OBJECTIVE To investigate the predictive value of the advanced lung cancer inflammation index(ALI)for postoperative pharyngocutaneous fistula,recurrence,metastasis,and prognosis in patients with laryngeal squamous cell carcinoma(LSCC).METHODS This retrospective study analyzed the clinical data of 114 LSCC patients treated at Huangshi Central Hospital between January 2014 and December 2023.The data included tumor staging,ALI scores,age,gender,smoking history,alcohol history,diabetes,hypertension,hyperlipidemia,coronary heart disease,tumor differentiation,HPV infection,and tumor location.Based on the occurrence of pharyngocutaneous fistula,the patients were divided into the fistula group(10 cases)and the non-fistula group(104 cases).Single-factor and multi-factor logistic regression analyses were conducted to identify independent factors associated with postoperative pharyngocutaneous fistula.Patients were also classified into recurrence and metastasis groups(22 cases)and non-recurrence groups(92 cases),and further into poor prognosis(25 cases)and good prognosis groups(89 cases)based on follow-up results.Cox regression analysis was performed to identify factors influencing recurrence,metastasis,and prognosis.RESULTS Multivariate logistic regression analysis showed that tumor stage(stage Ⅰ-Ⅱ)[HR:0.040(95％CI:0.004-0.392)]and ALI score[HR:0.885(95％CI:0.805-0.972)]were independent protective factors for the occurrence of pharyngeal fistula(P<0.05).Multivariate Cox regression analysis further confirmed that tumor stage(stage Ⅰ-Ⅱ)[OR:0.180(95％CI:0.063-0.518)]and ALI score[OR:0.970(95％CI:0.939-0.992)]were independent protective factors for recurrence,metastasis,and poor prognosis(P<0.05).ROC curve analysis revealed that the AUC for ALI in predicting pharyngeal fistula was 0.910(95％CI:0.849-0.970),with a cutoffvalue of 29.877,sensitivity of 0.827,and specificity of 1.000.The AUC for ALI in predicting recurrence and metastasis was 0.804(95％CI:0.698-0.910),with a cutoffvalue of 34.398,sensitivity of 0.920,and specificity of 0.618.CONCLUSION The ALI score is an independent protective factor for the occurrence of postoperative pharyngocutaneous fistula,recurrence,metastasis,and poor prognosis in LSCC patients.It is a valuable predictor for early warning of postoperative complications,recurrence,metastasis,and prognosis,with potential clinical utility in guiding personalized treatment strategies.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

Kidney cancer usually requires multidisciplinary individualized treatments. No matter what kind of treatment, drugs are essential. According to the "six-step process" (prescription legitimacy review, patient basic information evaluation review, treatment protocol review, organ function and laboratory index review, pretreatment review, and unconventional prescription review) in prescription review proposed by the anti-tumor drug prescription review expert group and referring to domestic and foreign kidney cancer guidelines and drug instructions in recent years, this consensus selects 9 targeted drugs and 4 immunotherapeutic drugs that are currently commonly used in China and elaborates the key review points in patient basic information evaluation review, treatment protocol review, and organ function and laboratory index review of kidney cancer drug treatment, in order to provide reference for clinical front-line pharmacists to review prescriptions of kidney cancer patients and promote rational drug use in clinic.

A 3-year-old female proband presented with patchy follicular keratotic papules on the hairless scalp after birth. At about the age of 2 years, sparse hairs of non-uniform thickness began to grow, but they fell out intermittently and were broken easily. Some eyebrows and eyelashes of different lengths fell out or were broken. Physical examination revealed good condition of nutrition, normal height, weight and intelligence, with no obvious abnormalities in other systems. Skin examination showed sparse and broken hairs with follicular keratotic papules on the vertex and occiput. Teeth, nails, toenails and sweat glands were normal. Dermoscopy, optical microscopy and scanning electron microscopy all showed that affected hairs gave a beaded appearance. Gene sequencing showed that the proband carried heterozygous deletions of exons 2-16 in the desmoglein 4 (DSG4) gene, and a heterozygous mutation c.574T>C (p.S192p) (NM-177986) in the DSG4 gene, which were inherited from her father and mother respectively. None of the above mutations in the DSG4 gene were found in 100 healthy controls. According to the gene sequencing results and clinical phenotype, the patient was finally diagnosed with autosomal recessive hereditary monilethrix, and the c.574T>C mutation and heterozygous deletions of exons 2-16 of the DSG4 gene may contribute to autosomal recessive hereditary monilethrix in the child.

Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology,neurology and GI clinics.Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening.Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9).The patients were divided into multiple somatic symptoms group (SOM+group,PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group,PHQ-15＜10).The detection rate of multiple somatic symptoms was calculated.Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic,course of disease,cumulative number of visits,and the total score of PHQ-9.Results The overall detection rate of multiple somatic symptoms was 32.67％ (489/1 497)in the three hospitals,and the highest was found in the department of digestive medicine (37.74％,191/506).There were significant differences in gender (x2=36.85,P＜0.01),working status (x2=19.78,P＜0.01),visiting department (x2=9.64,P＜0.01),first visiting/repeated visiting (x2=6.67,P＜0.01),and the total score of PHQ-9 (x2=231.52,P＜0.01).The detection rate of female patients was higher than that of male patients.The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients.The illness duration (r=0.07,P＜0.05,Bonferroni correction) and the total score of PHQ-9 (r=0.66,P＜0.05,Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15.Conclusions The detection rate of multiple somatic symptoms was high in general hospitals,especially highest in digestive outpatient clinics,and significantly higher in female,retired,unemployed,re-visited and patients who have depressive symptoms.Depressive symptoms and the illness duration were positively correlated with the severity of somatic symptoms.

Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology,neurology and GI clinics.Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening.Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9).The patients were divided into multiple somatic symptoms group (SOM+group,PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group,PHQ-15＜10).The detection rate of multiple somatic symptoms was calculated.Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic,course of disease,cumulative number of visits,and the total score of PHQ-9.Results The overall detection rate of multiple somatic symptoms was 32.67％ (489/1 497)in the three hospitals,and the highest was found in the department of digestive medicine (37.74％,191/506).There were significant differences in gender (x2=36.85,P＜0.01),working status (x2=19.78,P＜0.01),visiting department (x2=9.64,P＜0.01),first visiting/repeated visiting (x2=6.67,P＜0.01),and the total score of PHQ-9 (x2=231.52,P＜0.01).The detection rate of female patients was higher than that of male patients.The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients.The illness duration (r=0.07,P＜0.05,Bonferroni correction) and the total score of PHQ-9 (r=0.66,P＜0.05,Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15.Conclusions The detection rate of multiple somatic symptoms was high in general hospitals,especially highest in digestive outpatient clinics,and significantly higher in female,retired,unemployed,re-visited and patients who have depressive symptoms.Depressive symptoms and the illness duration were positively correlated with the severity of somatic symptoms.

A 22-year-old male patient visited the Department of Dermatology of the First Affiliated I Iospital of Zbengzhou University on October 31,2016 due to dark red papules,nodules,pustules and cysts on the face,neck,back and in the axillary and inguinal regions for 6 years,and multiple dark purple plaques and ulcers on bilateral lower limbs for 1 year.Six years ago,the patient was diagnosed with acne in other hospital,and no treatment was given.One year ago,multiple purple plaques occurred on the bilateral lower limbs,which then ruptured and progressed into ulcers with diameters of 1-12 cm.On May 9,2002,the patient visited the Department of Pediatric Medicine of the First Affiliated Hospital of Zhengzhou University due to the left knee joint swelling and pain for half a year.Laboratory examination showed negative rheumatoid factor,and smear examination of the left knee joint effusions revealed that there were neutrophils and a small amount of lymphocytes and monocytes in the joint effusions,and no abnormal cells were observed.Then,the patient was diagnosed with pyogenic arthritis of the left knee.Physical examination at admission showed poor general condition,walking difficulty,slightly increased blood pressure of 142/92 mmHg (1 mmHg =0.133 kPa),multiple purple plaques on the bilateral lower limbs with central ulcer formation.Histopathological examination of ulcer margin on the lower limbs showed ulceration,intercellular edema and infiltrating neutrophils in the epidermis,and edema,focal erythrocyte extravasation,diffuse infiltration of neutrophils,lymphocytes and histiocytes in the superficial and middle dermis.Clinical manifestations and pathological features confirmed a diagnosis of pyoderma gangrenosum.There were extensive inflammatory papules,pustules,abscesses and cysts on the face,neck,waist and back,and a small amount of dark red nodules on the axillary and inguinal regions,which were consistent with cystic acne and hidradenitis suppurativa.As PSTPIP1 gene sequencing showed,no mutations were found in exon fragments,while compound heterozygous mutations c.36 + 68 G ＞ A,c.137 + 47 G ＞ C and c.562 + 114 C ＞ G her were found in intron fragments.Among 100 healthy controls,45 carried the same mutations.So,these mutation sites were considered to be polymorphic sites,and the pathogenicity of these mutations was still unclear.Finally,the patient was diagnosed with PAPASH syndrome.The patient was treated with methylprednisolone,cefminox,isotretinoin and thalidomide,and the lesions were markedly improved after 2 weeks.Now the patient was still followed up.

