Oral squamous cell carcinoma (OSCC) is a common head and neck malignancy. Approximately 50% to 60% of patients with OSCC are diagnosed at a locally advanced stage (clinical staging III-IVa). Even with comprehensive and sequential treatment primarily based on surgery, the 5-year overall survival rate remains below 50%, and patients often suffer from postoperative functional impairments such as difficulties with speaking and swallowing. Programmed death receptor-1 (PD-1) inhibitors are increasingly used in the neoadjuvant treatment of locally advanced OSCC and have shown encouraging efficacy. However, clinical practice still faces key challenges, including the definition of indications, optimization of combination regimens, and standards for efficacy evaluation. Based on the latest research advances worldwide and the clinical experience of the expert group, this expert consensus systematically evaluates the application of PD-1 inhibitors in the neoadjuvant treatment of locally advanced OSCC, covering combination strategies, treatment cycles and surgical timing, efficacy assessment, use of biomarkers, management of special populations and immune related adverse events, principles for immunotherapy rechallenge, and function preservation strategies. After multiple rounds of panel discussion and through anonymous voting using the Delphi method, the following consensus statements have been formulated: 1) Neoadjuvant therapy with PD-1 inhibitors can be used preoperatively in patients with locally advanced OSCC. The preferred regimen is a PD-1 inhibitor combined with platinum based chemotherapy, administered for 2-3 cycles. 2) During the efficacy evaluation of neoadjuvant therapy, radiographic assessment should follow the dual criteria of Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 and immune RECIST (iRECIST). After surgery, systematic pathological evaluation of both the primary lesion and regional lymph nodes is required. For combination chemotherapy regimens, PD-L1 expression and combined positive score need not be used as mandatory inclusion or exclusion criteria. 3) For special populations such as the elderly (≥ 70 years), individuals with stable HIV viral load, and carriers of chronic HBV/HCV, PD-1 inhibitors may be used cautiously under the guidance of a multidisciplinary team (MDT), with close monitoring for adverse events. 4) For patients with a poor response to neoadjuvant therapy, continuation of the original treatment regimen is not recommended; the subsequent treatment plan should be adjusted promptly after MDT assessment. Organ transplant recipients and patients with active autoimmune diseases are not recommended to receive neoadjuvant PD-1 inhibitor therapy due to the high risk of immune related activation. Rechallenge is generally not advised for patients who have experienced high risk immune related adverse events such as immune mediated myocarditis, neurotoxicity, or pneumonitis. 5) For patients with a good pathological response, individualized de escalation surgery and function preservation strategies can be explored. This consensus aims to promote the standardized, safe, and precise application of neoadjuvant PD-1 inhibitor strategies in the management of locally advanced OSCC patients.

The parahippocampal gyrus-orbitofrontal cortex (PHG-OFC) circuit in humans is homologous to the postrhinal cortex (POR)-ventral lateral orbitofrontal cortex (vlOFC) circuit in rodents. Both are associated with visuospatial malfunctions in Alzheimer's disease (AD). However, the underlying mechanisms remain to be elucidated. In this study, we explored the relationship between an impaired POR-vlOFC circuit and visuospatial memory deficits through retrograde tracing and in vivo local field potential recordings in 5XFAD mice, and investigated alterations of the PHG-OFC circuit by multi-domain magnetic resonance imaging (MRI) in patients on the AD spectrum. We demonstrated that an impaired glutamatergic POR-vlOFC circuit resulted in deficient visuospatial memory in 5XFAD mice. Moreover, MRI measurements of the PHG-OFC circuit had an accuracy of 77.33% for the classification of amnestic mild cognitive impairment converters versus non-converters. Thus, the PHG-OFC circuit explains the neuroanatomical basis of visuospatial memory deficits in AD, thereby providing a potential predictor for AD progression and a promising interventional approach for AD.

