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 value of morphological and hemodynamic parameters of CT angiography(CTA)for predicting recurrence of intracranial aneurysms(IA)after endovascular embolization.Methods Totally 205 patients with ruptured IA who underwent endovascular embolization were retrospectively collected and divided into recurrence group(n=35)and non-recurrence group(n=170)according to follow-up results after embolization.The morphological and hemodynamic parameters of IA in CTA before treatment were compared between groups.Variance inflation factor(VIF)was used to explore whether there was collinearity between morphological and hemodynamic parameters,and those without collinearity were included in univariate and multivariate logistic regression analysis to screen predictors of recurrence of IA after endovascular embolization.Two prediction models were constructed based on morphological parameters(model 1)and combination with hemodynamic parameters(model 2).Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of models.Results The maximum diameter,aneurysm neck width,maximum height,maximum vertical height and size ratio(SR)of IA in recurrence group were all higher than those in non-recurrence group(all P＜0.05),while gradient oscillatory number(GON)in recurrence group was lower than that in non-recurrence group(P＜0.05).The neck width,SR,pressure at IA neck plane,intra-aneurysm time-averaged wall shear stress(TAWSS),oscillatory shear index(OSI)and GON had no significant collinearity(all VIF＜10),among which the neck width,SR and TAWSS were all independent predictors(all P＜0.05).AUC of model 1 and model 2 for predicting recurrence of IA after endovascular embolization was 0.668 and 0.723,respectively,which of model 2 was higher than which of model 1(integrated discrimination improvement index was 0.055,P=0.025).Conclusion CTA morphological parameters combined with hemodynamic parameters of IA could be used to predict its recurrence after endovascular embolization.

Objective:To explore the application value of extracellular volume fraction (ECVF) based on multi-phase CT images in the prognosis evaluation after radical resection of pancreatic cancer.Methods:Retrospective analysis of the clinical data of 119 patients with pancreatic ductal adenocarcinoma admitted to the First Affiliated Hospital of Wannan Medical College from January 2015 to December 2023, including 73 males and 46 females, aged 69 (62, 73) years. The clinical data including the patient's gender, age, imaging data, tumor major axis length, carbohydrate antigen (CA) 199, CA125 were collected. Based on multi-phase CT images, the ECVF of patients was calculated and subsequently 119 patients were divided into two groups according to the optimal cut-off value of ECVF: ECVF<0.31 group ( n=63) and ECVF≥0.31 group ( n=56). Postoperative survival information of patients was collected through telephone follow-up. The Kaplan-Meier method was used for survival analysis, and the log-rank test was applied for survival rate comparison. The Cox proportional hazards regression model was employed to analyze the impact of variables on overall survival time. Results:The differences in tumor location, tumor poor differentiation, and tumor major axis between the ECVF<0.31 group and the ECVF≥0.31 group were statistically significant (all P<0.05). The cumulative survival rates at 1, 3, and 5 years post-operation for patients in the ECVF<0.31 group were 34.7%, 10.3%, and 2.6%, respectively, while for patients in the ECVF≥0.31 group, they were 75.0%, 37.0%, and 25.6%, respectively. The cumulative survival rate after radical pancreatic cancer surgery for patients in the ECVF<0.31 group was lower than that for the ECVF≥0.31 group, and the difference is statistically significant ( χ2=24.50, P<0.001). Multivariate Cox analysis revealed that ECVF≥0.31 ( HR=0.25, 95% CI: 0.11-0.57), vascular invasion ( HR=2.43, 95% CI: 1.09-5.44), lymph node metastasis ( HR=3.01, 95% CI: 1.09-8.33), low tumor differentiation ( HR=2.32, 95% CI: 1.10-4.91), and lymphocyte count ≥1.25×10 9/L ( HR=0.31, 95% CI: 0.13-0.73) were risk factors affecting the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer (all P<0.05). Conclusion:ECVF based on multi-phase CT images has a predictive effect on the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer, and ECVF<0.31 is an independent risk factor for a short overall survival.

