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:To investigate the effects of scalp acupuncture of Baihui and Qubin acupoints combined with running track exercise on the neurological function of rats with middle cerebral artery occlusion(MCAO)cerebral ischemia and its regulatory effect on the Nrf2/HO-1 pathway by focusing on oxidative stress injury.Methods:A total of 40 male SD rats of SPF grade were selected and the cerebral ischemia model was established by ligation method.Among them,30 rats with successful modeling were randomly divided into the model group,the scalp-acupuncture group,and the combined group,with 10 rats in each group.Another 10 SPF male SD rats were used as the sham operation group.In the scalp-acupuncture group,electroacupuncture was applied to Baihui and Qubin acupoints.In the combined group,both electroacupuncture and running track exercise were applied.The treatment was carried out 6 times/week for a total of 4 weeks.The neurobehavioural function of rats was evaluated by Bederson Neurological Function Assessment.Pathological changes of rat brain tissue were observed by HE staining.SOD,serum MDA and GSH-px levels were detected by kit.The protein expression levels of Nrf2 and HO-1 in the rat brain tissue were detected by Western blot.Results:Compared with the sham-operated group,Bederson's neurological function score in the model group was significantly higher(P＜0.05),the pathological damage of HE-stained brain tissue was obvious,the level of MDA significantly increased(P＜0.05),the levels of SOD and GSH-px decreased(P＜0.05),and the protein expression levels of Nrf2 and HO-1 were significantly reduced(P＜0.05).Compared with the model group,Bederson neurological function scores were reduced in each treatment group(P＜0.05),the brain histopathological damage was alleviated,the level of MDA was reduced(P＜0.05),the levels of SOD and GSH-px was elevated(P＜0.05),and the protein expression levels of Nrf2 and HO-1 were significantly increased(P＜0.05).The Bederson neurological function score and MDA level in the combined group were lower than those in the scalp-acupuncture group(P＜0.05),and the levels of SOD and GSH-px and the expression levels of Nrf2 and HO-1 proteins were significantly higher than those in the scalp-acupuncture group(P＜0.05).Conclusions:Scalp acupuncture can improve the neurobehavioural dysfunction and pathological damage caused by cerebral ischemia,increase the antioxidant capacity,and the specific mechanism may be related to the activation of the Nrf2/HO-1 pathway.And scalp acupuncture combined with running track exercise has a synergistic effect and is more advantageous for treatment.

Objective:To explore the effect of evidence-based care model based on the need satisfaction theory in postoperative care of patients with intraspinal tumors.Methods:From August 2022 to August 2024, convenience sampling was used to select 150 patients with intraspinal tumors who underwent surgical treatment at Henan Provincial People's Hospital as research subjects. Patients enrolled from August 2022 to August 2023 were assigned to control group ( n=72), while those enrolled from September 2023 to August 2024 were assigned to intervention group ( n=78). Control group received routine postoperative care for intraspinal tumors, while intervention group received an evidence-based care model intervention based on the need satisfaction theory. Patients were surveyed using the Numerical Rating Scale (NRS), Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), Self-Perceived Burden Scale (SPBS), and Nursing Satisfaction Scale. Two groups of patients were compared in terms of the time to first ambulation after surgery, time to bowel movement recovery, hospital stay, pain levels at 1, 3, and 5 days postoperatively, psychological status, self-perceived burden, and patient satisfaction. Results:After intervention, patients in intervention group demonstrated shorter times to first ambulation after surgery, shorter times to bowel movement recovery, and shorter hospital stays compared to control group. Patients in intervention group had lower NRS scores than those in control group on both postoperative days 3 and 5. Patients in intervention group had higher CD-RISC scores across all dimensions and higher total scores compared to control group. Intervention group scored lower than control group on all dimensions of the SPBS and on the total score. Patients in intervention group reported higher satisfaction with nursing than those in control group. All differences were statistically significant ( P<0.05) . Conclusions:Evidence-based care model based on the need satisfaction theory accelerate postoperative recovery, alleviate postoperative pain, improve psychological status, reduce self-perceived burden in patients with intraspinal tumors, and enhance patient satisfaction.

