Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80％of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.

OBJECTIVE To explore the value of tuberculosis infection T cell spot test(T-SPOT.TB)combined with cytokines interleukin-2(IL-2),interferon-γ(IFN-γ)in differential diagnosis of active tuberculosis(ATB)and non-ATB.METHODS A total of 186 patients with pulmonary tuberculosis(TB)who were treated in Hebei Provincial Chest Hospital from Feb.2021 to Mar.2024 were recruited as the research subjects and were divided in-to the ATB group with 92 cases and the non-ATB group with 94 cases according to the result of sputum culture for MTB,which was taken as the golden standard.The T-SPOT.TB was carried out for all of the subjects.The base-line data were collected from the two groups of patients.The hierarchical regression analysis was performed by setting the T-SPOT.TB,IL-2 and IFN-γ as the dependent variables,clinical symptoms of cough and fever as the independent variables.The impact of the clinical characteristics on T-SPOT.TB,IL-2 and IFN-γ was observed.The value of T-SPOT.TB combined with cytokines IL-2 and IFN-γ in differential diagnosis and ATB and non-ATB was evaluated by means of principal component analysis(PCA)and partial least squares discrimi-nant analysis(PLS-DA).The efficiencies of T-SPOT.TB,IL-2,IFN-γ and prediction model were examined by receiver operating characteristic(ROC)curves.RESULTS There were significant differences in cough,fever,IL-1β,IL-2,IL-6,IL-8 and IFN-γ between the two groups(P＜0.05).There were statistically positive correlations between the clinical symptoms of cough,fever and the T-SPOT.TB,IL-2 and IFN-γ(P＜0.05).The result of PCA model and PLS-DA model showed that there were less significant individual differences between the ATB pa-tients and the non-ATB patients,the two groups could be remarkably clustered and identified.The area under the curve(AUC)of the joint model was highest(0.913)(0.875 to 0.950)(P＜0.05),with the sensitivity 90.24％,the specificity 74.54％.CONCLUSION The T-SPOT.TB combined with IFN-γ and IL-2 shows high sensitivity and specificity in differential diagnosis of ATB and non-ATB and can be used as method for auxiliary diagnosis of ATB,and it has significant clinical value.

Objective To explore the risk factors and incidence of epiretinal membrane(ERM)formation following scleral buckling(SB)for rhegmatogenous retinal detachment(RRD),and to construct a risk prediction model to facilitate screening of high-risk populations and prevent ERM formation.Methods RRD patients who underwent SB in the Second Affiliated Hospital of Harbin Medical University between February 2022 and April 2024 were included in the study.The pa-tients were divided into occurrence and non-occurrence groups according to whether they developed ERM.Patient data were analyzed,and univariate Cox regression analysis was performed to select variables,which were then incorporated into the multivariate Cox regression model for the identification of risk factors for ERM formation after SB in RRD patients.A predictive model for ERM risk in RRD patients was constructed based on this data,and nomograms,receiver operating characteristic(ROC)curves,and calibration curves were drawn to evaluate and validate the diagnostic performance of the model.Results A total of 126 RRD patients(126 eyes)who underwent SB were included.There were 27 cases develo-ping ERM(occurrence group)and 99 not developing ERM(non-occurrence group),with an ERM incidence of 21.4％.Multivariate Cox regression analysis revealed that a history of diabetes mellitus[Hazard ratio(HR)=3.52,95％CI:1.37-9.02,P=0.009],preoperative proliferative vitreoretinopathy(PVR)(HR=13.00,95％CI:5.18-32.63,P＜0.001),and ≥4 retinal holes(HR=2.33,95％CI:1.04-5.23,P=0.041)were independent influence factors for ERM formation in RRD patients.ROC curve analysis showed that the area under the curve(AUC)was 0.840(95％CI:0.740-0.940)at 30 days and 0.904(95％CI:0.834-0.975)at 90 days.Conclusion A history of diabetes mellitus,preoperative PVR,and ≥4 retinal holes are factors influencing the development of ERM after SB in RRD patients.It is verified that the risk prediction model constructed based on these factors can accurately predict the risk of ERM formation within 6 months in RRD patients.

This study analyzes the global patents development and clinical applications of photon counting CT (PCCT) technology in the past 20 years, including the trends of global patent application, the patent portfolio planning, key innovations and technological evolution of top medical device companies. The study utilizes patent retrievals in incoPat database, and then carries out patent navigation analysis. At the same time, with reports of clinical trials and research, the advantages and prospects of PCCT in clinical diagnosis are sorted out. With the rapid growth of the number of patent applications for PCCT, the technologies and clinical trials are becoming increasingly mature. It is expected that in the next few years, more PCCT products will be launched to the market, bringing a more accurate and safe diagnostic experience to radiologists and patients.
Patents as Topic ; Photons ; Tomography, X-Ray Computed ; Humans

