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 analyze the epidemiological characteristics of statutory infectious diseases in Yichang City from 2015 to 2023 and evaluate the effectiveness of non-pharmaceutical interventions (NPIs) in infectious disease prevention and control, and to provide a basis for formulating prevention and control strategies. Methods Descriptive epidemiological methods were used to analyze annual incidence rates. SARIMA and SARIMA intervention models were constructed to predict the incidence rates of infectious diseases. Interrupted time series analysis (ITS) was applied to assess the control effectiveness. Results The average annual incidence rate from 2015 to 2023 was 787.47/100 000, with the top five diseases being influenza, hand-foot-and-mouth disease, hepatitis B, tuberculosis, and diarrheal diseases. The average incidence rate from 2015 to 2019 (654.31/100 000) was significantly higher than that from 2020 to 2022 (489.01/100 000) (χ²= 3 499.6, P < 0.05). The total incidence rate in 2023 (2 396.51/100 000) was significantly higher than the average annual incidence rates from 2015-2019 (χ²= 108 186.1, P < 0.05) and 2020-2022 (χ²= 112 869.4, P < 0.05). SARIMA model results indicated that the actual incidence rate from 2020 to 2022 decreased by 73.49% compared to the predicted rate without intervention, with the highest decline observed in respiratory infectious diseases (79.57%). The SARIMA-intervention model showed a 55.48% relative decrease in the total incidence rate for 2023, with the largest reduction in respiratory infectious diseases (63.28%) and a slight increase in intestinal infectious diseases (5.48%). Conclusion NPIs effectively reduce the incidence of statutory infectious diseases in the short term, especially for acute respiratory and intestinal infectious diseases. However, long-term effectiveness faces challenges, necessitating the development of differentiated prevention and control strategies.

Objective:To observe the efficacy and safety of polatuzumab vedotin(pola)combined with chemotherapy in the treatment of relapsed and refractory diffuse large B-cell lymphoma(R/R DLBCL).Methods:A total of 23 patients with R/R DLBCL treated at the First Affiliated Hospital of Zhejiang University and its Liangzhu Branch from April 2023 to March 2024 were retrospectively collected.All patients were treated with pola combined with chemotherapy regimens such as BR,R-GDP,R-CHOP,or other regimens.Results:All 23 patients were evaluable for efficacy,with 10 achieving complete response(CR),7 partial response(PR),3 stable disease(SD),and 3 progressive disease(PD).The most common adverse events included myelosuppression,fever,and pulmonary infection.No severe adverse events resulted in drug withdrawal.Conclusion:Pola combined with chemotherapy demonstrates promising efficacy and a favorable safety profile in the treatment of R/R DLBCL.

Objective To explore the safety and efficacy of applying Bivalirudin in complex high-risk and indicated patients(CHIP)undergoing percutaneous coronary intervention(PCI)while on extracorporeal membrane oxygenation(ECMO).This study will provide additional evidence for making informed decisions regarding anticoagulation therapy during ECMO.Methods A total of 83 CHIP who underwent VA-ECMO assisted PCI in the Heart Center of the First Hospital of Lanzhou University from March 2019 to December 2022 were retrospectively enrolled as the research objects.According to the use of anticoagulant drugs during ECMO support and PCI,they were divided into Bivalirudin group(40 cases)and heparin group(43 cases).The cost of anticoagulants,coefficient of variation of activated partial thromboplastin time(APTT),APTT compliance rate,bleeding events,thrombotic events,blood product transfusion,and net adverse clinical events(NACE)at 30 days after PCI were compared between the two groups to determine the safety and efficacy of Bivalirudin in CHIP undergoing ECMO assisted PCI.Results The proportion of previous PCI(25.00％vs.4.65％),fibrinogen level[(3.52±1.14)g/L vs.(2.92±1.28)g/L],CRUSADE score[(32.00±12.69)scores vs.(26.14±10.60)scores],anticoagulation cost[1 400.00(700.00,2 100.00)RMB vs.107.69(58.74,205.59)RMB]and compliance rate of APTT[(57.76±33.11)％vs.(31.44±27.63)％]in the Bivalirudin group were higher,while the coefficient of variation for APTT[10.64(7.72,21.11)vs.19.47(10.48,31.28)]was lower than those in the heparin group.The total bleeding events(25.00％vs.46.51％),Bleeding Academic Research Consortium(BARC)1-2 bleeding events(12.50％vs.32.56％),and total thrombotic events(12.50％vs.32.56％)of the Bivalirudin group was significantly lower compared with the heparin group.Kaplan-Meier curves showed that cumulative incidence of 30-days NACE was significantly lower in the Bivalirudin group than in the heparin group.The differences between the above two groups were statistically significant(Log-rank P＜0.001).Conclusions Compared with heparin,Bivalirudin has better safety and efficacy in CHIP undergoing PCI assisted by VA-ECMO.