Objective To evaluate the short?term efficacy and safety of endoscopic photodynamic therapy ( PDT ) for esophageal squamous cell carcinoma ( ESCC ) and precancerous lesion. Methods Retrospective analysis was performed on 30 patients with early ESCC or precancerous lesions who received PDT between September 2013 and April 2015 in Endoscopy Center, Henan Tumor Hospital,and its indications were summarized. The main outcomes including histological complete response rate ( CR ) , recurrence rate and adverse events after treatment of one year were analyzed. Results Three patients with middle grade dysplasia( MGD) , 18 with high grade dysplasia( HGD) and 4 with squamous cell carcinoma in situ, all negative lymph node metastasis, received PDT. CRs were 72?0%(18/25) and 88?0%(22/25)after one PDT session in 3 months and 12 months, respectively. One?year follow?up showed 3 recurrences ( 12?0%) ,4 ( 16?0%) severe strictures, and no perforation. Five patients with advanced squamous cell carcinoma received palliative PDT. Partial remission rate was 60?0%( 3/5) after one PDT session in 3 months, and 40?0% ( 2/5) after 12 months. Two died of tumor metastasis, one died of gastrointestinal bleeding one year after PDT. No perforation occurred. Conclusion Endoscopic photodynamic therapy for esophageal squamous cell carcinoma and precancerous lesions is safe and feasible, with remarkable short?term effect. As for the patients with advanced squamous cell carcinoma, it is equally safe and effective in the short term.

Objective To explore the optimal cutoff point defining remission on 17-item Hamilton Depression Scale (HAMD17) for major depressive disorder (MDD),and examine the validity of this cutoff point.Method We interviewed 251 MDD responders with the HAMD17,Global Assessment of Functioning,Generic Quality of Life Inventory.Results After acute phase treatment for MDD,even the HAMD17 scored 7 or less,92.3％ (203/220) of remitters had at least one subthreshold depressive symptoms,48.6％ (107/220) of them also experienced functioning impairment,when psychosocial functioning taken into account,a cutoff of ≤ 3 might be the operational criterion of MDD remission.Compared to MDD patients scoring 4-14 on HAMD17,patients scoring 0-3 had significantly better psychological functioning,social functioning and physical functioning (separately 60.1 ± 15.4 vs.52.0 ± 12.3,62.0 ± 11.2 vs.54.0 ± 11.0,60.5±14.3vs.52.7±10.2; t=3.307,4.119,3.626,all P＜0.01).Compared to4-14 score group,the rate of ones with psychosocial functioning being normal in 0-3 score group was higher (74.2％ vs.12.6％ ; x2 =97.10,P ＜ 0.01).Conclusion The results indicate that patients with MDD whose score of ≤3 on HAMD17 after the acute phase treatment may have better psychosocial functioning than those whose score of ＞ 3,suggesting this criterion be valid.

Objective To explore the optimal cutoff point defining remission on 17-item Hamilton Depression Scale (HAMD17) for major depressive disorder (MDD),and examine the validity of this cutoff point.Method We interviewed 251 MDD responders with the HAMD17,Global Assessment of Functioning,Generic Quality of Life Inventory.Results After acute phase treatment for MDD,even the HAMD17 scored 7 or less,92.3％ (203/220) of remitters had at least one subthreshold depressive symptoms,48.6％ (107/220) of them also experienced functioning impairment,when psychosocial functioning taken into account,a cutoff of ≤ 3 might be the operational criterion of MDD remission.Compared to MDD patients scoring 4-14 on HAMD17,patients scoring 0-3 had significantly better psychological functioning,social functioning and physical functioning (separately 60.1 ± 15.4 vs.52.0 ± 12.3,62.0 ± 11.2 vs.54.0 ± 11.0,60.5±14.3vs.52.7±10.2; t=3.307,4.119,3.626,all P＜0.01).Compared to4-14 score group,the rate of ones with psychosocial functioning being normal in 0-3 score group was higher (74.2％ vs.12.6％ ; x2 =97.10,P ＜ 0.01).Conclusion The results indicate that patients with MDD whose score of ≤3 on HAMD17 after the acute phase treatment may have better psychosocial functioning than those whose score of ＞ 3,suggesting this criterion be valid.