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 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.

The mortality and disability rates of intracranial aneurysm(IA)remain extremely high.CT angiography(CTA)has been widely used for first-line examination of IA,yet with limited diagnostic accuracy and time-consuming procedures.Artificial intelligence(AI)developed continuously in recent years,which could help to improve the accuracy of diagnosing IA and predicting its rupture.The research progresses of AI in CT A evaluating IA were reviewed in this article.

The main tasks of artificial intelligence(AI)for intracranial aneurysms included automated detection,rupture risk assessment,and prognosis assessment.Effective application of AI technology could improve efficiency of detecting intracranial aneurysm and enhance the ability of risk stratification.The current status and challenges of clinical application of AI in intracranial aneurysms were reviewed in this article.

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.

The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

The mortality and disability rates of intracranial aneurysm(IA)remain extremely high.CT angiography(CTA)has been widely used for first-line examination of IA,yet with limited diagnostic accuracy and time-consuming procedures.Artificial intelligence(AI)developed continuously in recent years,which could help to improve the accuracy of diagnosing IA and predicting its rupture.The research progresses of AI in CT A evaluating IA were reviewed in this article.

The main tasks of artificial intelligence(AI)for intracranial aneurysms included automated detection,rupture risk assessment,and prognosis assessment.Effective application of AI technology could improve efficiency of detecting intracranial aneurysm and enhance the ability of risk stratification.The current status and challenges of clinical application of AI in intracranial aneurysms were reviewed in this article.

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.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.