Head and neck squamous cell carcinoma （HNSCC） is one of the ten most common cancers worldwide and is one of the refractory cancers with a poor prognosis in otorhinolaryngology-head and neck surgery. Cetuximab is widely used in the clinical treatment of HNSCC and has been approved by the FDA as a first-line chemotherapeutic agent. However, its efficacy varies significantly among different individuals. Therefore, exploring the resistance mechanisms of cetuximab in the treatment of HNSCC and screening for sensitive populations are essential for the precision treatment of head and neck cancer. This article summarizes the research progress on cetuximab resistance mechanisms in HNSCC, and the main aspects include: alterations in epidermal growth factor receptor （EGFR） and its ligands, changes in downstream effectors of EGFR, bypass activation and crosstalk, epithelial-mesenchymal transition, epigenetic modifications, and immunosuppression in the tumor microenvironment.
Humans ; Cetuximab/therapeutic use* ; Drug Resistance, Neoplasm ; Squamous Cell Carcinoma of Head and Neck/drug therapy* ; Head and Neck Neoplasms/drug therapy* ; ErbB Receptors/metabolism* ; Tumor Microenvironment ; Epithelial-Mesenchymal Transition ; Molecular Targeted Therapy ; Antineoplastic Agents, Immunological/therapeutic use*

OBJECTIVE: To develop a digital intelligent multimodal shift handover system for the intensive care unit (ICU) and evaluate its application effect in ICU shift handovers. METHODS: A research and development team was established, consisting of 1 department director, 1 head nurse, 3 information technology engineers, 3 nurses, and 2 doctors. Team members were assigned responsibilities including overall coordination and planning, platform design and maintenance, pre-application training, collection and organization of clinical feedback, and research investigation respectively. A digital intelligent multimodal shift handover system was developed for ICU based on the Shannon-Weaver linear transmission model. This innovative system integrated automated data collection, intelligent dynamic monitoring, multidimensional condition analysis and visual reporting functions. A cloud platform was used to gather data from multi-parameter vital signs monitors, infusion pumps, ventilators and other devices. Artificial intelligence algorithms were employed to standardize and analyze the data, providing personalized recommendations for healthcare professionals. A self-controlled before-after method was adopted. Before the application of the ICU digital intelligent multimodal shift handover system (from December 2023 to March 2024), the traditional verbal bedside handover was used; from June 2024 to March 2025, the ICU digital intelligent multimodal shift handover system was applied for shift handovers. Questionnaires before the application of the shift handover system were collected in April 2024, and those after the application were collected in April 2025. The shift handover time, handover quality (scored by the nursing handover evaluation scale), satisfaction with doctor-nurse communication (scored by the ICU doctor-nurse scale) before and after the application of the handover system were compared, and nurses' satisfaction with the shift handover system (scored by the clinical nursing information system effectiveness evaluation scale) was investigated. RESULTS: After the application of the ICU digital intelligent multimodal shift handover system, the shift handover time was significantly shorter than that before the application [minutes: 20 (15, 25) vs. 30 (22, 40)], the handover quality was significantly higher than that before the application [score: 84.0 (78.0, 88.5) vs. 71.0 (55.0, 79.0)], and the satisfaction with doctor-nurse communication was also significantly higher than that before the application (score: 84.58±6.79 vs. 74.50±11.30). All differences were statistically significant (all P < 0.05). In addition, the nurses' system effectiveness evaluation scale score was 102.30±10.56, which indicated that nurses had a very high level of satisfaction with the ICU digital intelligent multimodal shift handover system. CONCLUSIONS The application of the ICU digital intelligent multimodal shift handover system can shorten the shift handover time, improve the handover quality, and enhance the satisfaction with doctor-nurse communication. Nurses have a high level of satisfaction with this system.
Intensive Care Units ; Humans ; Patient Handoff ; Artificial Intelligence ; Algorithms

