that on day 7 the macular superficial foveal PD in the control group was significantly better than that in the treatment group （P＜0.05）. During the treatment period， no serious adverse events occurred in either group. ConclusionWHTF can improve the visual function indicators including visual acuity and visual field， as well as TCM syndrome scores in atrophic-stage NAION patients with qi deficiency and blood stasis. It shows clinical safety， although it does not appear to have a significant effect on optic disc or macular blood flow.

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 investigate the prognostic value of tissue plasminogen activator-inhibitor complex(tPAIC)for mortality in patients with sepsis associated thrombocytopenia(SAT).Methods A retrospective analysis was conducted on the clinical data of 74 patients with SAT admitted to the Intensive Care Unit of the 908th Hospital of the Joint Logistics Support Force of PLA between Septem-ber 2017 and December 2021.Based on 28-day follow-up for outcomes,the patients were divided into survival group(43 cases)and death group(31 cases).The Boruta algorithm based on random forest and Lasso regression algorithm were used to screen the risk fac-tors from a total of 29 candidate variables,including age,sex,SOFA score on admission,APACHE Ⅱ score,and various hematological indexes,(e.g.,white blood cell count).The time-dependent receiver operating characteristic(ROC)curves and the survival analysis were performed for the key variables identified.Results Compared with the survival group,the nonsurvivors in death group had signif-icantly higher SOFA and APACHE Ⅱ scores.The levels of thrombomodulin(TM),thrombin-antithrombin complex(TAT),and tissue plasminogen activator inhibitor complex(tPAIC)were also markedly elevated in death group(P＜0.05).Similarly,PT,APTT,TT,FDP,and D-dimer in the death group were significantly higher than those in survivalroup,whereas the fibrinogen levels were signifi-cantly decreased(P＜0.05).The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(T-Bil),and lactate(Lac)levels were likewise significantly elevated in the death group.Random forest and Lasso regression analysis identified SOFA score,tPAIC,INR,and Lac as the independent risk factors of mortality in the patients with sepsis-associated thrombo-cytopenia(SAT)patients.Time-dependent ROC curve analysis showed that a higher C-index and average area under the curve(AUC)in tPAIC than any other variables for predicting the prognosis of SAT patients.Kaplan-Meier survival analysis stratified by the optimal cutoff value of tPAIC(38.9 ng/mL)revealed that a 2.31-fold higher 28-day survival rate in the patients with tPAIC＜38.9 ng/mL group compared those with tPAIC ≥38.9 ng/mL.Conclusion tPAIC demonstrates significant predictive value for mortality in SAT patients.

Objective·To evaluate the effects of normally positioned flap(NPF)and coronally advanced flap(CAF)techniques on clinical results after epulis excision.Methods·A total of 55 patients with epulis who visited the Department of Periodontology,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from August 2022 to December 2023 were included.The patients were divided into the NPF group and the CAF group.After epulis excision,the surgical area was closed using NPF or CAF technique.The following parameters were recorded:baseline epulis width(EW)and epulis height(EH);papilla width(PW)and papilla height(PH)at 6 months post-surgery;probing depth(PD),attachment loss(AL),and keratinized gingiva width(KGW)at both baseline and 6 months post-surgery.The esthetic outcomes were evaluated using a visual analog scale(VAS)by 2 periodontal specialists.t test was used to compare the differences in periodontal indices between baseline and 6 months post-surgery,as well as between the 2 flap techniques.Results·At 6 months post-surgery,PD of the CAF group was(1.68±0.79)mm,significantly lower than at baseline(P<0.001),but not significantly different from that in the NPF group(P=0.365);the AL in the CAF group was(1.26±1.18)mm,not significantly different from baseline(P=0.746),but significantly lower than in the NPF group(P<0.001).At 6 months post-surgery,PH of the CAF group was(3.74±0.62)mm,significantly higher than that in the NPF group(P<0.001),and the VAS score of the CAF group was significantly higher than that of the NPF group(P<0.001).Conclusion·Compared with NPF,CAF could effectively improve post-surgical KGW and reduce AL,which could prevent periodontal soft tissue defects,and improve esthetic outcome after epulis excision.

Objective To explore the effect of classroom pivotal response teaching(CPRT)-based fun-damental motor skills intervention on the motor coordination ability in children with autism spectrum disorder(ASD).Methods Seventeen boys with ASD(aged 5～9 years)were recruited from a leading au-tism rehabilitation center.According to the principle of convenience sampling,the school-age class 3(n=9)was taken as the experimental group,and class 1 and 2(n=8)were chosen as the control group.Before the intervention,there was no significant difference between the two groups in terms of social communication skills.The experimental group was given CPRT-based fundamental motor skills in-tervention 3 times/week,60 minutes/session,for 9 weeks,while the control group did not receive the intervention.Before and after the intervention,as well as 4 weeks after the intervention,both groups were evaluated their motor coordination skills(manual dexterity,aiming and catching,and balance)us-ing the movement assessment battery for children(Movement-ABC).Repeated measures ANOVA was used to compare the differences in the total Movement-ABC scores and scores across its subdomains between the experimental group and the control group during different intervention periods.Results(1)After the intervention,the scores of experimental group were significantly higher than the control group in total motor skills,aiming and catching,and balance[F(1,15)=14.308,P<0.01;F(1,15)=7.244,P<0.05;F(1,15)=9.362,P<0.01].Moreover,4 weeks after the intervention,the scores of the former group were also significantly higher than the latter in all the above measurements[F(1,15)=11.670,P<0.01;F(1,15)=5.549,P<0.05;F(1,15)=9.209,P<0.01].(2)After the intervention,there was an improvement in manual dexterity in the experimental group,but without significant differences compared with the control group[F(1.316,19.736)=4.795,P>0.05].Conclusion The CPRT-based fundamental motor skills inter-vention can improve and sustain motor coordination among children with ASD,primarily through en-hanced performance in aiming,catching and balancing.

