Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.

The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.

Thymocyte selection-associated HMG box(TOX)is a DNA-binding transcription factor that involved in the deve-lopment of immune cells.Several studies have shown that TOX is a critical regulator of T cell exhaustion,and associated with the de-velopment of tumorigenesis,suggesting that TOX may be a potential immune biomarker and target for immunotherapy for malignant tu-mors.In this review,we review the molecular mechanisms and reversals of TOX mediated T cell depletion and provide evidence for the design of more accurate tumor immunotherapy strategies based on TOX.

Objective To observe the effect of a new cell delivery tool(MSC exo)on the proliferation of pancreatic cancer by transferring targeted genes.Methods Transmission Electron Microscope(TEM)and Nanoparticle Tracking Analysis(NTA)were used to identify human mesenchymal stem cell exosomes(MSC-exo)and transport miR-450a-5p into CFPAC-1,to explore the effect of miR-450a-5p targeting BZW2 on inhibiting the proliferation of pancreatic cancer cells.Results The expression of miR-450a-5p was low in pancreatic cancer tissue(P<0.05),and the expression of CD63 and TSG101 of MSC-exo-miR-450a-5p in CFPAC-1 cells was higher than that of MSC-exo by Western blot(P<0.05).CCK-8 and EdU results showed that MSC-exo-miR-450a-5p significantly inhibited the proliferation of CFPAC-1 cells(P<0.05).Cell scratch and Transwell experiments showed that MSC-exo-miR-450a-5p can inhibit the migration and invasion of CFPAC-1 cells(P<0.05).Through dual luciferase assay,it was confirmed that miR-450a-5p targets BZW2,and RT-qPCR and Western blotting showed a negative correlation(P<0.05)between miR-450a-5p and BZW2 expression.Overexpression of BZW2,CCK-8,EdU,cell scratch,and Transwell experiments confirmed that pc-BZW2 reversed the anti-cancer function of MSC-exo-miR-450a-5p on CFPAC-1.Western blot detected PCNA,Ki-67,MMP2,MMP9,and the results were consistent with the above experiments(P<0.05).Conclusion hMSC exo is a new delivery system,targeting BZW2 to transport miR-450a-5p to inhibit the biological malignancy of pancreatic cancer cells,which provides an important clue for the research of targeted treatment of pancreatic cancer.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Objective: To investigate the association of parental weight related knowledge, attitude and practice (KAP) with abdominal obesity among primary and middle school students and to provide evidence for related intervention measures. Methods: In September 2013, the multistage random sampling method was used to select 17 307 primary and secondary school students with normal waist circumference in seven provinces/municipalities in China. After nine month follow up, 14 118 students aged 6-18 years were included in the final analysis. Questionnaires were used to assess parental weight related KAP, and students’ waist circumference was measured objectively at baseline and follow up. Multiple linear regression and multivariate Logistic regression were conducted to analyze the relationship between parents’ KAP with the change of students waist circumference and abdominal obesity, respectively. Results: The nine month cumulative incidence of pre and abdominal obesity among students was 6.67% and 0.85%, respectively. The scoring rates of parents knowledge, attitude and practice were 80.17%, 78.17%, 50.50%, respectively. The score of parents weight related attitude was inversely associated with the changes of waist circumference ( β=-0.18, 95%CI = -0.26- -0.10) and cumulative incidence of pre and abdominal obesity ( OR=0.90, 95%CI =0.82-0.98)( P <0.05). Conclusion Parental positive and correct weight related attitude is inversely associated with the incidence of abdominal obesity among children and adolescents. Interventions targeting establishing parents correct beliefs may be an effective way to prevent abdominal obesity in children and adolescents.

Objective: To gain a better understanding of the emotional and behavioral problems associated determinants of primary and middle school students from Guangdong Province during the COVID-19 pandemic, so as to provide a basis for developing targeted intervention strategies. Methods: Using the method of convenience sampling, an online questionnaire survey was carried out among primary and middle school students from Guangzhou, Zhanjiang and Zhongshan from March to April 2020. The emotional and behavioral problems of primary and middle school students were assessed using the Conners Parental Symptoms Questionnaire(PSQ), and a self compiled questionnaire was used to collect basic information related to the primary and middle school students and the influencing factors of emotional and behavioral problems. A total of 7 755 valid questionnaires were retrieved and statistically analyzed using the chi square test and multivariate Logistic regression. Results: The detection rate of emotional and behavioral problems among children and adolescents aged 6 to 17-years-old in Guangdong Province was 14.8%; that was 21.0%, 14.4%, 7.3 %, and 10.1% in lower primary school students, upper primary school students, junior high school students, and high school students, respectively. The detection rate of the psychosomatic and hyperactivity index in boys was higher than that observed in girls, and the detection rate of anxiety in boys was lower than that observed in girls( P <0.05). There were statistically significant differences in emotional and behavioral problems in children in different grades( P <0.05). The results of the regression analysis showed that male students were at risk of psychosomatic ( OR= 1.37 , 95%CI =1.04-1.82) and hyperactivity disorders( OR=1.58, 95%CI =1.21-2.06), whereas the male gender was a protective factor for anxiety( OR=0.50, 95%CI =0.39-0.64). Grades were identified as the influencing factors of all of the factors related to emotional and behavioral problems. Students who reported excessive screen time and insufficient sleep were more likely to experience emotional and behavioral problems. Conclusion The detection rate of emotional and behavioral problems among primary and middle school students in Guangdong Province during the COVID-19 epidemic was high, which was associated with sex, grade, screen time and sleep. It is necessary to develop and implement targeted intervention measures.