Objective To investigate the therapeutic efficacy of Wenyang Yiqi Therapy,the method of warming yang and replenishing qi in traditional Chinese medicine(TCM),combined with Alendronate Sodium Vitamin D3 in the treatment of elderly patients with osteoporosis(OP)of the spleen-kidney yang deficiency syndrome,and to observe its effect on bone metabolism and serum inflammatory factors.Methods A total of 110 cases of elderly patients with OP of spleen-kidney yang deficiency syndrome who admitted to the Department of Orthopedics and Traumatology of Traditional Chinese Medicine of Wuxi Ninth People's Hospital from October 2021 to October 2023 were randomly divided into a trial group and a control group,with 55 patients in each group.The two groups were treated with Alendronate Sodium Vitamin D3,and additionally the trial group was treated with Wenyang Yiqi Therapy by using Chinese herbal medicines of Epimedii Folium,Astragali Radix,Ostreae Concha,Angelicae Sinensis Radix,Cyathulae Radix,Psoraleae Fructus,Taxilli Herba,etc.The course of treatment for the two groups covered three months.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,bone mineral density(BMD),Visual Analogue Scale(VAS)score of pain,bone metabolism indicators of β-C-terminal telopeptide of type 1 collagen(β-CTX),total procollagen type 1 N-terminal propeptide(PINP)and bone gla-protein(BGP),and serum inflammatory factor indicators of interleukin 6(IL-6)and tumor necrosis factor α(TNF-α)].After treatment,the clinical efficacy of the two groups of patients was evaluated.Results(1)After three months of treatment,the total effective rate of the trial group was 94.55%(52/55)and that of the control group was 74.55%(41/55),and the intergroup comparison(tested by chi-square test)showed that the efficacy of the trial group was significantly superior to that of the control group(P<0.01).(2)After treatment,the scores of TCM symptoms of soreness and weakness in the waist and knee,aversion of cold with cold limbs,fatigue and tiredness,and nocturnal frequent polyuria in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).(3)After treatment,the BMD of patients in the two groups were increased(P<0.05)while the pain VAS scores were decreased compared with those before treatment(P<0.05),and the increase in BMD and the decrease in pain VAS score of the trial group were significantly superior to that of the control group(P<0.01).(4)After treatment,the serum levels of bone metabolism indicators of β-CTX and PINP in the two groups were decreased compared with those before treatment(P<0.05),and the serum BGP level was increased compared with that before treatment(P<0.05).And the decrease of the serum β-CTX and PINP levels as well as the increase of the serum BGP levels in the trial group were significantly superior to that in the control group(P<0.01).(5)After treatment,the serum levels of inflammatory factors of IL-6 and TNF-αof patients in the two groups were decreased compared with those before treatment(P<0.05),and the decrease in the trial group was significantly superior to that in the control group(P<0.01).Conclusion Wenyang Yiqi Therapy combined with Alendronate Sodium Vitamin D3 exerts certain efficacy in the treatment of elderly patients with OP of spleen-kidney yang deficiency syndrome.The combined therapy is effective on alleviating the symptoms such as soreness in the waist and legs,improving bone metabolism,increasing BMD,and inhibiting the inflammatory responses,which will provide evidence for the clinical treatment.

This paper summarizes Li Fei's academic insights and clinical experience in treating intractable facial paralysis.Li Fei posits that prolonged illness inevitably leads to deficiency and stasis,and thus,the treatment of intractable facial paralysis should first focus on identifying the etiology and syndrome differentiation,resolving stasis and unblocking stagnation,and regulating qi and blood,with particular emphasis on the relaxation of the meridian sinew system.The meridian sinew system,affiliated with the meridian and collateral,serves as the framework through which qi and blood nourish muscles,tendons,and joints,playing a crucial role in facial paralysis treatment.Guided by the theory of the meridian sinew system,Li Fei employs syndrome-based treatment,integrating the anatomy of facial expression muscles.His approach includes needle-knife therapy to release adhesions and break stasis,acupuncture to harmonize qi and blood,and intradermal needle therapy for sustained stimulation.Through these methods,the meridian sinew system is relaxed,qi and blood are regulated,and facial muscles are nourished,leading to gradual recovery from facial paralysis.

