Esophageal cancer （EC） is a highly prevalent malignant tumor in China. The phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway， as one of the key oncogenic pathways， can promote the cell cycle progression， proliferation， migration， and invasion， induce chemoresistance， and inhibit apoptosis and autophagy of EC cells. Traditional Chinese medicine （TCM）， with the advantages of targeting multiple points with multiple components to delay cancer progression， can target the PI3K/Akt signaling pathway for EC treatment. This article preliminarily discusses the molecular mechanism and role of the PI3K/Akt signaling pathway in EC and elaborates on the specific targets and efficacy of TCM in treating EC through intervention in the PI3K/Akt signaling pathway in the past five years. TCM materials and extracts inhibiting the PI3K/Akt signaling pathway in EC include Borneolum， spore powder of Ganoderma lucidum without spore coat， extract of Celastrus orbiculatus， root extract of Taraxacum， and Bruceae Fructus oil emulsion. TCM active ingredients exerting the effect include flavonoids， terpenoids， saponins， phenols， polysaccharides， alkaloids， and other compounds. TCM compound prescriptions with such effect include Qige San， Huqi San， Xuanfu Daizhetang， Tongyoutang and its decomposed prescriptions， Liujunzi Tang， and Xishenzhi Formula. In addition， TCM injections such as Compound Kushen Injection and Kang'ai injection also inhibit the PI3K/Akt signaling pathway in EC. This paper summarizes the role of the PI3K/Akt signaling pathway in EC and the TCM interventions， aiming to provide reference for the research and clinical application of new drugs for EC.

Objective To explore the pathogenesis and prognostic factors of liposarcoma in the head and neck region, and simultaneously analyze the efficacy of different treatment regimens. Methods A retrospective analysis was performed on all patients with primary untreated head and neck liposarcoma who were diagnosed and underwent surgical treatment at our hospital from January 2008 to January 2024. All patients were monitored during follow-up, and their prognoses were analyzed using SPSS software. Results A total of 30 patients were included in the study. Liposarcoma accounted for up to 60% of the cases in the orbit, while the remaining liposarcomas were primarily located in various interspaces of the neck. Dedifferentiated liposarcoma was the most common type, comprising 33%, while myxoid pleomorphic liposarcoma was the rarest at 4%. The tumor pathological type (P<0.001) and Ki67 (P=0.014) significantly affected the tumor control rate. However, an analysis of disease-specific survival rates revealed no significant differences across various factors (all P>0.05). Conclusion The prognosis of head and neck liposarcoma is better compared to that of liposarcomas in other parts of the body. However, myxoid pleomorphic liposarcoma, pleomorphic fat sarcoma, and high Ki67 levels are indicators of poor prognosis. Additionally, postoperative adjuvant radiotherapy does not significantly enhance disease-specific survival rates.

Ischemic stroke (IS) is a globally life-threatening disease. Presently, few therapeutic medicines are available for treating IS, and rt-PA is the only drug approved by the US Food and Drug Administration (FDA) in the US. In fact, many agents showing excellent neuroprotection but no blood flow-improving activity in animals have not achieved ideal clinical efficacy, while thrombolytic drugs only improving blood flow without neuroprotection have limited their wider application. To address these challenges and meet the huge unmet clinical need, we have designed and identified a novel compound AAPB with dual effects of neuroprotection and cerebral blood flow improvement. AAPB significantly reduced cerebral infarction and neural function deficit in tMCAO rats, pMCAO rats, and IS rhesus monkeys, as well as displayed exceptional safety profiles and excellent pharmacokinetic properties in rats and dogs. AAPB has now entered phase I of clinical trials fighting IS in China.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Filamentous fungi represent an important group of eukaryotic microorganisms with diverse ecological functions and ubiquitous distribution in various ecosystems. Among them, many species are closely associated with agriculture, functioning as major plant pathogens that cause yield losses and produce mycotoxins to compromise both the quality and safety of agricultural products. In recent years, the CRISPR/Cas system has emerged as a powerful and programmable genome editing tool, and it has been extensively applied to the genetic study of plant pathogenic fungi. This technology has greatly facilitated the investigation of pathogenic mechanisms, mycotoxin biosynthetic pathways and key gene functions, antifungal resistance, and rapid pathogen detection. This review summarizes the development of CRISPR/Cas systems and the key strategies for their application in plant pathogenic fungi and makes an outlook on the practical deployment. With the continuous advancement of gene editing technologies, emerging fungal-adapted editing systems hold great promise for advancing functional genomics and enabling innovations in disease-resistant breeding and sustainable crop protection.
Gene Editing/methods* ; Fungi/pathogenicity* ; CRISPR-Cas Systems/genetics* ; Plant Diseases/microbiology* ; Plants/microbiology* ; Genome, Fungal/genetics*

