Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.

Objective:To analyze the impact of transcervical resection of adhesion (TCRA) on obstetric complications in patients after frozen-thawed embryo transfer (FET) and its associated factors.Methods:A retrospective cohort study was conducted by collecting clinical data from patients who underwent autologous oocyte FET treatment and gave birth to at least one live newborn at the Reproductive Medicine Center of Nanjing Women and Children's Healthcare Hospital from April 2015 to May 2022. Based on the uterine condition, patients were divided into three groups: control group with normal uterine morphology (712 cases); the intrauterine adhesion (IUA) group consisting of IUA patients who did not undergo TCRA surgery (45 cases); the TCRA group, which included IUA patients who received TCRA treatment (51 cases). The relationship between uterine conditions and obstetric complications among the three groups was investigated using propensity score matching (PSM). Multivariate logistic regression analysis was applied to identify risk factors associated with obstetric complications related to TCRA. The performance of the constructed multivariate logistic regression model was evaluated using calibration curves and receiver operating characteristic (ROC) curves.Results:1) Before PSM, statistically significant differences were observed among the three groups regarding endometrial thickness, the presence of a scarred uterus, numbers of pregnancies, deliveries, miscarriages, induced abortions, and transferred embryos (all P<0.05). After PSM, baseline characteristics were balanced across the groups. The rates of placenta accreta spectrum disorders (PAS) in the TCRA group [48.8% (20/41)] and the IUA group [45.2% (19/42)] were significantly higher than those in control group [24.7% (18/73), P=0.016; 22.8% (18/79), P=0.019]. 2) Multivariable logistic regression analysis revealed that endometrial thickness ( OR=0.79, 95% CI: 0.69-0.90, P<0.001], number of pregnancies (2 times, OR=2.25, 95% CI: 1.33-3.82, P=0.003), endometrial preparation protocol (gonadotropin-releasing hormone agonist plus hormone replacement therapy, OR=2.29, 95% CI: 1.16-4.52, P=0.017), the presence of a scarred uterus ( OR=2.19, 95% CI: 1.39-3.45, P<0.001), and uterine cavity conditions (IUA and TCRA, OR=2.11, 95% CI: 1.07-4.17, P=0.031; OR=2.70, 95% CI: 1.37-5.31, P=0.004) were independent predictors of PAS occurrence. 3) The area under the ROC curve for this model was 0.732 (95% CI: 0.686-0.778). Calibration curve results, after internal validation, showed good consistency between predicted risks and actual outcomes, demonstrating good discriminative ability and calibration ( P=0.540). Conclusion:The incidence of obstetric complications such as placenta previa, postpartum hemorrhage, and premature rupture of membranes in patients who underwent TCRA surgery was comparable to that of patients with a normal uterine morphology. However, TCRA significantly increased the risk of PAS in patients with IUA undergoing FET assisted reproductive treatment.

