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*

Oral squamous cell carcinoma(OSCC)associated pain commonly predicts adverse events among patients.This clinical feature indicates the engagement of nociceptors on sensory neurons during the development of malignancy.However,it is yet to be determined if targeting oncometabolite-associated nociception processes can hinder OSCC progression.In this study,we reported that nociceptive endings infiltrating both clinical samples and mouse tumor xenografts were associated with poorer clinical outcomes and drove tumor progression in vivo,as evidenced by clinical tissue microarray analysis and murine lingual denervation.We observed that the OSCC microenvironment was characteristic of excessive adenosine due to CD73 upregulation which negatively predicted clinical outcomes in the TCGA-HNSC patient cohort.Notably,such adenosine concentrative OSCC niche was associated with the stimulation of adenosine A2A receptor(A2AR)on trigeminal ganglia.Antagonism of trigeminal A2AR with a selective A2AR inhibitor SCH58261 resulted in impeded OSCC growth in vivo.We showed that trigeminal A2AR overstimulation in OSCC xenograft did not entail any changes in the transcription level of CGRP in trigeminal ganglia but significantly triggered the release of CGRP,an effect counteracted by SCH58261.We further demonstrated the pro-tumor effect of CGRP by feeding mice with the clinically approved CGRP receptor antagonist rimegepant which inhibited the activation of ERK and YAP.Finally,we diminished the impact of CGRP on OSCC with istradefylline,a clinically available drug that targets neuronal A2AR.Therefore,we established trigeminal A2AR-mediated CGRP release as a promising druggable circuit in OSCC treatment.

Oral squamous cell carcinoma(OSCC)associated pain commonly predicts adverse events among patients.This clinical feature indicates the engagement of nociceptors on sensory neurons during the development of malignancy.However,it is yet to be determined if targeting oncometabolite-associated nociception processes can hinder OSCC progression.In this study,we reported that nociceptive endings infiltrating both clinical samples and mouse tumor xenografts were associated with poorer clinical outcomes and drove tumor progression in vivo,as evidenced by clinical tissue microarray analysis and murine lingual denervation.We observed that the OSCC microenvironment was characteristic of excessive adenosine due to CD73 upregulation which negatively predicted clinical outcomes in the TCGA-HNSC patient cohort.Notably,such adenosine concentrative OSCC niche was associated with the stimulation of adenosine A2A receptor(A2AR)on trigeminal ganglia.Antagonism of trigeminal A2AR with a selective A2AR inhibitor SCH58261 resulted in impeded OSCC growth in vivo.We showed that trigeminal A2AR overstimulation in OSCC xenograft did not entail any changes in the transcription level of CGRP in trigeminal ganglia but significantly triggered the release of CGRP,an effect counteracted by SCH58261.We further demonstrated the pro-tumor effect of CGRP by feeding mice with the clinically approved CGRP receptor antagonist rimegepant which inhibited the activation of ERK and YAP.Finally,we diminished the impact of CGRP on OSCC with istradefylline,a clinically available drug that targets neuronal A2AR.Therefore,we established trigeminal A2AR-mediated CGRP release as a promising druggable circuit in OSCC treatment.

Objective: To evaluate the inter-observer agreement of the severity of oral epithelial dysplasia in oral leukoplakia, providing a theoretical basis for the development of a more objective grading system. Methods: This study included 60 digital pathological slides of oral leukoplakia from Oral Medicine Department of West China Hospital of Stomatology, Sichuan University, and 239 tissue microarray images of oral leukoplakia from State Key Laboratory of Oral Diseases, Sichuan University, to evaluate the agreement of grading. Besides, 1 000 patches were generated from the 60 digital pathological slides and were divided into 500 small-sized patches (224 pixel×224 pixel) and 500 large-sized patches (1 024 pixel×1 024 pixel), to evaluate the agreement of feature detection. Gradings and feature detections were completed by three pathological experts from the oral pathology departments of two Grade 3, Class A stomatological hospitals in China. Kappa coefficient was used to quantify the inter-observer agreement among pathologists. Results: Minimal agreement was found in the grading of oral epithelial dysplasia among pathologists (Kappa=0.30 in the pathological slide group, Kappa=0.30 in the tissue microarray group). None agreement was found in feature detection within the small-sized patches group (median Kappa=0.14 for architectural features, median Kappa=0.18 for cytological features), and minimal agreement was found in feature detection within the large-sized patches group (median Kappa=0.25 for architectural features, median Kappa=0.25 for cytological features). Conclusions: Generally, the agreement of grading and feature detection of oral epithelial dysplasia in oral leukoplakia is poor. Development of a more objective grading system of oral epithelial dysplasia based on artificial intelligence may be helpful to improve the agreement.
Artificial Intelligence ; China ; Humans ; Leukoplakia, Oral ; Observer Variation ; Precancerous Conditions