OBJECTIVE To investigate the prognostic factors of chondrosarcoma of the larynx,deeply analyze its clinical data,and provide a theoretical basis for better treatment of chondrosarcoma of the larynx.METHODS A retrospective analysis was conducted on the complete clinical data of patients with primary chondrosarcoma of the larynx admitted to the Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University from January 2010 to December 2024.RESULTS A total of 15 patients were included,including 11 males and 4 females,with a gender ratio of 11∶4.The average age of onset was 57.3 years,and the average clinical symptom duration was 12.2 months.The tumors were mainly located in the cricoid cartilage in 11 patients,in the arytenoid cartilage in 2 patients,and in the thyroid cartilage in 2 patients.Tumor grading showed that 7 patients were grade I and 8 were grade II.Four patients underwent transoral laser minimally invasive surgery,2 patients underwent partial laryngectomy+tracheotomy,and 9 patients underwent total laryngectomy/cervical lymph node dissection+tracheostomy.The 5-year overall survival rate was 85.7%,the 5-year disease-specific survival rate was 100%,and the 5-year local-regional control rate was 90.9%.Gender,tumor location,tumor grade,Ki-67,tumor size,and whether larynx preservation surgery was performed did not affect the local-regional control rate or disease-specific survival rate.CONCLUSION Laryngeal chondrosarcoma generally has a longer disease history and is difficult to detect.The pathological type is mostly well-differentiated.Regional or distant metastasis is rare,and the long-term survival rate is good.Surgical resection is the preferred treatment option.On the basis of not reducing the tumor control rate,surgery that prioritizes preserving laryngeal function should be given priority,while comprehensive treatment is generally not recommended.

Objective To explore the correlation between the actual age and the pulp chamber volume(PCV)and pulp dentinal index(PDI)of the right first molars based on cone beam computed tomog-raphy(CBCT)technology,and to construct an accurate and convenient model for age estimation.Methods CBCT image data of 1 857 Han adults(883 males and 974 females)from the Department of Stomatology,Affiliated Hospital of North Sichuan Medical College were collected.The data were di-vided into training and validation sets at a ratio of 8∶2.A total of 1 485 training samples were used to construct the age estimation model,and 372 samples were used to validate the accuracy of the model.The Mimics 21.0 software was used to measure the PCV and calculate the PDI of the right first molars.Their correlations with age and the differences between different sexes and tooth positions were analyzed.Results Both the PCV and the PDI of the first molars showed strong negative correla-tions with the actual age(r values ranged from 0.82 to 0.89).The differences in PCV and PDI be-tween different sexes and tooth positions were statistically significant(P<0.05).The age estimation model based on PDI was superior to that based on PCV.The model based on the PDI values of the two right first molars(y=73.72-44.15 x3-28.27 x4,where x3 and x4 are the PDI values of the right maxil-lary and mandibular first molars,respectively)was the best,with the R2 of 0.79 and the mean abso-lute error of 4.90 years.Conclusion Both PCV and PDI of the first molars are effective indicators for age estimation.The age estimation model based on the PDI is more convenient and accurate than that based on the PCV,providing a more effective method for age estimation in forensic practice.