Objective This paper investigates the effect of a multi-physical field fusion intervention based on transcranial direct current stimulation(tDCS),transcranial magnetic stimulation(TMS)and music on mental fatigue.Methods After fatigue induction,10 subjects received blank group stimulation,music group stimulation and tDCS-TMS-Music stimulation,respectively.tDCS stimulation sites were located in the bilateral frontal regions of the subjects,and TMS stimulation sites were located in the bilateral occipital regions of the hindbrain.Heart rate variability and reaction performance were measured before and after each intervention to determine the elimination effect of different intervention programs on mental fatigue.Results Compared with the control group,the tDCS-TMS-Music group showed significantly greater improvements in subjective mental workload,response performance,and heart rate variability.Conclusion The results of this study support that tDCS-TMS-Music can effectively alleviate mental fatigue induced by long-term cognitive performance tasks,and the intervention effect is better than music intervention and resting-state relief at the same time.

Purpose/Significance To investigate the effectiveness of experiential teaching in perinatal healthcare management contin-uing education.Method/Process The perinatal healthcare team of Peking Union Medical College Hospital holds a four-day experiential learning program for 30 maternity-related medical staffs from China.Through the self-administered experiential teaching questionnaire(ETQ)and satisfaction questionnaire,the researchers analyze the participants'post-teaching skill acquisition,clinical application abil-ity and educational needs,as well as their satisfaction with course content,course duration,teaching design,classroom atmosphere,and teaching format,which are quantified with Likert scale.Result/Conclusion The experiential teaching mode shows good teaching effects in perinatal healthcare management continuing education,and has higher application value.In the future,the researchers should combine it with theoretical teaching and carry out more comprehensive and structured periodic learning classes throughout the country,so as to im-prove both the theoretical foundation and practical ability of healthcare workers for better healthcare services for pregnant women.

Vascular stents are an essential tool in cardiovascular interventional therapy, and their demand is growing with the increasing incidence of cardiovascular diseases. Compared with permanent stents, which are prone to in-stent restenosis, and drug-eluting stents, which may cause late stent thrombosis, biodegradable stents offer advantages. After providing early radial support to prevent elastic recoil, biodegradable stents gradually degrade, allowing the vessel to regain its natural physiological contractility and undergo positive remodeling. A review of the current mainstream biodegradable metal stents, magnesium-based, iron-based, and zinc-based alloys, shows promising findings in both preclinical and clinical research. Magnesium-based stents exhibit good operability and low thrombosis rates, but their limitations include rapid degradation, hydrogen evolution, and significant pH changes in the microenvironment. Iron-based stents demonstrate excellent mechanical strength, formability, biocompatibility, and hemocompatibility, but their slow corrosion rate hampers broader clinical application; accelerating degradation remains key. Zinc-based alloys have a moderate degradation rate but relatively low mechanical strength; enhancing stent strength by alloying with other elements is the main improvement direction for zinc-based stents.
Humans ; Absorbable Implants ; Stents ; Alloys/chemistry* ; Magnesium/chemistry* ; Biocompatible Materials/chemistry* ; Zinc/chemistry* ; Drug-Eluting Stents ; Iron/chemistry* ; Metals/chemistry*