As a pivotal noninvasive diagnostic tool of coronary artery disease,coronary CT angiography(CCTA)has achieved remarkable advancements over the past four decades.From early electron beam CT to contemporary photon counting detector CT,CCTA technology has undergone continuous innovation,and its clinical applications expanded from pure anatomical assessment to a multidimensional comprehensive evaluation integrating anatomy,function and histology.The technological evolution clinical application status and future development directions of CCTA were reviewed in this article.

Microbial communities such as those residing in the human gut are highly diverse and complex, and many with important implications for health and diseases. The effects and functions of these microbial communities are determined not only by their species compositions and diversities but also by the dynamic intra- and inter-cellular states at the transcriptional level. Powerful and scalable technologies capable of acquiring single-microbe-resolution RNA sequencing information in order to achieve a comprehensive understanding of complex microbial communities together with their hosts are therefore utterly needed. Here we report the development and utilization of a droplet-based smRNA-seq (single-microbe RNA sequencing) method capable of identifying large species varieties in human samples, which we name smRandom-seq2. Together with a triple-module computational pipeline designed for the bacteria and bacteriophage sequencing data by smRandom-seq2 in four human gut samples, we established a single-cell level bacterial transcriptional landscape of human gut microbiome, which included 29,742 single microbes and 329 unique species. Distinct adaptive response states among species in Prevotella and Roseburia genera and intrinsic adaptive strategy heterogeneity in Phascolarctobacterium succinatutens were uncovered. Additionally, we identified hundreds of novel host-phage transcriptional activity associations in the human gut microbiome. Our results indicated that smRandom-seq2 is a high-throughput and high-resolution smRNA-seq technique that is highly adaptable to complex microbial communities in real-world situations and promises new perspectives in the understanding of human microbiomes.
Humans ; Gastrointestinal Microbiome/genetics* ; Bacteriophages/physiology* ; High-Throughput Nucleotide Sequencing ; Sequence Analysis, RNA/methods* ; Bacteria/virology*

Objective: To investigate the efficacy，safety and feasibility of regional lymph node dissection in laparoscopic radical surgery for bladder cancer under the guidance of indocyanine green fluorescence imaging. Methods: A total of 30 patients with muscle invasive bladder cancer (T2/T3NxM0) who volunteered to enter the clinical trial were randomly divided into the indocyanine green imaging guided laparoscopic regional lymph node dissection group (n=15) and the standard pelvic lymph node dissection group (n=15).The number of positive lymph nodes，operation time，intraoperative bleeding volume，incidence of lymph leakage，and tumor recurrence and metastasis rate 2-year after surgery were collected. Results: The number of positive lymph nodes was (4.20±1.66) and (4.60±1.72) respectively in the indocyanine green and standard groups，with no statistically significant difference (P>0.05).There were no statistically significant difference in the tumor recurrence and metastasis rates 2-year after surgery between the two groups (P>0.05).However，the indocyanine green group had shorter operation time，less intraoperative bleeding volume，and lower incidence of lymphatic leakage than the standard group (P<0.05). Conclusion: Indocyanine green fluorescence imaging guided laparoscopic lymph node dissection has comparable clinical efficacy to standard lymph node dissection，but with fewer complications.