Objective:To analyze the impact of transcervical resection of adhesion (TCRA) on obstetric complications in patients after frozen-thawed embryo transfer (FET) and its associated factors.Methods:A retrospective cohort study was conducted by collecting clinical data from patients who underwent autologous oocyte FET treatment and gave birth to at least one live newborn at the Reproductive Medicine Center of Nanjing Women and Children's Healthcare Hospital from April 2015 to May 2022. Based on the uterine condition, patients were divided into three groups: control group with normal uterine morphology (712 cases); the intrauterine adhesion (IUA) group consisting of IUA patients who did not undergo TCRA surgery (45 cases); the TCRA group, which included IUA patients who received TCRA treatment (51 cases). The relationship between uterine conditions and obstetric complications among the three groups was investigated using propensity score matching (PSM). Multivariate logistic regression analysis was applied to identify risk factors associated with obstetric complications related to TCRA. The performance of the constructed multivariate logistic regression model was evaluated using calibration curves and receiver operating characteristic (ROC) curves.Results:1) Before PSM, statistically significant differences were observed among the three groups regarding endometrial thickness, the presence of a scarred uterus, numbers of pregnancies, deliveries, miscarriages, induced abortions, and transferred embryos (all P<0.05). After PSM, baseline characteristics were balanced across the groups. The rates of placenta accreta spectrum disorders (PAS) in the TCRA group [48.8% (20/41)] and the IUA group [45.2% (19/42)] were significantly higher than those in control group [24.7% (18/73), P=0.016; 22.8% (18/79), P=0.019]. 2) Multivariable logistic regression analysis revealed that endometrial thickness ( OR=0.79, 95% CI: 0.69-0.90, P<0.001], number of pregnancies (2 times, OR=2.25, 95% CI: 1.33-3.82, P=0.003), endometrial preparation protocol (gonadotropin-releasing hormone agonist plus hormone replacement therapy, OR=2.29, 95% CI: 1.16-4.52, P=0.017), the presence of a scarred uterus ( OR=2.19, 95% CI: 1.39-3.45, P<0.001), and uterine cavity conditions (IUA and TCRA, OR=2.11, 95% CI: 1.07-4.17, P=0.031; OR=2.70, 95% CI: 1.37-5.31, P=0.004) were independent predictors of PAS occurrence. 3) The area under the ROC curve for this model was 0.732 (95% CI: 0.686-0.778). Calibration curve results, after internal validation, showed good consistency between predicted risks and actual outcomes, demonstrating good discriminative ability and calibration ( P=0.540). Conclusion:The incidence of obstetric complications such as placenta previa, postpartum hemorrhage, and premature rupture of membranes in patients who underwent TCRA surgery was comparable to that of patients with a normal uterine morphology. However, TCRA significantly increased the risk of PAS in patients with IUA undergoing FET assisted reproductive treatment.

Objective:This meta-analysis aims to explore the most consistent changes in cortical thickness in drug-naive first-episode patients with major depressive disorder (DF-MDD).Methods:Systematic and comprehensive searches were conducted to acquire relevant literature from the PubMed and Web of Science databases for the studies published from inception to July 23, 2023, by using the keywords ("depression" OR "depressive disorder" OR "unipolar depression") AND ("cortical thickness"OR"thickness"). The SDM (signed differential mapping) software was used to perform whole-brain voxel-wise meta-analysis, heterogeneity test, and assess publication bias. Meta-regression analysis was employed to examine the impact of disease severity on cortical thickness in depression, and heterogeneity was tested, along with an assessment of publication bias.Results:Eight studies were ultimately included, encompassing 417 DF-MDD patients and 409 healthy controls. Compared to the healthy control group, DF-MDD patients exhibited significantly decreased cortical thickness in multiple brain regions, including the supplementary motor area ( Z=-2.471, P<0.000 5) and the rolandic operculum ( Z=-2.190, P<0.000 5). Further regression analysis found that the disease severity was positively correlated with the cortical thickness in the supplementary motor area ( Z=2.265, P<0.000 5) and the rolandic operculum ( Z=1.56, P<0.000 5). Additionally, the average depressive duration was positively correlated with cortical thickness in the right opercular part of the inferior frontal gyrus ( Z=1.922, P<0.000 5), and negatively correlated with changes in the right midcingulate cortex ( Z=-3.035, P<0.000 5) in DF-MDD. Conclusion:DF-MDD patients exhibit reduced cortical thickness in the supplementary motor area and the operculum area during the early stages of the disease. And the observed pattern of cortical alterations is associated with both the severity and duration of the disease.