Objective Through in vitro experiments,biomechanical data of the transtibial pullout suture(TPS),tendon reconstruction(TR),and tendon reconstruction with suture augmentation(TRS)were collected,so as to evaluate the biomechanical effectiveness of tendon reconstruction for repairing medial meniscus posterior root tear(MMPRT).Methods Eighteen porcine knee joint models were divided into TPS,TR,and TRS groups.Sutures were used to fix the meniscal root in TPS group.Tendons were passed through an incision at the meniscal root in TR group.Tendons were passed through an incision at the meniscal root and secured at tendon-meniscus contact area with additional sutures in TRS group.The sutures and tendons were pulled out through tibial tunnels and fixed at the anteromedial tibia.All groups underwent failure load tests,and ultimate failure load,displacement at failure load,load at clinical failure,stiffness,and failure modes of the samples were recorded.Results The maximum failure load in TPS group was significantly higher than that in TR group(P＜0.05),but there was no significant difference between TPS group and TRS group(P＞0.05).The maximum failure load in TRS group was significantly higher than that in TR group(P＜0.05).The displacement under failure load in TR group and TRS group was significantly lower than that in TPS group(P＜0.05),but there was no significant difference between TR group and TRS group(P＞0.05).There were no significant differences in the load under clinical failure among the 3 groups(P＞0.05).The stiffness of TRS group was significantly greater than that of TPS group(P＜0.05),but no significant difference was observed between TR group and TPS group,as well as between TR group and TRS group(P＞0.05).All failures were caused by suture or tendon cutting through the meniscus.Conclusions The tendon reconstruction techniques is superior to the TPS in terms of failure displacement and stiffness,while the TRS further enhances the stability of the repair.

Objective:To investigate the dietary iodine intake of students at Mudanjiang Medical University, Heilongjiang Province.Methods:From September 2023 to June 2024, a two-stage sampling method was used to investigate students at Mudanjiang Medical University. In stage one, 250 students were selected and investigated on their dietary iodine intake using the Iodine Specific Food Frequency Questionnaire (I-FFQ). In stage two, 55 students were selected and the double-meal method was used to investigate the dietary iodine intake of students. Iodine content in food samples was determined by inductively coupled plasma mass spectrometry. Curve estimation (power function, S-shaped curve, cubic equation, growth curve) was applied to analyze the dietary iodine intake of I-FFQ and double-meal method, the regression equation was used to adjust I-FFQ.Results:A total of 237 students were enrolled in I-FFQ, with a dietary iodine intake [ M( Q1, Q3)] of 342.61 (203.77, 399.26) μg/d. The dietary iodine intake of males and females was 361.82 (235.56, 428.98) and 330.87 (190.47, 366.11) μg/d, respectively, and the difference between the two was statistically significant ( Z = - 3.06, P = 0.002). The proportions of insufficient iodine intake, appropriate iodine intake, and excessive iodine intake were 13.92% (33/237), 82.70% (196/237), and 3.38% (8/237), respectively. A total of 52 students were enrolled in the double-meal method, with an average dietary iodine intake of 645.22 (435.91, 960.50) μg/d over 3 days. The proportion of appropriate iodine intake and excessive iodine intake was 44.23% (23/52) and 55.77% (29/52), respectively. After adjusting for I-FFQ, the dietary iodine intake was 650.13 (441.68, 728.53) μg/d, with the proportions of appropriate iodine intake and excessive iodine intake being 35.02% (83/237) and 64.98% (154/237), respectively. Conclusion:More than half of the students at Mudanjiang Medical University in Heilongjiang Province are in a state of excessive iodine intake, and dietary iodine intake should be appropriately controlled.