Objective·To explore the effects and potential molecular mechanisms of blocking cannabinoid receptor 1(CB1)in acute lung injury(ALI)in mice.Methods·Forty mice were randomly divided into blank control group,AM281(CB1 antagonist)control group,lipopolysaccharide(LPS)group,and LPS+AM281 group,with ten mice in each group.ALI models were induced by LPS.The pathological manifestations of lung tissues were observed in each group of mice by hematoxylin and eosin(H-E)staining and the inflammation scores were calculated.The mRNA levels of M1 markers[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-12]and M2 markers[arginase(Arg),mannose receptor,C type 2(Mrc2),macrophage galactose-type lectin 1(Mgl1)]in lung macrophages were measured by reverse transcription and real-time fluorescence quantitative polymerase chain reaction(qPCR).Human myeloid leukemia monocytes THP-1 cells were cultured in vitro,and the expression of CB1 and CB2 in THP-1 cells was detected by immunofluorescence.After further blocking CB1 and inhibiting the Gαi/o/RhoA signaling pathway,the mRNA levels of M1 markers were assessed.Results·The LPS group showed significant lung tissue damage and a significant increase in inflammation scores in mice.After blocking CB1,compared with the LPS group,the LPS+AM281 group of mice showed improvements in lung injury,manifested as improved congestion of alveolar wall capillaries,reduced infiltration of inflammatory cells in the lung interstitium and alveolar cavity,and a decreased inflammation score(P=0.007).Compared with the control group,the levels of M1 marker in the lung tissue of the LPS group were upregulated,while the polarization of macrophages changed and the M1/M2 ratio was reversed after blocking CB1(all P<0.05).In vitro studies found that macrophages expressed CB1 and CB2.Activation of CB1 by arachidonyl-2-chloroethylamide(ACEA)upregulated the expression of M1 markers.Blocking CB1 and selectively inhibiting Gαi/o/RhoA signaling significantly downregulated M1 markers(all P<0.05).Conclusion·CB1 promotes the polarization of macrophage towards the M1 phenotype through the Gαi/o/RhoA signaling pathway in ALI,and blocking CB1 can improve lung injury.

Objective:To explore the predictive value of neutrophil-to-lymphocyte ratio (NLR) and tumor necrosis factor -α (TNF-α) level on the therapeutic effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation in patients with massive liver cancer.Methods:The medical records of 106 patients with massive liver cancer who underwent TACE combined with microwave ablation treatment in the Affiliated Hospital of Weifang Medical University from February 2020 to February 2023 were retrospectively analyzed. The efficacy was evaluated 6 weeks after surgery, and the patients were divided into remission group and non-remission group according to the therapeutic effect. The levels of NLR and TNF-α in the two groups were detected before surgery, 3 days after surgery and 7 days after surgery. Point two column correlation was used to analyze the relationship between the levels of NLR and TNF-α in different time periods and the therapeutic effect of TACE combined with microwave ablation in patients with massive liver cancer. The receiver operator characteristic (ROC) curve was drawn to analyze the predictive value of NLR and TNF-α levels in different time periods for the therapeutic effect of TACE combined with microwave ablation in patients with massive liver cancer.Results:Six weeks after surgery, out of 106 patients with massive liver cancer, 13 achieved complete remission, 48 achieved partial remission, 20 experienced disease progression, and 25 remained stable. The overall remission rate was 57.55% (61/106). Before surgery, the levels of NLR [ (2.26±0.13) vs. (2.43±0.12), t=6.87, P<0.001] and TNF-α [ (36.20±4.38) pg/ml vs. (42.74±5.74) pg/ml, t=6.66, P<0.001] in the remission group ( n=61) were lower than those in the non-remission group ( n=45), with statistically significant differences. At 3 days after surgery, there were no statistically significant difference in the levels of NLR [ (6.16±3.22) vs. (6.22±3.30), t=0.09, P=0.925] or TNF-α [ (48.84±7.22) pg/ml vs. (49.13±7.34) pg/ml, t=0.20, P=0.840] between the remission group and the non-remission group. At 7 days after surgery, the levels of NLR [ (2.60±0.18) vs. (2.82±0.26), t=5.15, P<0.001] and TNF-α [ (38.20±6.30) pg/ml vs. (45.57±5.79) pg/ml, t=6.16, P<0.001] in the remission group were lower than those in the non-remission group, with statistically significant differences. There were statistically significant differences in NLR and TNF-α levels before surgery, 3 days and 7 days after surgery between the remission group and the non-remission group ( F=82.43, P<0.001; F=54.45, P<0.001; F=76.23, P<0.001; F=15.61, P<0.001). Further