Fusobacterium nucleatum (F. nucleatum) is an early pathogenic colonizer in periodontitis, but the host response to infection with this pathogen remains unclear. In this study, we built an F. nucleatum infectious model with human periodontal ligament stem cells (PDLSCs) and showed that F. nucleatum could inhibit proliferation, and facilitate apoptosis, ferroptosis, and inflammatory cytokine production in a dose-dependent manner. The F. nucleatum adhesin FadA acted as a proinflammatory virulence factor and increased the expression of interleukin(IL)-1β, IL-6 and IL-8. Further study showed that FadA could bind with PEBP1 to activate the Raf1-MAPK and IKK-NF-κB signaling pathways. Time-course RNA-sequencing analyses showed the cascade of gene activation process in PDLSCs with increasing durations of F. nucleatum infection. NFκB1 and NFκB2 upregulated after 3 h of F. nucleatum-infection, and the inflammatory-related genes in the NF-κB signaling pathway were serially elevated with time. Using computational drug repositioning analysis, we predicted and validated that two potential drugs (piperlongumine and fisetin) could attenuate the negative effects of F. nucleatum-infection. Collectively, this study unveils the potential pathogenic mechanisms of F. nucleatum and the host inflammatory response at the early stage of F. nucleatum infection.
Humans ; Fusobacterium nucleatum/metabolism* ; NF-kappa B/metabolism* ; Periodontal Ligament/metabolism* ; Signal Transduction ; Fusobacterium Infections/pathology* ; Stem Cells/metabolism*

Objective:To evaluate the safety and efficacy of Delorme procedure for adults with full-thickness rectal prolapse.Methods:Clinical data of 17 adult patients suffering from full-thickness rectal prolapse undergoing Delorme procedure from June 2014 to May 2018 in Hangzhou Third Hospital were retrospectively analyzed. Patient characteristics, operative data, postoperative complications, recurrence of rectal prolapse, continence state and constipation state were evaluated.Results:Eleven patients were female, 6 patients were male with a mean age of (68 ± 9) years. Operations were successfully performed in these 17 cases. The operation time was (88 ± 16) minutes. The estimated blood loss during operation was (23 ± 9) ml. The postoperative time of hospital stay was (8 ± 1) d. Two complications in two patients were observed. There was no treatment related death. One recurrent case was observed during (16 ± 2) months follow-up. The preoperative and postoperative mean constipation score of five patients with fecal constipation were (23 ± 2) and (11 ± 3) respectively ( t = 9.51, P<0.01). The mean fecal incontinence score of six patients with fecal incontinence, before and after Delorme procedure, were (14 ± 2) and (6 ± 2) respectively ( t = 9.09, P<0.01). Conclusions:The Delorme procedure for adults with full-thickness rectal prolapse is a safe and effective surgery with less complications and low recurrence rate. The Delorme procedure may be one of the preferred option of perineal approach for adults with full-thickness rectal prolapse, but the long-term outcome of Delormer procedure and its effect on postoperative anal function need to be further studied.

Objective:To investigate the personality traits of patients with anxious depression and the relationship between personality traits and clinical symptoms.Methods:From December 2011 to October 2014, 177 first-episode untreated patients with depression from the psychiatric department of the First Affiliated Hospital of Kunming Medical University and 185 healthy controls(HC group) recruited by the community were included.All patients were divided into anxious depression group ( n=92) and non-anxious depression group ( n=85) according to whether the anxiety/somatization factor score ≥7.The simplified version of Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI) and the Hamilton depression scale-17 (HAMD-17) were used to assess all the subjects.Statistical analyses were conducted in SPSS 21.0.Analysis of covariance was used to compare the differences of the scores on personality dimensions among the three groups.The relationship between personality dimensions and anxious depression was confirmed by Logistic regression, linear regression analysis and generalized linear models. Results:The differences of the scores on the four dimensions of neuroticism ( F=108.863, P<0.01), extraversion ( F=86.357, P<0.01), agreeableness ( F=50.615, P<0.01), and conscientiousness ( F=24.730, P<0.01) among the three groups were statistically significant.Further pairwise comparision showed, the score of neuroticisms was higher in the anxious depression group(43.05±8.92) and non-anxious depression group(39.85±7.21) than that in the HC group (30.16±6.25)( P<0.01, Bonferroni corrected). The scores of extroversion (31.22±6.33, 32.61±6.83), agreeableness (38.66±5.80, 39.46±6.19) and conscientiousness (39.75±6.89, 38.85±7.26) were lower in the anxious depression group and non-anxious depression group than those in the HC group (40.29±5.37, 44.79±4.68, 44.09±5.66, all P<0.01, Bonferroni corrected). The score of neuroticisms in anxious depression group was higher than that in non-anxious depression group, and the difference was statistically significant ( P<0.01, Bonferroni corrected). Logistic regression analysis with age, gender and years of education controlled showed that the score of neuroticism ( B=0.082, OR=1.085, 95% CI=1.020-1.154, P=0.009) and conscientiousness ( B=0.060, OR=1.062, 95% CI=1.006-1.120, P=0.028) were risk factors for anxiety symptoms in patients with depression.Linear regression analysis showed that the scores on neuroticism had positive predictive effects on the anxiety/somatization factor score ( B=0.055, 95% CI=0.021-0.089, P=0.002) and cognitive impairment factor score ( B=0.074, 95% CI=0.023-0.125, P=0.005) in the anxious depression group. Conclusion:Compared to non-anxious depression, patients with anxious depression show higher level of neuroticism, and the level of neuroticism can positively predict the symptoms of anxiety and cognitive impairment.The high level of neuroticism and conscientiousness may be risk factors for the occurrence of anxiety symptoms in patients with depressed.