Objective:To construct a multimodal induction educational system suitable for standardized pediatric residency training bases, and to evaluate its effectiveness, thereby obtaining suggestions for further improvement.Methods:Twelve residents newly enrolled in the 2023 standardized residency training program who commenced their first-year training were included as study subjects. The induction educational system comprised multiple modules: department introduction, training plan and assessment requirements, departmental workflow, routine diagnosis and treatment of major diseases, specialized skills/procedures, and lifestyle guidance. Training materials and methods were tailored to the characteristics of each training module. Checklists were used for supervision and review, and a competency checklist was designed to evaluate residents' mastery of the training at two weeks of induction, which would guarantee the effectiveness of the training. A questionnaire survey, powered by wjx.cn, was used to obtain the experience and suggestions from the residents and ward instructors on induction education, and content ranking analysis was performed on the survey results.Results:The survey revealed that, before starting a new rotation, residents' top three educational needs were departmental workflow, routine diagnosis and treatment of common diseases, and specialized skills/procedures. Residents preferred face-to-face lectures and demonstrations by attending physicians or senior residents; instructors suggested improving relevant materials (such as resident physician manuals and video materials) and face-to-face lectures. The residents considered the current induction educational system to be greatly beneficial in basic theories, treatment principles, basic skills, and auxiliary examination processes.Conclusions:Through the above research, a multimodal induction educational system suitable for the standardized pediatric residency training base in the Peking University First Hospital has been preliminarily established, and suggestions for further improvement have been obtained, which is conducive to further improving the system and residents' post competency.

Objective To explore the real experiences of nutrition impact symptoms in esophageal cancer patients during diagnosis and treatment,and to provide references for developing nutritional management strategies.Methods Using purposive sampling,15 esophageal cancer patients admitted to the thoracic surgery department of a tertiary grade A hospital in Guangzhou from October to December 2024 were selected for semi-structured interviews.Thematic analysis was used for data analysis.Results 4 themes and 12 sub-themes were identified:①Multiple symptom perceptions:esophageal obstruction-dysphagia,appetite-affecting symptoms,multiple symptom over-lap,and individual differences in symptom perception.② Insufficient symptom cognition:overestimation of symptom controllability and biased symptom attribution.③ Negative emotional reactions:anxiety and fear about eating,frustration with declining eating function,and helplessness and guilt about losing control over eating.④ Di-verse symptom coping strategies:avoidance coping,adaptive coping,and active nutritional management.Conclusion The nutrition impact symptom experiences of esophageal cancer patients are complex and diverse.Healthcare professionals should promptly identify and assess nutrition impact symptoms,provide nutrition health education,strengthen psychological guidance,and develop culturally distinctive individualized nutritional management strategies.

AIM To investigate the effects of Xuesaitong Capsules(Panax notoginseng saponins)on ischemia/reperfusion injury in a mouse model of skin frostbite.METHODS The mice were randomly divided into the control group,the model group,the dexamethasone group(1 mg/kg),and the low-dose,medium-dose,and high-dose Xuesaitong Capsules groups(0.036,0.072,and 0.144 g/kg),with eight mice in each group.A frostbite model was established using a dry ice-cooled ceramic(ferrite)magnet.On the 2nd day after modeling,each group started its corresponding dosing by gavage for 14 consecutive days.The wound healing,histopathological changes,and serum levels of high-sensitivity C-reactive protein(hs-CRP),thromboxane B2(TXB2),6-keto-prostaglandin F1α(6-K-PGF1α),nitric oxide(NO)and endothelin(ET)were assessed using ELISA.The superoxide dismutase(SOD)activity and malondialdehyde(MDA)levels in skin tissues were measured biochemically.The protein expressions of tumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-6,Toll-like receptor(TLR)4 and phosphorylated nuclear factor-KB p65(p-NF-κB p65)in skin tissues were determined by Western blot.Additionally,LncRNA H19 mRNA expression in skin tissues was evaluated using RT-qPCR.RESULTS After the final administration,compared with the control group,the model group exhibited partial scab detachment,wound healing,and larger wound areas;hyperkeratosis with incomplete keratinization,detachment of the dermis and subcutaneous tissue,partial loss of appendages,subcutaneous edema,and dilated,congested,and hemorrhagic stromal vessels with extensive lymphocyte infiltration revealed by the histopathological examination;elevated serum levels of hs-CRP,TXB2,and ET(P＜0.05,P＜0.01);decreased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);reduced SOD activity in skin tissues(P＜0.01);increased MDA levels(P＜0.01);and upregulated protein expressions of TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65,as well as LncRNA H19 mRNA expression(P＜0.05,P＜0.01).Compared with the model group,the group intervened with high-dose Xuesaitong Capsules displayed reduced wound areas(P＜0.01);decreased serum levels of hs-CRP,TXB2 and ET(P＜0.05,P＜0.01);increased 6-K-PGF1α and NO levels(P＜0.05,P＜0.01);enhanced SOD activity(P＜0.05,P＜0.01);reduced MDA level in skin tissues(P＜0.05,P＜0.01);and down-regulated TNF-α,IL-1β,IL-6,TLR4 and p-NF-κB p65 protein expressions and suppressed LncRNA H19 mRNA expression in skin tissues as well(P＜0.05,P＜0.01).CONCLUSION Xuesaitong Capsules alleviate ischemia/reperfusion injury in frostbite-injured mice by exerting anti-inflammatory and anti oxidative stress effects and restoring vascular endothelial function mediated by the downregulation of LncRNA H19 expression and inhibition of the TLR4/NF-κB signaling pathway.