: To investigate the current status of online classes, screen time and its influencing factors among primary school students in Guangdong during the 2019 novel coronavirus pandemic. Methods: Using the convenience sampling method, a total of 5 266 pupils aged 6-12-years-old from Guangzhou, Zhanjiang, and Zhongshan participated in the online questionnaire. ANOVA or chi square tests were performed to compare differences in online classes and screen time between grades, and multinomial Logistic regression was performed to analyze the correlates of recreational screen time. Results: The prevalence of prolonged recreational screen time was 42.2% and 55.2% on weekdays and weekends, respectively. Recreational screen time increased by 40.31 min/d on weekdays and 33.07 min/d on weekends, compared to usual school semesters. The average duration of an online class was (26.07±9.62) min, which totaled (110.41±51.98)min per day. Sex, grade, being the only child, and parents education levels were identified as the influencing factors of prolonged recreational screen time. Children who practiced moderate levels (weekdays: OR =1.27; weekends: OR =1.40; P <0.05) or lower levels of physical activity (weekdays: OR =1.86; weekend: OR =1.84; P < 0.05 ) were at a higher risk of prolonged recreational screen time than those who practiced more vigorous physical activity. Children whose parents limited their screen time to a moderate (weekdays: OR=1.61, P <0.05) or lower level (weekdays: OR=1.32, P < 0.05 ) had a higher risk of prolonged recreational screen time than those with a higher frequency. Children with parents recreational screen time ≥ 2 h/d had a higher risk of prolonged recreational screen time than the reference group; children who exhibited moderate to vigorous levels of physical activity <1 h/d (weekdays: OR=1.31, P <0.05), and those used electronic devices for learning 1-2 h/d (weekdays: OR =2.65; weekend: OR =2.65; P <0.05) or for ≥2 h/d (weekdays: OR =4.05, weekend: OR=5.24, P < 0.05 ) were at a higher risk of prolonged recreational screen time than the reference group. Conclusion During the COVID-19 pandemic, the level of screen time among children in Guangdong was high. Behavioral monitoring and targeted interventions are needed to promote children s health.

Objective:To explore the efficacy of small incision open reduction and internal fixation and arthroscopic high strength non-absorbable suture in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL).Methods:The clinical data of 72 patients with ACL tibial avulsion fracture treated in Shantou Central Hospital from April 2018 to April 2020 were analyzed retrospectively. The patients were randomly divided into control group ( n=36) and experimental group ( n=36). The control group was treated with small incision open reduction and internal fixation and the experimental group was treated with high intensity non-absorbable suture under arthroscopy. The general data, surgical indexes and postoperative adverse reactions of the two groups were compared, and the knee joint function indexes of the two groups before and after treatment were compared and evaluated by random walking model. The counting data were expressed by percentage, the comparison between groups was expressed by chi-square test, the measurement data was expressed by mean ±standard deviation, the independent t-test was used for inter-group comparison, and the paired t-test was used for intra-group comparison. Results:There was no significant difference in general information, intraoperative blood loss, preoperative Lysholm score, IKDC score, Tegner score, knee mobility, and bilateral tibial displacement distance between the two groups of patients ( P>0.05). In the experimental group, the operation time, hospitalization time, the first postoperative time to move to the ground, bone healing time, and the total incidence of adverse reactions were (68.41±7.65) min, (11.93±3.24) d, (6.37±1.85) d, (23.65± 2.28) weeks, 2.78% (1/36), the control group were (55.37±8.62) min, (13.45±2.96) d, (8.16±2.08) d, (25.79±2.46) weeks, 22.22% (8/36), the difference between the two groups was statistically significant ( P<0.05). The Lysholm score, IKDC score, Tegner score, range of motion of the knee joint, and the difference of bilateral tibial displacement distance after treatment in the experimental group were (85.27±5.28) points, (85.43±1.74) points, and (6.65±1.41) points, respectively. (108.45±5.79)°, (1.12±0.65) mm, the control group was (79.73±4.69) points, (80.37±1.59) points, (5.72±1.31) points, (97.58±5.42)°, (2.24±0.72) mm, the difference between the two groups was statistically significant ( P<0.05). Random walking model evaluation the improvement of knee joint function in the experimental group was significantly better than that in the control group. Conclusion:Arthroscopic treatment of ACL tibial avulsion fracture with high-intensity non-absorbable suture can significantly improve the knee joint function of patients with rapid recovery and high safety, so it has a broad prospect of clinical application.