Objective To observe the clinical efficacy and safety of tirofiban in stent-assisted coil(SAC)embolization for patients with acutely ruptured wide-necked intracranial aneurysms.Methods Patients with acutely ruptured wide-necked intracranial aneurysms who underwent SAC embolization were divided into the control group and the treatment group according to cohort method.The control group was treated with aspirin enteric-coated tablets(300 mg,qd)and clopidogrel bisulfate tablets(300 mg,qd,oral administration)at 2 h before surgery.The treatment group was treated with tirofiban hydrochloride and sodium chloride injection at 10 μg·kg-1 during surgery,which was administrated via intravenous injection at a constant speed within 10 min.Then,the injection rate was adjusted to 0.1 μg·kg-1·min-1 for 12-24 h.The two groups were compared on clinical efficacy,platelet activation function[platelet alpha granule membrane glucoprotein(CD62p)positive rate,platelet adhesion rate and platelet aggregation rate],and perioperative complications.The patients were followed up for 6 months after surgery.The Glasgow Outcome Scale(GOS)scores,recurrence rate and safety were recorded.Results Fifty-three cases and forty-seven cases were included in the treatment group and the control group,respectively.After treatment,the total effective rates of embolization in the treatment group and the control group were 91.49％(43 cases/47 cases)and 81.13％(43 cases/53 cases),without statistically significant difference(P＞0.05).On day 7 after surgery,CD62p positive rates were(56.31±7.41)％and(60.71±7.38)％;platelet adhesion rates were(37.56±3.64)％and(38.04±3.89)％;platelet aggregation rates were(27.03±3.39)％and(30.19±3.63)％.The differences in above indicators between the treatment group and the control group were statistically significant(all P＜0.05).During 6 months of follow-up,the good prognosis rates in the treatment group and the control group were 89.36％and 81.13％;recurrence rates were 4.26％and 9.43％.There were not statistically significant differences in above indicators between the treatment group and the control group(all P＞0.05).The perioperative complications in the two groups mainly included rerupture and bleeding of arterial aneurysms,subdermal ecchymosis,gingival bleeding,thrombotic events,etc.The total incidences of complications in the treatment group and the control group were 10.64％and 28.30％,with statistically significant difference(P＜0.05).Conclusion Tirofiban hydrochloride and sodium chloride injection can effectively reduce the incidence of thrombotic events in patients with acutely ruptured wide-necked intracranial aneurysms during perioperative period of SC A embolization,and improve platelet activation function.