Objective:To understand the status of intestinal helminth infections in Lunan area of Shandong Province (Jining City, Rizhao City, Linyi City, Heze City, and Zaozhuang City), and provide scientific basis for formulating parasitic disease prevention and control strategies.Methods:From 2016 to 2023, a stratified sampling method was used to conduct surveillance in 33 counties (cities, districts, hereinafter referred to as counties) in Lunan area of Shandong Province. Each county was divided into five areas (east, south, west, north, and center), with one administrative village (community) selected from each area. And ≥200 permanent residents (aged ≥3 years old, having lived locally for ≥6 months) were sampled from each village (community), and one stool sample was collected from each participant. The Kato-Katz method (two slides per sample) was used for parasite detection, and the results were analyzed.Results:From 2016 to 2023, a total of 49 436 people were surveyed, including 23 861 males and 25 575 females, with an age range of 3 - 105 years old. The testing identified 687 intestinal helminth infections, with an overall infection rate of 1.39%. The predominant infection was whipworm (582 cases), with an infection rate of 1.18%; followed by roundworm and hookworm, with infection rates of 0.13% (62 cases) and 0.05% (23 cases) respectively; other types of helminths ( Clonorchis sinensis and pinworm) totaled 20 cases, with an infection rate of 0.04%. From 2016 to 2023, the annual intestinal helminth infection rates were 2.76% (201/7 292), 0.90% (56/6 327), 0.84% (52/6 200), 1.70% (124/7 282), 1.23% (88/7 133), 1.45% (104/7 150), 0.34% (17/5 058), and 1.46% (45/3 084), showing an overall downward trend (χ 2trend = 42.40, P < 0.001). The ≥60 age group had the highest intestinal helminth infection rate (2.39%, 323/13 489), while the 30 - 39 age group had the lowest rate (0.68%, 48/7 016). There was statistically significant difference in infection rates among different age groups (χ 2 = 172.25, P < 0.001). There was no statistically significant difference in infection rates between genders (χ 2 = 0.03, P = 0.862). Farmers had the highest infection rate (1.69%, 560/33 118), with statistically significant differences among different occupational groups (χ 2 = 64.88, P < 0.001). Those with primary school education or below had the highest infection rate (1.82%, 445/24 469), with statistically significant differences among different education levels (χ 2 = 64.93, P < 0.001). Conclusions:In Lunan area of Shandong Province, whipworm is the predominant intestinal helminth infection, with elderly people being the high-risk group. Although the intestinal helminth infection rate in this region remains at a low level, there is still a risk of transmission. Continuous surveillance is needed, along with strengthened prevention and control measures for key populations.

Objective:To understand the status of intestinal helminth infections in Lunan area of Shandong Province (Jining City, Rizhao City, Linyi City, Heze City, and Zaozhuang City), and provide scientific basis for formulating parasitic disease prevention and control strategies.Methods:From 2016 to 2023, a stratified sampling method was used to conduct surveillance in 33 counties (cities, districts, hereinafter referred to as counties) in Lunan area of Shandong Province. Each county was divided into five areas (east, south, west, north, and center), with one administrative village (community) selected from each area. And ≥200 permanent residents (aged ≥3 years old, having lived locally for ≥6 months) were sampled from each village (community), and one stool sample was collected from each participant. The Kato-Katz method (two slides per sample) was used for parasite detection, and the results were analyzed.Results:From 2016 to 2023, a total of 49 436 people were surveyed, including 23 861 males and 25 575 females, with an age range of 3 - 105 years old. The testing identified 687 intestinal helminth infections, with an overall infection rate of 1.39%. The predominant infection was whipworm (582 cases), with an infection rate of 1.18%; followed by roundworm and hookworm, with infection rates of 0.13% (62 cases) and 0.05% (23 cases) respectively; other types of helminths ( Clonorchis sinensis and pinworm) totaled 20 cases, with an infection rate of 0.04%. From 2016 to 2023, the annual intestinal helminth infection rates were 2.76% (201/7 292), 0.90% (56/6 327), 0.84% (52/6 200), 1.70% (124/7 282), 1.23% (88/7 133), 1.45% (104/7 150), 0.34% (17/5 058), and 1.46% (45/3 084), showing an overall downward trend (χ 2trend = 42.40, P < 0.001). The ≥60 age group had the highest intestinal helminth infection rate (2.39%, 323/13 489), while the 30 - 39 age group had the lowest rate (0.68%, 48/7 016). There was statistically significant difference in infection rates among different age groups (χ 2 = 172.25, P < 0.001). There was no statistically significant difference in infection rates between genders (χ 2 = 0.03, P = 0.862). Farmers had the highest infection rate (1.69%, 560/33 118), with statistically significant differences among different occupational groups (χ 2 = 64.88, P < 0.001). Those with primary school education or below had the highest infection rate (1.82%, 445/24 469), with statistically significant differences among different education levels (χ 2 = 64.93, P < 0.001). Conclusions:In Lunan area of Shandong Province, whipworm is the predominant intestinal helminth infection, with elderly people being the high-risk group. Although the intestinal helminth infection rate in this region remains at a low level, there is still a risk of transmission. Continuous surveillance is needed, along with strengthened prevention and control measures for key populations.

