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.

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.

Objective To explore the efficacy of fixed-loop fixation and adjustable-loop fixation in arthroscopic anterior cruciate ligament(ACL)reconstruction with excessively short femoral tunnel.Methods A total of 493 patients undergoing ACL reconstruction at our hospital from January 2019 to July 2020 were reviewed,including 57 patients with femoral tunnel＜30 mm and 47 patients ultimately included.According to the fixation method,they were divided into EndoButton group(n=31)and TightRope group(n=16).The International Knee Documentation Committee(IKDC)score,Lysholm score,and Tegner score were used to evaluate joint function at 6 and 12 months postoperatively,respectively.The Lachman test and anterior drawer test were used to evaluate joint laxity at 12 months postoperatively.The clinical effects of the two fixation methods were compared.Results At 6 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(64.1±11.0)points and(62.6±9.2)points,respectively,with no significant difference(t=0.464,P=0.645).The Lysholm scores were(81.9±10.6)points and(85.3±9.3)points,with no significant difference(t=-1.079,P=0.286).The Tegner scores were(2.2±0.9)points and(1.9±0.9)points,with no statistically significant difference(t=0.933,P=0.356).At 12 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(81.4±9.3)points and(78.2±9.2)points,with no statistically significant difference(t=1.068,P=0.291).The Lysholm scores were(94.6±6.1)points and(93.4±7.4)points,with no statistically significant difference(t=0.626,P=0.534).The Tegner scores were(3.8±1.0)points and(3.4±1.2)points,with no statistically significant difference(t=1.402,P=0.168).There was no significant difference in the Lachman test and front drawer test between the two groups at 12 months after surgery(Z=-0.039,P=0.969;Z=-0.294,P=0.769).Conclusion In arthroscopic ACL reconstruction surgery,both EndoButton(15 mm)and TightRope can achieve good clinical results for excessively short femoral tunnel(＜30 mm).

Objective To explore the efficacy of fixed-loop fixation and adjustable-loop fixation in arthroscopic anterior cruciate ligament(ACL)reconstruction with excessively short femoral tunnel.Methods A total of 493 patients undergoing ACL reconstruction at our hospital from January 2019 to July 2020 were reviewed,including 57 patients with femoral tunnel＜30 mm and 47 patients ultimately included.According to the fixation method,they were divided into EndoButton group(n=31)and TightRope group(n=16).The International Knee Documentation Committee(IKDC)score,Lysholm score,and Tegner score were used to evaluate joint function at 6 and 12 months postoperatively,respectively.The Lachman test and anterior drawer test were used to evaluate joint laxity at 12 months postoperatively.The clinical effects of the two fixation methods were compared.Results At 6 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(64.1±11.0)points and(62.6±9.2)points,respectively,with no significant difference(t=0.464,P=0.645).The Lysholm scores were(81.9±10.6)points and(85.3±9.3)points,with no significant difference(t=-1.079,P=0.286).The Tegner scores were(2.2±0.9)points and(1.9±0.9)points,with no statistically significant difference(t=0.933,P=0.356).At 12 months postoperatively,the IKDC scores of the EndoButton group and TightRope group were(81.4±9.3)points and(78.2±9.2)points,with no statistically significant difference(t=1.068,P=0.291).The Lysholm scores were(94.6±6.1)points and(93.4±7.4)points,with no statistically significant difference(t=0.626,P=0.534).The Tegner scores were(3.8±1.0)points and(3.4±1.2)points,with no statistically significant difference(t=1.402,P=0.168).There was no significant difference in the Lachman test and front drawer test between the two groups at 12 months after surgery(Z=-0.039,P=0.969;Z=-0.294,P=0.769).Conclusion In arthroscopic ACL reconstruction surgery,both EndoButton(15 mm)and TightRope can achieve good clinical results for excessively short femoral tunnel(＜30 mm).

Migraine is a complex disorder of brain function. The hypothalamus has been identified to play a crucial role in attack generation and secretes various neuropeptides. The orexinergic system plays a role in energy metabolism, arousal, sleep, stress and pain modulation. These disorders are closely related to clinical symptoms of migraine. Therefore, the study of the mechanism of hypothalamic orexinergic system in migraine may provide a new perspective for treatment. This article discusses the relationship between hypothalamic orexin system and migraine premonitory symptoms, and briefly summarizes the possible role and mechanism of hypothalamic orexin system in migraine.