Objective To investigate the fertility history and demand for reproductive health services of new residents in Shanghai. Methods A questionnaire survey was conducted among 1 358 new residents in 36 survey sites in 7 districts of Shanghai from July to September 2020. The content includes fertility history， induced abortion history， demand for reproductive health-related services， awareness rate of the Shanghai Family Planning Association and service access rate， etc. Results Among the new residents themselves and their spouses/sexual partners， 31.3% （374/1 194） had been pregnant once and 33.6% （401/1 194） had been pregnant twice； 46.3% （533/1 194）had one child and 29.7% （355/1 194）had two children. The difference of number of births among new residents with different residence time， those who did or did not possess permanent residency or residence permits， and those from different sources （urban or rural） was statistically significant （ χ ²=158.664， 50.263， 16.011， 114.419， all P <0.001）. Among the new residents themselves and their spouses / sexual partners， the proportion of induced abortion of more than once was 36.1%. The difference of the number of abortions of new residents with or without permanent residency was statistically significant （ χ ²=19.389， P <0.001）. The awareness rate of new residents of the harm of induced abortion to health was 92.1% （1 100/1 194）； There were significant differences in the scientific knowledge of harm of induced abortion to health among new residents with different local residence time and those with or without a residence permit （ χ ²=36.590， 20.926， both P <0.001）. The awareness rate of the Family Planning Association was 82.6% （986/1 194）， and the service access rate was 51.3% （613/1 194）. Permanent residency and residence permits are the main factors that affect the service accessibility of the Shanghai Family Planning Association. 44.8% （535/1 194） of new residents hope to receive reproductive health services in their place of residence， and they are most concerned about knowledge on good prenatal and postnatal care. Conclusion We should further publicize the "three-child" fertility policy， advocate a friendly fertility culture， and provide new residents with people-centered and accurate reproductive health services adapted to their needs through multi-sectoral cooperation， so as to improve their reproductive health level.

Autism spectrum disorder (ASD), a representative disease of children's neurodevelopmental disorders, brings huge pressure and financial burden to families and society. It is of great significance to explore its etiology and pathogenesis. Therefore, we established an ASD Cohort based on the existing China National Birth Cohort (CNBC), which applied parallel design to recruit and follow up families who achieved pregnancy after receiving assisted reproductive technologies (ART) and families with spontaneous conception. The main aims of this study are to compare the incidence of ASD among children born after ART with those born under spontaneous pregnancy, and to evaluate the impact of ART on the neurobehavioral development of offspring. Additionally, with a variety of clinical and behavioral related information collected during pregnancy and at early life of offspring, we are able to investigate the risk factors associated with ASD comprehensively. This article briefly introduces the objectives, contents, preliminary progress, strength and limitations, as well as further prospects of the ASD cohort study, mainly focusing on the overall design and current progress.