Objective To analyze the changes in number and biological ability of endothelial progenitor cells (EPCs) from peripheral blood of SLE patients. Methods Mononuclear cells (MNCs) were isolated by Ficoll density gradient centrifugation from peripheral blood of 20 female SLE patients and 20 healthy female controls. EPCs were identified by double staining using antibodies to CD34 and CD133, or antibodies to CD133 and vascular endothelial growth factor receptor 2 (VEGFR2). Phycoerythrin (PE) conjugated antiCD34, fluorescein isothiocyanate (FITC) conjugated anti-CD133 and APC conjugated anti-VEGFR2 antibodies were used in a three color flow cytometric analysis to determine the percentage of EPCs in peripheral MNCs.The proliferation and migration ability of EPCs were measured by MTT assay and modified millicell chamber assay, respectively. The adhesion activity of EPCs was evaluated by counting the number of adherent cells.Results The percentage and proliferation rate of EPCs in peripheral MNCs from female SLE patients were significantly lower than those from the healthy controls(4.49% ± 1.66% vs 20.81% ± 4.14%, 23.11% ± 3.16%vs 35.65% ± 1.74%, both P ＜ 0.01 ). The migration and adhesion ability of EPCs from SLE patients was impaired compared with those from the healthy controls (12.00 ± 2.12 vs 23.60 ± 3.0 cells/field, 22.43 ± 4.43vs 36.43 ± 3.69 cells/filed, both P ＜ 0.01 ). Conclusion There is a decrease in the number and an impairment in biological ability of EPCs in SLE patients.

AIM　To establish the fluorescent measurement technique for H+/K+ exchange in primary cultured IMCD cell monolayers of rabbit kidney. METHODS　To measure H+/K+ exchange in the primary cultured IMCD cell monolayers under different CO2 concentrations by the BCECF/AM fluorescent probe.RESULTS　［pH］i recovery rate after acid loaded in the respiratory acidosis group was 0.0620±0.012，and was significantly higher than that of the control group（0.0504±0.009，P<0.05）;which in the respiratory alkalosis group was 0.0476±0.007, there was no signifacant difference between ALG and CG （P>0.05）. CONCLUSION　The fluorescent measurements of H+/K+ exchange in primary cultured IMCD cell monolayers of rabbit kidney has many benefits which are convenient manipulation, stable and credit result, economy and safety , this method should further be popularized.

Objective To evaluate the effect of furosemide on Cl -/HCO- 3 exchange of inner medullary collecting duct(IMCD) in rabbit kidney. Methods The effect of furosemide in different concentrations on the changes in Cl -/HCO- 3 exchange in mono-layer of IMCD cell in rabbit kidney was determined by fluorescent probe technique. Results Cl -/HCO- 3 exchange in IMCD cell could be inhibited by 4.3% by 15?mol/L furo semide solution, and 480?mol/L furosemide solution could inhibit the exchange by 97.4%. The Cl -/HCO- 3 exchange rates of the groups, in which the final concentrations of furosemide were equal to or higher than 30?mol/L, were significantly lower than that of the control group(P

Objective To investigate the influence of clindamycin (CM) on the biofilm of mucoid P. aeruginosa (PA). Methods A biofilm model of mucoid PA were reproduced in vitro by plate culture method, and it was identified under SEM (scanning electronic microscopy). The viable bacteria were counted by MTT method. The morphology of biofilms was observed under SEM. Results Stable PA biofilms formed after PA was incubated for 7 days. The viable bacteria and biofilm morphology showed little change in single CM or levofloxacin (LFX) drug groups. When CM was combined with LFX, the number of viable bacteria was significantly decreased, and the biofilm structure was damaged, and the remaining bacteria were separated. Conclusion Clindamycin can suppress the biofilm formation of mucoid PA when combined with LFX.

Objective To investigate the synergic bactericidal activity of Herba Houttuyniae combined with levofloxacin on the biological envelope of mucoid Pseudomonas aeruginosa(PA).Methods MIC (minimal inhibitory concentration) was determined by using tube doubling dilution method. In-vitro biological envelope models of PA were established by plate cultivation method. The bacterial colony were counted by MTT method. The morphology of biological envelope were observed under scanning electronic microscope (SEM) .Results On the 7th day of cultivation,the stable biological envelope formed.Herba Houttuyniae or levofloxacin alone had no effect on the biological envelope or the number of surviving bacterial colony. The combination of the above two could destroy the structure of biological envelope and decrease the number of surviving bacterial colony.Conclusion Herba Houttuyniae combined with levofloxacin has synergistic germicidal actions on biological envelope of PA.

AIM To establish the fluorescent measurement technique for H+ /K+ exchange in primary cultured IMCD cell monolayers of rabbit kidney. METHODS To measure H+ /K+ exchange in the primary cultured IMCD cell monolayers under different CO2 concentrations by the BCECF/AM fluorescent probe. RESULTS [pH], recovery rate after acid loaded in the respiratory acidosis group was 0.0620 ? 0.012, and was significantly higher than that of the control group (0.0504 ? 0.009, P 0.05). CONCLUSION The fluorescent measurements of H+ /K+ exchange in primary cultured IMCD cell monolayers of rabbit kidney has many benefits which are convenient manipulation, stable and credit result, economy and safety, this method should further be popularized.