CUDC-101, an effective and multi-target inhibitor of epidermal growth factor receptor (EGFR), histone deacetylase (HDAC), and human epidermal growth factor receptor 2 (HER2), has been reported to inhibit many kinds of cancers, such as acute promyelocytic leukemia and non-Hodgkin's lymphoma. However, no studies have yet investigated whether CUDC-101 is effective against myeloma. Herein, we proved that CUDC-101 effectively inhibits the proliferation of multiple myeloma (MM) cell lines and induces cell apoptosis in a time- and dose-dependent manner. Moreover, CUDC-101 markedly blocked the signaling pathway of EGFR/phosphoinositide-3-kinase (PI3K) and HDAC, and regulated the cell cycle G2/M arrest. Moreover, we revealed through in vivo experiment that CUDC-101 is a potent anti-myeloma drug. Bortezomib is one of the important drugs in MM treatment, and we investigated whether CUDC-101 has a synergistic or additive effect with bortezomib. The results showed that this drug combination had a synergistic anti-myeloma effect by inducing G2/M phase blockade. Collectively, our findings revealed that CUDC-101 could act on its own or in conjunction with bortezomib, which provides insights into exploring new strategies for MM treatment.
Humans ; Antineoplastic Agents/therapeutic use* ; Apoptosis ; Bortezomib/pharmacology* ; Cell Line, Tumor ; Cell Proliferation ; ErbB Receptors/antagonists & inhibitors* ; G2 Phase Cell Cycle Checkpoints ; Histone Deacetylase Inhibitors/pharmacology* ; Histone Deacetylases/metabolism* ; M Cells ; Multiple Myeloma/drug therapy*

Autapses selectively form in specific cell types in many brain regions. Previous studies have also found putative autapses in principal spiny projection neurons (SPNs) in the striatum. However, it remains unclear whether these neurons indeed form physiologically functional autapses. We applied whole-cell recording in striatal slices and identified autaptic cells by the occurrence of prolonged asynchronous release (AR) of neurotransmitters after bursts of high-frequency action potentials (APs). Surprisingly, we found no autaptic AR in SPNs, even in the presence of Sr²⁺. However, robust autaptic AR was recorded in parvalbumin (PV)-expressing neurons. The autaptic responses were mediated by GABA_A receptors and their strength was dependent on AP frequency and number. Further computer simulations suggest that autapses regulate spiking activity in PV cells by providing self-inhibition and thus shape network oscillations. Together, our results indicate that PV neurons, but not SPNs, form functional autapses, which may play important roles in striatal functions.
Parvalbumins/metabolism* ; Corpus Striatum/metabolism* ; Interneurons/physiology* ; Neurons/metabolism* ; Neostriatum

Objective:To explore the impact of PM 2.5 concentration in Shanghai on the incidence of allergic rhinitis（AR） in the population, and provide strategies for early warning and prevention of AR. Methods:Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1, 2017 to December 31, 2019, and clinical data of AR patients from five hospitals in Shanghai during the same period. We used a time-series analysis additive Poisson regression model to analyze the correlation between PM 2.5 levels and outpatient attendance for AR patients. Results:During the study period, a total of 56 500 AR patients were included, and the daily average concentration of PM 2.5 was（35.28±23.07）μg/m³. There is a correlation between the concentration of PM 2.5 and the number of outpatient attendance for AR cases. There is a positive correlation between the daily average number of outpatient for AR and levels of PM 2.5 air pollution（（P<0.05）） . We found that every 10 μg/m³ increase in PM 2.5, the impact of on the number of AR visits was statistically significant on the same day, the first day behind, and the second day behind, with the strongest impact being the exposure on the same day. Every 10 μg/m³ increases in PM 2.5, the number of outpatient visits increased by 0.526% on the same day（95%CI 1.000 50-1.010 04）. Conclusion:The atmospheric PM 2.5 concentration in Shanghai is positively correlated with the number of outpatient for AR, and PM 2.5 exposure is an independent factor in the onset of AR. This provides an important theoretical basis for AR.
Humans ; Particulate Matter/analysis* ; Air Pollutants/adverse effects* ; Incidence ; China/epidemiology* ; Air Pollution/adverse effects* ; Rhinitis, Allergic/etiology*