Objective:To assess the diagnostic value of anti-salivary gland protein-1(SP1)antibody combined with anti-parotid secretory protein(PSP)antibody for Sj?gren's syndrome(SS).Methods:A total of 60 patients with primary SS(pSS)who were treated in the outpatient and inpatient department of Department of Rheumatology and Immunology of the Second Hospital of Hebei Medical University from January 2020 to December 2022 were collected.Thirty patients with other autoimmune diseases accompa-nied by dry mouth and/or dry eyes were collected as disease control group.Thirty healthy subjects from the physical examination center were collected for healthy control group,serum samples were obtained from all of them.Their general features and clinical information including clinical manifestations,labora-tory examinations and other examinations were recorded.The 2016 American College of Rheumatology(ACR)/European League against Rheumatism(EULAR)classification criteria were adopted as the diag-nostic standard of pSS.Immunoglobulin G(IgG)subtype of anti-SP1 antibody and anti-PSP antibody were detected by chemiluminescence immunoassay.The receiver operating characteristic(ROC)curve was used to evaluate the accuracy of anti-SP1 antibody and anti-PSP antibody in diagnosing pSS.The cli-nical characteristics of anti-SP1 antibody and anti-PSP antibody positive patients and negative patients in pSS group were further compared.Independent samples t test,Mann-Whitney U test,variance analysis,Kruskal-Wallis test,Chi-square test or Fisher's exact test and Spearman correlation analysis were used for statistical analysis.Results:There was no significant difference in age(F=1.406,P=0.495)and gender(x2=2.105,P=0.349)among pSS group,disease control group and healthy control group.The expression levels of anti-SP1 antibody(H=16.73,P＜0.001)and anti-PSP antibody(H=26.09,P＜0.001)were statistically different among the three groups.An intergroup comparison of anti-SP1 antibody expression levels showed that there was a statistically significant difference between pSS and healthy con-trol group(P＜0.001),but no statistically significant difference between the other groups.Comparison of anti-PSP antibody expression levels between the groups showed that there were statistically significant differences between pSS and healthy control group(P＜0.001),and between disease control group and healthy control group(P=0.009),while no statistically significant differences between the other groups.The positive rate of anti-SP1 antibody in pSS group was significantly higher than that in disease control group and healthy control group(58.33％vs.40.00％vs.13.33％,P＜0.001).The positive rate of anti-PSP antibody in pSS group was significantly higher than that in disease control group and healthy control group(75.00％vs.56.17％vs.16.67％,P＜0.001).The area under the curve for anti-SP1 antibody was 0.688(P＜0.001).The sensitivity and specificity of anti-SP1 antibody were 58.33％(35/60)and 70.00％(42/60)respectively,the positive predictive value was 66.04％(35/53)and the negative predictive value was 54.55％(42/77)of anti-SP1 antibody.The area under the curve of anti-PSP antibody was 0.720(P＜0.001),with a sensitivity was 75.00％(45/60),and spe-cificity was 63.33％(38/60).The positive predictive value and negative predictive value of anti-PSP an-tibody were 67.16％(45/67)and 71.70％(38/53)respectively.All the 13 pSS patients were negative for anti-Sjogren's syndrome A(SSA,including SSA52 and SSA60)antibody and anti-Sjogren's syn-drome B(SSB)antibody.Among them,11 patients were positive for both anti-SP1 antibody and anti-PSP antibody,1 patient was positive for anti-SP1 antibody and 1 patient was positive for anti-PSP anti-body.The clinical features of anti-SP1 antibody and anti-PSP antibody positive and negative groups were compared in pSS patients.The duration of disease in anti-SP1 antibody positive group was shorter(Z=-2.277,P=0.023)when compared with the negative patients.The patients with positive anti-PSP an-tibody were younger than those in the negative group(t=2.598,P＜0.05),the positive rate of rheuma-toid factor(P=0.002)and the serum level of IgG(t=3.806,P=0.003)in anti-PSP antibody positive group were higher than in the negative group.Analysis of the correlation between anti-SP1 antibody and anti-PSP antibody in the pSS patients showed that there was significant correlation between them(r=0.801,P＜0.001).Conclusion:Both anti-SP1 antibody and anti-PSP antibody are valuable in the diag-nosis of SS,and anti-SP1 antibody is helpful for the early diagnosis of pSS.The combined detection of anti-SP1 antibody and anti-PSP antibody is helpful for the early diagnosis of pSS patients with negative anti-SSA antibody and anti-SSB antibody.

OBJECTIVE To compare the consistency between the semi-quantitative detection of HPV E6/E7 mRNA and the detection of p16 IHC and E6/E7RNA ISH in the tissues,and the feasibility of detecting high-risk HPV in head and neck mucosal lesions by HPV E6/E7 mRNA detection in the swabs was discussed.METHODS A total of 100 cases of head and neck mucosal lesions treated by the Department of Head and Neck Surgery,Beijing Tongren Hospital Affiliated to Capital Medical University from September 2022 to August 2023 were collected.Semi-quantitative detection of HPV E6/E7 mRNA was performed in oropharynx,lesion surface swab and lesion tissue specimen,and p16 immunohistochemical staining(IHC)and E6/E7 mRNA in situ hybridization(ISH)were detected in lesion tissue,and the consistency and difference of different detection results were studied.RESULTS Among the 100 patients,83 met the inclusion criteria and were divided into 21 papilloma cases,10 polyps/chronic inflammation cases,19 laryngeal cancer cases,13 oropharyngeal cancer cases,and 20 hypopharyngeal cancer cases according to pathological diagnosis.The HPV E6/E7 mRNA semi-quantitative results of oropharyngeal swab and lesion surface swab showed moderate or near high consistency with p16 IHC results.The results of HPV E6/E7 mRNA semi-quantitative in diseased tissue were highly consistent with those of p16 IHC(Kappa=0.780).In the diagnostic efficacy analysis,both swabs showed high consistency with HPV E6/E7 mRNA ISH(Kappa=0.690 and 0.708).CONCLUSION In the head and neck mucosal lesions,the HPV semi-quantitative detection results of oropharyngeal and lesion surface swab showed good consistency compared with classical p16 IHC and gold standard HPV E6/E7 mRNA ISH.It is a simple and reliable method for clinical high-risk HPV detection,which is helpful for the screening and individualized precise prevention and control of HPV infection in head and neck mucosal lesions.