Objective:To investigate the regulatory effect of non-specific immunity induced by Trichinella spiralis (Ts) on the immune response of small intestinal tissue of mice infected with Plasmodium berghei (Pb)ANKA. Methods:Thirty-six specific pathogen free female Kunming mice (6-8 weeks old, weighting 18-22 g) were randomly divided into 4 groups according to body weight by the random number table method, including control group, Ts-mono-infected group (Ts group), PbANKA-mono-infected group (Pb group), and Ts + Pb-co-infected group (Ts + Pb group), 9 mice in each group. The mice were fed normal food, water and normal feed. The control group was not given any experimental treatment; the Ts group was infected with 20 Ts larvae orally on the first day of the experiment; the Pb group was infected with 1 × 10 6 PbANKA erythrocytes by intraperitoneal injection on the 9th day of the experiment; the Ts + Pb group was infected with 20 Ts larvae orally on the first day of the experiment, and 1 × 10 6 PbANKA erythrocytes were given by intraperitoneal injection on the 9th day. Mice were sacrificed on 22th day after Ts infection and/or 13th day after PbANKA infection, the morphological changes of peritoneal macrophages in each group were observed by transmission electron microscope; the mRNA expression levels of M1-type macrophage markers [inducible nitric oxide synthase (iNOS) and interleukin-6 (IL-6)], M2-type macrophage markers [mannose receptor C type 2 (Mrc-2) and chitinase-like 3 (Ym1)] in the small intestinal tissue of mice in each group were detected by quantitative real-time PCR (qRT-PCR), and the ratios of mRNA expression levels of M2/M1 macrophage markers were compared. Results:Transmission electron microscope showed that the morphology and structure of peritoneal macrophages in the control were normal; more pseudopodia were observed in the peritoneal macrophages in Ts group; and more pseudopodia and engulfed Plasmodium parasites were observed in the peritoneal macrophages in Pb group and Ts + Pb group. The iNOS (1.000 ± 0.290, 1.277 ± 0.251, 3.088 ± 1.110, 2.604 ± 0.773) and IL-6 mRNA expression levels (1.000 ± 0.393, 2.180 ± 0.629, 1.650 ± 0.612, 3.242 ± 1.780) of small intestinal tissue were compared among the 4 groups, the differences were statistically significant ( F=12.420, 5.270, P < 0.05). Compared with the control group, the iNOS mRNA expression levels in the Pb and Ts + Pb groups were significantly increased ( P < 0.05); compared with the Ts group, the iNOS mRNA expression level in the Ts + Pb group was significantly increased ( P < 0.05). Compared with the control group, the IL-6 mRNA expression level in the Ts + Pb group was significantly increased ( P < 0.05). The mRNA expression levels of Mrc-2 and Ym1 of small intestinal tissue in the 4 groups were significantly different ( F=9.890, 20.500, P < 0.05). The Mrc-2 mRNA expression level in the Ts + Pb group was significantly higher than those in the control, Ts, and Pb groups ( P < 0.05). The Ym1 mRNA expression level in the Pb group was significantly higher than that in the control group ( P < 0.05); the Ym1 mRNA expression level in the Ts + Pb group was significantly higher than those in the control, Ts, and Pb groups ( P < 0.05). The Mrc-2/iNOS, Ym1/iNOS of small intestinal tissue in the 4 groups were significantly different ( F=3.642, 22.360, P < 0.05). The Mrc-2/iNOS in the Ts + Pb group was significantly higher than those in the control and Pb groups ( P < 0.05). The Ym1/iNOS in the Ts + Pb group was higher than those in the control, Ts, and Pb groups ( P < 0.05). Conclusion:The non-specific immunity induced by Ts infection is involved in the regulation of intestinal immune response of mice infected with PbANKA, which may promote M2 polarization of macrophages in the small intestinal tissue.