In response to the current problems in the traditional methods used for teaching the course of "maternal, child, and adolescent health", including the monotony of teaching modes, poor learning outcomes, limited use of information technology-based teaching, and the need for improved faculty professionalism, this study explored the reform and practice of teaching modes for this course. Teaching reform centered on a task-driven pre-class learning guide, supported by the development of a resource platform. This platform was used to assign pre-class and post-class tasks. An information technology-based platform facilitated teaching implementation during class. Systematical analysis and evaluation were performed on the teaching process and implementation effects. By continuously optimizing course design, adjusting teaching strategies, and improving the autonomy and learning efficiency of students, the system can be used to improve teaching effectiveness and quality. This system provides a reference for information technology-based teaching reform in similar courses.

Objective:To investigate the effects of combination therapy with aqueous extract of corn silk(CS)and training on exercise capacity and glycolipid metabolism in mice with metabolic syndrome(MS).Methods:In this study,db/db mice were used as the animal model of MS.The mice were administered aqueous extract of CS via gavage and subjected to different intensities of training for 12 weeks(3 months).The specific experimental design was as follows:24 db/db mice were randomly divided into four groups on average:negative control group(NC),aqueous extract of CS group(CS),aqueous extract of CS+moderate-intensity training group(CS+MT),and CS aqueous extract of CS+high-intensity training group(CS+HT).The maximum running speed,forelimb grip strength,body weight and fasting blood glucose of mice were measured before and after treatment.After the intervention,oral glucose tolerance test(OGTT)and insulin tolerance test(ITT)were conducted to assess glucose metabolism,while serum triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)levels were measured to evaluate lipid metabolism.Results:After 3 months of intervention,there were significant differences in the maximum running speed and forelimb grip strength among the four groups(P＜0.05).The maximum running speed and forelimb grip strength of CS group,CS+MT group and CS+HT group were higher than those of NC group(P＜0.05).The CS+MT group exhibited higher forelimb grip strength,and the CS+HT group showed higher maximum running speed and forelimb grip strength compared to the CS group(P＜0.05),while no significant difference was found between the CS+MT and CS+HT groups(P＞0.05).Significant differences in body weight were observed among the four groups after 3 months of intervention(P＜0.05).Specifically,the CS+MT and CS+HT groups exhibited significantly lower body weight compared to both the NC and CS groups(P＜0.05),with the CS+MT group having the lowest body weight(P＜0.05).Fasting blood glucose levels also differed significantly among the groups after 2 and 3 months of intervention(P＜0.05).The CS,CS+MT,and CS+HT groups had lower fasting blood glucose levels compared to the NC group(P＜0.05),with the CS+MT and CS+HT groups showing the lowest levels(P＜0.05).No significant difference was found between the CS+MT and CS+HT groups(P＞0.05).After 3 months of intervention,significant differences in the area under the curve(AUC)of OGTT and ITT were observed among the four groups(P＜0.05).The AUC of OGTT and ITT were significantly lower in the CS,CS+MT,and CS+HT groups compared to the NC group(P＜0.05).The CS+MT and CS+HT groups exhibited the lowest AUC values for both OGTT and ITT(P＜0.05),with the CS+MT group showing the lowest AUC for OGTT(P＜0.05).Significant differences in serum lipid levels were observed among the four groups after 3 months of intervention(P＜0.05).TG,TC,and LDL-C levels were significantly lower,while HDL-C levels were higher in the CS,CS+MT,and CS+HT groups compared to the NC group(P＜0.05).The CS+MT group had the lowest TG levels and the highest HDL-C levels compared to the CS+HT group(P＜0.05),with no significant differences in TC and LDL-C levels between these two groups(P＞0.05).Conclusion:Aqueous extract of CS combined with different intensity training can significantly improve the exercise capacity and glycolipid metabolism of MS mice and reduce body weight,especially CS combined with MT treatment is more effective in improving lipid metabolism.In addition,when combined with HT,aqueous extract of CS can also play an auxiliary role in reducing the side effects of high-intensity exercise and improving the therapeutic effect.

Enhancer of zeste homolog 2(EZH2)is a histone methyltransferase It mediates trimethylation of lysine 27 on histone H3,thereby facilitating the epigenetic silencing of downstream genes.In conjunc-tion with SUZ12,EED,and other components,it constitutes the polycomb repressive complex 2(PRC2)complex.While EZH2 is intricately involved in cellular proliferation and cardiac development,the chan-ges in its expression during cardiac terminal differentiation remain elusive.In this study,we employed differential gene expression analysis of embryonic and adult myocardial cells using the GEO database,and found that EZH2 is highly expressed in embryonic myocardium,but is present at very low levels in adult myocardium(P＜0.0001).Conversely,the expression changes of PRC2 members SUZ12 and EED are not as pronounced.Online analysis through the Tabula Muris database indicates that under physiological conditions,various cell subpopulations in the adult mouse heart exhibit negligible expression of EZH2.Immunohistochemical staining of mouse cardiac tissues shows that EZH2 is highly expressed in embryonic and neonatal myocardium but declines progressively from the first day after birth(P＜0.0001),becoming almost undetectable by the third day.Western blotting further confirms the rapid disappearance of EZH2 expression post-birth(P＜0.05),with EZH1 compensating for the downregulation of EZH2 to maintain H3K27me3 modification levels.Additionally,using the P19 teratocarcinoma stem cell model for cardio-myocyte differentiation,it is observed that EZH2 is significantly upregulated during the transition from cardiac progenitor cells to spontaneously beating cardiomyocytes,correlating with the expression of the cardiomyocyte transcription factor Gata4(P＜0.01).Targeted degradation of EZH2 using the small mole-cule drug MS1943 significantly inhibits the proliferation of induced cardiomyocytes,as evidenced by 5-e-thynyl-2'-deoxyuridine(EdU)incorporation assays(P＜0.01),and RT-qPCR reveals a marked in-crease in the expression of the proliferation inhibitor CDKN1A(P＜0.01).In summary,the high expres-sion of EZH2 in embryonic myocardial cells is associated with enhanced cell proliferation.The rapid loss of EZH2 expression postnatally correlates with the loss of proliferative capacity in cardiomyocytes,mark-ing it as a key indicator of cardiac terminal differentiation.