Objective To investigate the role of additional platelet protein kinase C epsilon(PKCε)assay in risk stratification and additional diagnostic testing in elderly patients with acute chest pain and normal hypersensitive cardiac troponin I(hs-cTnI)level.Methods A prospective trial was conducted on 220 consecutive elderly patients with angina-like acute chest pain and normal hs-cTnI level in our hospital from April 2022 to April 2023.According to whether major adverse cardiovascular events(MACE)occurred during the 1-year follow-up period,they were assigned in-to MACE group(24 cases)and non-MACE group(196 cases).Their general clinical data and platelet PKCε expression were compared between the two groups.Kaplan-Meier survival curve was plotted to analyzed the event-free time between the platelet PKCε expression＜2.05％group and the≥2.05％group.Multivariate Cox regression analysis was used to investigate the impact of baseline data on the occurrence of MACE during the 1-year follow-up period.Decision tree model was employed to analyze the influencing factors for MACE.Results During 1-year follow-up,24 patients(10.91％)developed MACE.The platelet PKCε expression was significantly higher in the MACE group than the non-MACE group[9.25％(6.60％,15.25％)vs 1.70％(0.80％,3.25％),Z=-7.596,P＜0.01].Kaplan-Meier survival curve analysis showed that the patients in the PKCε＜2.05％group had no events within 360 d,while those in the ≥2.05％group had an average event-free time of 297.13±12.77 d,with a statistical difference(log rank Chi-square=27.051,P=0.000).Multivariate Cox regression analysis showed that highly suspicious angina,hs-cTnI and platelet PKCε were independent risk factors for MACE within 1 year of follow-up(HR=3.011,95％CI:1.049-8.641,P=0.040;HR=1.216,95％CI:1.044-1.418,P=0.012;HR=1.160,95％CI:1.104-1.218,P=0.000).In the decision tree model,the 1-year incidence of MACE was notably higher in the platelet PKCε≥2.05％group than the＜2.05％group(P=0.011).The probability of severe coronary artery stenosis or myocardial ischemia in the platelet PKCε≥2.05％group was remarkably higher than the＜2.05％group(P=0.006).Conclusion In elderly patients suffering from acute chest pain with normal hs-cTnI level,additional platelet PKCε detection appears to have a good prognostic gain.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.

Objective:To explore the characteristics of blood lipid profile and its correlation with clinical features and cytokines in patients with active systemic sclerosis (SSc).Methods:In this study, from January 2018 to March 2023, a total of 102 SSc patients visited the Second Hospital of Shanxi Medical University and the First Hospital of Shanxi Medical University were enrolled, among which 57 cases were localized skin type, 25 cases were diffuse skin type, 20 cases were overlap syndrome. At the same time, 89 gender and age-matched health check-up subjects in the Second Hospital of Shanxi Medical University were selected as the healthy control group. The total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were compared between the two groups. According to the blood lipid level, they were grouped into normal blood lipid group and abnormal group, TG elevated group and normal group, HDL-C decreased group and normal group. The association between various lipid groups and organ involvement, modified Rodnan skin score (mRSS), laboratory examination and cytokines were analyzed. Continuous data were analyzed using t-test or Mann-Whitney U test, count data were tested with chi-square test, and Spearman correlation analysis was used for correlation analysis. Results:The level of TG [1.31 (1.04, 1.77) mmol/L vs. 1.05 (0.79, 1.35) mmol/L] and LDL-C [(2.33±0.69)mmol/L vs. (2.12±0.64) mmol/L] in active SSc patients were higher than that in HCs, and the level of TC [(4.27±1.11)mmol/L vs. (4.85±0.98)mmol/L] was lower than that in HCs ( Z=3.821, P<0.001; t=2.171, P=0.031; t=-3.791, P<0.001). Fifty-six (54.9%) SSc patients had dyslipidemia, the incidence of the TG increase and the HDL-C reduction was significantly higher. ESR, mRSS score and renal involvement in the dyslipidemia group were higher than that in normal blood lipid group. mRSS score and the incidence of cardiac and renal involvement were higher in the TG elevated group than that in normal group. TG was positively correlated with the mRSS scores ( r=0.321, P=0.001). The incidence of ESR increase and cardiac involvement was higher in HDL-C decreased group than that in normal group, while anti-Scl-70 positive rate was lower. HDL-C was negatively correlated with the ESR ( r=-0.411, P<0.001). In active SSc patients, levels of IL-2[2.78(2.04, 4.96)pg/ml], IL-6[14.71(7.74,28.38)pg/ml], IL-17[10.73(4.38, 26.62)pg/ml], and IFN-γ[5.40(3.11, 10.45)pg/ml] in the dyslipidemia group were higher than those in normal blood lipid group [IL-2:1.73(0.96, 3.75)pg/ml, Z=2.452, P=0.014; IL-6:6.78(4.38, 9.17)pg/ml, Z=3.726, P<0.001; IL-17:4.46(2.98, 12.53)pg/ml, Z=2.176, P=0.030;IFN-γ:3.76(2.20, 4.87)pg/ml, Z=2.960, P=0.003]. TG was positively associated with IL-2( r=0.358, P=0.002), IL-6( r=0.324, P=0.006), IL-10( r=0.270, P=0.024), IL-17( r=0.279, P=0.019), and IFN-γ( r=0.297, P=0.012)in patients with active SSc. HDL-C was negatively associated with levels of IL-2( r=-0.292, P=0.014), IL-6( r=-0.348, P=0.003), IL-10 ( r=-0.261, P=0.029)and TNF-α( r=-0.251, P=0.036). Conclusion:The incidence of dyslipidemia is higher in active SSc patients than that in HCs, the main manifestations are increased TG and LDL-C and decreased TC and HDL-C. Active SSc patients with dyslipidemia have higher levels of ESR and inflammatory cytokines, higher incidence of cardiac and renal involvement, and relatively severe skin fibrosis, which suggest that abnormal lipid metabolism plays an important role in the development of active SSc and organ involvement.