BACKGROUND:At present, isokinetic testing system has attracted more and more attentions in the evaluation of athlete muscle function, but its application in the detection of waist and abdomen muscle strength characteristics in juvenile male basketbal athletes is rarely reported. OBJECTIVE:To study the biomechanical characteristics of waist flexor and extensor muscles inoutstanding juvenile male basketbal athletes in order to provide the basis for waist and abdominal strength training, scientific selection and prevention of lumbar abdomen injury in basketbal sport. METHODS:Eighteen athletes from the Guangzhou Men’s Basketbal Team were subjected to the detection of muscle strength and work of waist flexor and extensor muscles at 60(°)/s and 180(°)/s using Cybex-Norm isokinetic test system. RESULTS AND CONCLUSION:At the same testing speed, the peak torque and relative peak torque of the extensor muscles were higher than those of the flexor muscles (P<0.01). The increase in the peak torque, relative peak torque and total work of the waist extensor and flexor muscles exhibited a reduced tendency with the increasing of testing speed (P<0.05);the peak torque and relative peak torque of the extensor muscles were decreased more significantly (P<0.01);the relative power of the waist extensor and flexor muscles were increased gradual y with the increasing of testing speed (P<0.01). These parameters were better in perimeter players than in post players. Under the isokinetic concentric contraction, the peak torque ratio of extensor to flexor muscles showed a decreasing trend with the increasing of testing speed and the waist flexor peak torque and extensor muscles flexion showed a decreasing trend, and the trunk stability was weakened. These findings indicate that the muscle strength of the extensor muscles was higher than that of the flexor muscles;the muscles strength of the waist flexor and extensor muscles was better in perimeter players than in post players. In isokinetic rapid movement, the muscle strength of the waist flexor and extensor muscles were reduced and the balance of the muscle strength of the waist flexor and extensor muscles was weakened, suggesting rapid strength training of the waist and abdominal core muscles should be strengthened in juvenile male basketbal athletes.

Objective To observe the difference among the patients with chronic fatigue syndrome (CFS), mild-to-moderate depression or anxiety disorders in symptoms of fatigue, depression and anxiety. Methods Fatigue Scale-14 (FS-14), Hamilton Rating Scale for Depression (HAMD) and Hamilton Rating Scale for Anxiety (HAMA) were used to evaluate 182 cases with CFS, mild-to-moderate depression or anxiety disorders. Results There was no significant difference in physical fatigue, mental fatigue and comprehensive fatigue among 3 groups (P>0.05). There were 39 (62.9%) CFS patients perhaps with depression symptoms and 23 (37.1%) patients with mild-to-moderate depression symptoms. There were 46 (74.2%) CFS patients perhaps with anxiety symptoms and 16 (25.8%) patients with mild-to-moderate anxiety symptoms. The score of HAMD was significant lower in the CFS group than in the mild-to-moderate depression disorder group (P<0.001). There were significant differences in the anxiety/somatization and hysteresis (P<0.01), as well as in cognitive disturbance, diurnal variation and hopelessness (P<0.05) between the CFS group and mild-to-moderate depression disorder group. The scores of HAMA was significant lower in the CFS group than in the mild-to- moderate anxiety disorder group (P<0.001). There was significant difference in mental-anxiety (P<0.01), as well as in body-anxiety (P<0.05) between the CFS group and the mild-to-moderate anxiety disorder group. Conclusion The symptoms of emotion disorders and fatigue symptoms were both presented in patients with CFS, mild-to-moderate depression and anxiety disorders. They share common clinical features.

Objective To investigate the effect of self-designed closed negative pressure drainage combined with sponge dressings on refractory wounds.Methods Sixty patients with phase III-IV pressure ulcers were randomly divided into experiment group and control group in equal number.The self-designed closed negative pressure drainage combined with sponge dressing was applied in the experiment group and in the control group the conventional dressings were used.The two groups were compared in terms of hyperplasia of fresh granulation tissue,time for filling the defect and the healing time and the medical expense.Results Compared to the control group,the time for hyperplasia of fresh granulation tissue,the time for filling the defect and the healing time in the experiment group were all significantly shorter,and the medical expense of the experiment group was significantly less(all P<0.01). Conclusion The self-designed closed negative pressure drainage combined with sponge dressings in the treatment of phase III-IV refractory pressure ulcers may effectively shorten the healing time,improve the curative effects and reduce the economic burden of patients.

0.05,X 2 =0.45),and the focus stability ratio were42.5%and32.4%respectively.Compared with the FOLFOX4group,the hospitalization course in capecitabine group is significantly shorter(8.5days vs25.3days,P=0.000)and the total medical cost was significantly lower(5941.7RMB vs13304.6RMB,P=0.001).The cost structure analysis showed that the direct and indirect medical costs of the FOLFOX4group increased more significantly(P=0.001)and the incidence for adverse effects of this group was lower than that of the capecitabine group.CONCLUSION:From the perspective of pharmacoeconomic evaluation,capecitabine is better than FOLFOX4in treating the digestive malignant tumor.