Occlusal reconstruction is an important method of restoring a normal occlusal relationship to the natural dentition.The cor-rect choice of lateral occlusion scheme is necessary for physiological occlusal reconstruction.The main lateral occlusion schemes for the occlusal reconstruction of the natural dentition are canine protection and group function.This article reviews the effects of lateral occlu-sion schemes on the stomatognathic system and factors affecting the choice of lateral occlusion schemes in the occlusal reconstruction of natural dentition.According to the literature review,the lateral occlusion schemes affect the physiological functions of the stomatognath-ic system.Both lateral occlusion schemes have less impact on the temporomandibular joint.Group function produces greater EMG activi-ty,jaw movement velocity,and jaw lateral freedom than canine protection.The lateral occlusion schemes of the natural dentition should be selected according to the degree of lateral movement,types of static occlusion,and age of patients.For patients with Angle's ClassⅢ malocclusion,skeletal Class Ⅱ,Ⅲ malocclusion,and the elderly,group function is recommended,while canine protection is more recommended for young adults.For patients who eventually need to achieve canine protection,it is recommended to design group func-tion in the early stage of lateral movement,and gradually transition to canine protection with the increase of lateral movement.Thus,clinicians need to fully understand the influencing factors of lateral occlusion selection during occlusal reconstruction in natural denti-tion,providing a basis for the development of personalized diagnostic and treatment plans.

Occlusal reconstruction is an important method of restoring a normal occlusal relationship to the natural dentition.The cor-rect choice of lateral occlusion scheme is necessary for physiological occlusal reconstruction.The main lateral occlusion schemes for the occlusal reconstruction of the natural dentition are canine protection and group function.This article reviews the effects of lateral occlu-sion schemes on the stomatognathic system and factors affecting the choice of lateral occlusion schemes in the occlusal reconstruction of natural dentition.According to the literature review,the lateral occlusion schemes affect the physiological functions of the stomatognath-ic system.Both lateral occlusion schemes have less impact on the temporomandibular joint.Group function produces greater EMG activi-ty,jaw movement velocity,and jaw lateral freedom than canine protection.The lateral occlusion schemes of the natural dentition should be selected according to the degree of lateral movement,types of static occlusion,and age of patients.For patients with Angle's ClassⅢ malocclusion,skeletal Class Ⅱ,Ⅲ malocclusion,and the elderly,group function is recommended,while canine protection is more recommended for young adults.For patients who eventually need to achieve canine protection,it is recommended to design group func-tion in the early stage of lateral movement,and gradually transition to canine protection with the increase of lateral movement.Thus,clinicians need to fully understand the influencing factors of lateral occlusion selection during occlusal reconstruction in natural denti-tion,providing a basis for the development of personalized diagnostic and treatment plans.

Sepsis is a life-threatening organ dysfunction disease caused by a dysregulated host response to infection.It has com-plex pathophysiological changes,and in severe cases,it can rap-idly develop into septic shock and multiple organ dysfunction or multiple organ failure.At present,the pathological mechanism of sepsis and its induced organ dysfunction is complex and the in-fluencing factors are numerous.So far,there is still a lack of specific and effective treatment strategies.RNA modify-N6-methyladenosine(m6 A)is one of the most common post-tran-scriptional modifications on eukaryotic RNAs.It is involved in the regulation of the occurrence and development of a variety of inflammatory diseases,including sepsis,and even multiple organ dysfunction induced by sepsis by affecting the metabolism of RNAs.It includes cardiac dysfunction,acute lung injury(ALI)and acute kidney injury(AKI).Therefore,this article will dis-cuss the effect of m6A modification on the function of immune cells,and its important role in sepsis and its induced multiple or-gan dysfunction diseases by regulating inflammatory signals,py-roptosis,mitochondrial damage and ferroptosis.This will provide new therapeutic targets and strategies for the clinical prevention and treatment of sepsis and its induced multiple organ dysfunc-tion diseases.