Objective:To investigate the application value of early and late interventional embolization in intracranial aneurysms.Methods:Eighty-two patients with intracranial aneurysm who received treatment in Wenzhou People's Hospital from October 2015 to February 2020 were included in this study. These patients were divided into early (≤ 3 days) and late (> 3 days) groups, with 41 patients in each group, according to time from disease onset to surgery. The early group was subjected to early interventional embolization, and the late group was treated with late interventional embolization. The effects of embolization and National Institutes of Health Stroke Scale score pre- and post-treatment, as well as modified Barthel index, Mini-Mental State Exam score, matrix metalloproteinase-9 level, and soluble intercellular adhesion molecule-1 level post-treatment and prognosis were compared between the two groups.Results:The embolization effects in the early group were statistically superior to those in the late group ( P = 0.046). After treatment, National Institutes of Health Stroke Scale score in the early group was significantly lower than that in the late group [(4.02 ± 1.64) points vs. (6.81 ± 2.02) points, t = 6.86, P < 0.01]. Mini-Mental State Exam score and modified Barthel index in the early group were (28.09 ± 1.35) points and (81.12 ± 9.67) points, respectively, which were significantly higher than (26.01 ± 1.19) points and (73.02 ± 8.19) points in the late group ( t = 7.40, 4.09, both P < 0.001). After treatment, matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels in the early group were (420.33 ± 29.40) μg/L and (403.70 ± 23.28) ug/L, respectively, which were significantly lower than (491.30 ± 31.19) μg/mL and (496.37 ± 30.46) μg/L in the late group ( t = 10.60, 15.47, both P < 0.001). Prognosis in the early group was superior to that in the late group ( P = 0.049). Conclusion:Early interventional embolization has better efficacy than late interventional embolization in the treatment of intracranial aneurysm. The former can effectively improve neurological function and mental state, enhance living ability, and improve prognosis, which may be related to the regulation of matrix metalloproteinase-9 and soluble intercellular adhesion molecule-1 levels.

Objective To understand the primary structure and potential antigenic epitopes of antigen Pf332(Ag332) of P.falciparum iso late FCC1/HN.Methods　Based on the published Pf332 gene sequence , nine pairs of primers were designed for the PCR amplification of the Pf332 gen e fragments from genomic DNA of P.falciparum isolate FCC1/HN. The amplified gene fragments were subcloned into pMD-18T vectors and sequenced. The sequences were aligned using DNAstar software to obtain the full-length sequence of the gene Pf332. The primary structure and sequence homology of Ag332 were analyzed by SAPS, Tmpred, SingalP and Blastn programs. Three fragments, R0, R1 and R2, cor responding to nt#9595-10083, nt#10339-10767 and nt#10855-11247 of Pf332 gene were subcloned into the eukaryotic expression vector pcDNA3-S separately. The Balb/c mice were immunized with pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3- S-R2 separately, and the expressions of the recombinant proteins were detected by immunohistochemistry assay. The protective immune responses elicited by DNA I mmunization were analyzed by ELISA and parasite growth inhibition tests in vitro .Results　Nine Pf332 gene fragments were specifically amplif ied, subcloned into pMD-18T vectors and sequenced. Pf332 gene of the P.falci parum isolate FCC1/HN was 16,377 bp in length, encoding a protein of 5,458 ami no acids, about 615.28kDa. The Ag332 contains 17 regions of highly degenerated Glu-rich repeats, with 30.18% Glu in total amino acids of Ag332. Ag332 of P.falciparum isolate FCC1/HN and 3D7 exhibited 94.55 % homology in amino acid residues. The results of immunohischemistry assay showed that R0, R1 and R2 were expressed in mice muscle tissue. The amount of IgG antibody of the groups immu nized with pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3-S-R2 were higher than those of blank and pcDNA3 groups (P＜0.05). The result of parasite growth inhibition test showed that the immunized sera at 1∶5 dilution of groups of pcDNA3-S-R0, pcDNA3-S-R1 and pcDNA3-S-R2 had an incomplete inhibitor y effect on P.falciparum growth. Conclusion　The antigen Pf332 is an large protein containing highly degenerated Glu-rich repeats. Pf332 gene fragments, R1 and R2 encoding potent antigenic epitope repeats.