Objective To investigate the value of morphological and hemodynamic parameters of CT angiography(CTA)for predicting recurrence of intracranial aneurysms(IA)after endovascular embolization.Methods Totally 205 patients with ruptured IA who underwent endovascular embolization were retrospectively collected and divided into recurrence group(n=35)and non-recurrence group(n=170)according to follow-up results after embolization.The morphological and hemodynamic parameters of IA in CTA before treatment were compared between groups.Variance inflation factor(VIF)was used to explore whether there was collinearity between morphological and hemodynamic parameters,and those without collinearity were included in univariate and multivariate logistic regression analysis to screen predictors of recurrence of IA after endovascular embolization.Two prediction models were constructed based on morphological parameters(model 1)and combination with hemodynamic parameters(model 2).Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of models.Results The maximum diameter,aneurysm neck width,maximum height,maximum vertical height and size ratio(SR)of IA in recurrence group were all higher than those in non-recurrence group(all P＜0.05),while gradient oscillatory number(GON)in recurrence group was lower than that in non-recurrence group(P＜0.05).The neck width,SR,pressure at IA neck plane,intra-aneurysm time-averaged wall shear stress(TAWSS),oscillatory shear index(OSI)and GON had no significant collinearity(all VIF＜10),among which the neck width,SR and TAWSS were all independent predictors(all P＜0.05).AUC of model 1 and model 2 for predicting recurrence of IA after endovascular embolization was 0.668 and 0.723,respectively,which of model 2 was higher than which of model 1(integrated discrimination improvement index was 0.055,P=0.025).Conclusion CTA morphological parameters combined with hemodynamic parameters of IA could be used to predict its recurrence after endovascular embolization.

Objective:To explore the application value of extracellular volume fraction (ECVF) based on multi-phase CT images in the prognosis evaluation after radical resection of pancreatic cancer.Methods:Retrospective analysis of the clinical data of 119 patients with pancreatic ductal adenocarcinoma admitted to the First Affiliated Hospital of Wannan Medical College from January 2015 to December 2023, including 73 males and 46 females, aged 69 (62, 73) years. The clinical data including the patient's gender, age, imaging data, tumor major axis length, carbohydrate antigen (CA) 199, CA125 were collected. Based on multi-phase CT images, the ECVF of patients was calculated and subsequently 119 patients were divided into two groups according to the optimal cut-off value of ECVF: ECVF<0.31 group ( n=63) and ECVF≥0.31 group ( n=56). Postoperative survival information of patients was collected through telephone follow-up. The Kaplan-Meier method was used for survival analysis, and the log-rank test was applied for survival rate comparison. The Cox proportional hazards regression model was employed to analyze the impact of variables on overall survival time. Results:The differences in tumor location, tumor poor differentiation, and tumor major axis between the ECVF<0.31 group and the ECVF≥0.31 group were statistically significant (all P<0.05). The cumulative survival rates at 1, 3, and 5 years post-operation for patients in the ECVF<0.31 group were 34.7%, 10.3%, and 2.6%, respectively, while for patients in the ECVF≥0.31 group, they were 75.0%, 37.0%, and 25.6%, respectively. The cumulative survival rate after radical pancreatic cancer surgery for patients in the ECVF<0.31 group was lower than that for the ECVF≥0.31 group, and the difference is statistically significant ( χ2=24.50, P<0.001). Multivariate Cox analysis revealed that ECVF≥0.31 ( HR=0.25, 95% CI: 0.11-0.57), vascular invasion ( HR=2.43, 95% CI: 1.09-5.44), lymph node metastasis ( HR=3.01, 95% CI: 1.09-8.33), low tumor differentiation ( HR=2.32, 95% CI: 1.10-4.91), and lymphocyte count ≥1.25×10 9/L ( HR=0.31, 95% CI: 0.13-0.73) were risk factors affecting the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer (all P<0.05). Conclusion:ECVF based on multi-phase CT images has a predictive effect on the overall survival of patients with pancreatic ductal adenocarcinoma after radical resection of pancreatic cancer, and ECVF<0.31 is an independent risk factor for a short overall survival.