County medical community serves as pivotal instruments for the hierarchical diagnostic and treatment system. Since their nationwide implementation in December 2023, there has been a pressing demand for governance theories to direct practical applications. Based on polycentric-collaborative governance theory, this study articulated a framework that modeled county medical community as accountable care organizations, anchored by a foundation of primary health care and a polycentric-collaborative governance structure. The framework encompassed critical dimensions, including problem orientation, diverse governance actors, multi-dimensional governance mechanisms, governance objectives, and evaluative metrics. This research also introduced 17 governance instruments, delineated 13 priority action fields, and pinpointed 5 potential reform areas, with a pronounced focus on bolstering governance capacity through value-based payment reforms and technological underpinnings of digital innovation. The framework′s viability and efficacy have been substantiated through a case study in Zhejiang Province. The framework presented herein could offer a comprehensive and systematic guide for county medical community practice, capturing the essence of the reform through a problem-oriented lens, fostering multi-actor involvement, and ensuring the harmonization of multi-dimensional governance mechanisms, thereby fortifying the reform′s systematic, integrative, and collaborative attributes.

Objective To investigate the relationship between the mRNA expression levels of colony stimulating factor 2 receptor subunit beta CSF2RB and granase A(GZMA)in peripheral blood mononuclear cells(PBMC)of patients with acute myocardial infarction(AMI)and ventricular remodeling after percutaneous coronary intervention(PCI).Methods A total of 161 AMI patients admitted to the First Affiliated Hospital of Hebei North University from February 2022 to August 2023 were selected as the study objects,and were further divided into non-remodeling group(n=105)and remodeling group(n=56)according to whether ventricular remodeling was possible.A total of 85 patients with coronary heart disease who did not have myocardial infarction were taken as control group.The clinical data of patients were collected,and the expression levels of CSF2RB and GZMA mRNA in peripheral blood mononuclear cells were detected by real-time fluorescence quantitative PCR.Cardiac structural parameters were detected by echocardiography,and the relationship between CSF2RB and GZMA mRNA levels and cardiac structural parameters was analyzed by Pearson correlation.The influencing factors of ventricular remodeling in AMI patients were analyzed by univariate and Logistic regression,and P<0.05 was considered statistically significant.Results The mRNA expression of CSF2RB(1.15±0.28 vs 1.80±0.37),GZMA(0.85±0.16 vs 1.15±0.26),Cys C and Hcy levels were compared between the two groups,and the differences were statistically significant(t=-39.002～-4.854,all P<0.05).The follow-up was up to August 2024.Among 161 AMI patients who underwent PCI,56 cases had ventricular remodeling.The expression level of CSF2RB mRNA(1.85±0.31),GZMA mRNA(1.27±0.29)in the reconstructed group were significantly higher than that in the non-reconstructed group(1.71±0.34,1.12±0.30),and the differences were statistically significant(t=2.564,3.057,all P<0.001).LAD,LVEDD,LVPWTd and IVST in the postoperative reconstruction group were higher than those in the non-reconstruction group(t=11.247～26.008),and LVEF was lower than that in the reconstruction group(t=-15.271),with statistical significance(all P<0.001).The level of CSF2RB and GZMA in AMI patients was positively correlated with LAD,LVEDD,LVPWTd and IVST(rCSF2RB mRNA=0.657～0.754,rGZMA mRNA=0.512～0.745),and negatively correlated with LVEF(r=-0.684,-0.754),with statistical significance(all P<0.05).There was a statistically significant differences in the levels of Cys C and Hcy between the reconstructed group and non-reconstructed group after the use of aldehyed steroid receptor antagonsts(t=5.495,20.710,30.906,all P<0.05).Logistic regression analysis showed that CSF2RBmRNA＞1.79,GZMAmRNA＞1.18,Hcy＞20.15μmol/L and no use of aldosterol receptorantagonists were independent risk factors for ventricular remodeling in AMI patients.LVEF＞58.11%was an independent protective factor for ventricular remodeling in AMI patients(Wald χ2=1.137～3.206,P<0.05).Conclusion The expression levels of CSF2RB and GZMA in PBMC of AMI patients were significantly increased.CSF2RB and GZMA are independent risk factors for postoperative ventricular remodeling in patients with AMI,and can be used as potential diagnostic markers for ventricular remodeling after acute myocardial infarction.