pair-to-pair comparison showed that the levels of NLR and TNF-α were higher in both groups 3 and 7 days after surgery than before surgery, but the levels of NLR and TNF-α were lower in both groups 7 days after surgery than 3 days after surgery, with statistically significant differences (all P<0.005). Point two column correlation analysis showed that NLR level, TNF-α level and the efficacy of TACE combined with microwave ablation in patients with massive liver cancer were significantly positively correlated before and 7 days after surgery ( r=0.42, P<0.001; r=0.49, P<0.001; r=0.43, P<0.001; r=0.46, P<0.001). ROC curve showed that the area under the curve (AUC) of NLR and TNF-α alone in predicting the efficacy of TACE combined with microwave ablation in patients with massive liver cancer before and 7 days after surgery was 0.750 (95% CI: 0.656-0.844), 0.788 (95% CI: 0.699-0.877), 0.751 (95% CI: 0.652-0.850), 0.788 (95% CI: 0.700-0.876), respectively. The AUC of combined prediction of NLR and TNF-α before and 7 days after surgery were 0.818 (95% CI: 0.736-0.900) and 0.813 (95% CI: 0.730-0.897), respectively. There were no statistically significant differences in the AUC values of NLR and TNF-α alone or in combination for predicting the therapeutic effect of TACE combined with microwave ablation in patients with massive liver cancer before and 7 days after surgery (all P>0.05) . Conclusions:The levels of NLR and TNF-α before and 7 days after surgery are related to the effect of TACE combined with microwave ablation in patients with massive liver cancer, and the combination of NLR and TNF-α levels before and 7 days after surgery has certain value in predicting the effect of TACE combined with microwave ablation in patients with massive liver cancer.

Objective:To investigate the role of microRNA-25-5p (miR-25-5p) in melanogenesis, and to explore its underlying mechanisms.Methods:Target genes of miR-25-5p were predicted using the TargetScan database. The interaction between miR-25-5p and the 3' untranslated region (3' UTR) of the RAB11B gene (a member of RAS oncogene family) was validated through a dual-luciferase reporter assay. Post-inflammatory hyperpigmentation (PIH) models were established in female C57BL/6J mice (6 - 8 weeks old) and female brown guinea pigs (4 - 6 weeks old) through daily broadband ultraviolet B (UVB) irradiation on the dorsal skin of the mouse ear or shaved dorsal skin of guinea pigs, while untreated mice and untreated dorsal skin areas of guinea pigs served as control groups. During modeling, these experimental animals received intradermal injections of a miR-25-5p agomir or a miR control agomir. Changes in skin pigmentation were observed, and skin tissue samples were harvested for further analysis after modeling. Melanin content in skin tissues was evaluated using Masson-Fontana staining. Expression of RAB11B and tyrosinase (TYR) in skin tissues was determined using immunohistochemical staining and quantitative real-time PCR (qPCR). Primary human melanocytes were isolated from discarded normal foreskin tissues of healthy males after circumcision. Both primary human melanocytes and human MNT1 melanoma cells were transfected with miR-25-5p mimics or miR control mimics. Relative expression levels of miR-25-5p and RAB11B mRNA were quantified by qPCR using the 2 -ΔΔCt calculation method. In MNT1 cells, miR-25-5p and RAB11B were co-overexpressed to assess their effect on the mRNA expression of RAB11B and TYR. Statistical analysis was conducted using t test or one-way analysis of variance followed by Tukey's post hoc test for multiple comparisons. Results:The bioinformatic prediction and dual-luciferase reporter assay confirmed a binding site for miR-25-5p in the 3′ UTR of the RAB11B gene. In both animal models, the treatment with the miR-25-5p agomir significantly reduced local skin pigmentation compared to the control groups; Masson-Fontana staining showed a marked decrease in the density of melanin granules in the epidermis and dermis in the miR-25-5p agomir groups compared with the miR control agomir groups (mice: 0.050 ± 0.005 vs. 0.087 ± 0.008; guinea pigs: 0.067 ± 0.015 vs. 0.110 ± 0.013; both P < 0.05). Immunohistochemical staining revealed significantly lower expression of RAB11B in mouse skin tissues in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). qPCR revealed significantly lower mRNA expression of RAB11B and TYR in skin tissues of guinea pigs in the miR-25-5p agomir group than in those in the miR control agomir group (both P < 0.05). Similarly, RAB11B mRNA expression significantly decreased in the miR-25-5p mimics group compared with the miR control mimics group in primary human melanocytes and MNT1 cells (both P < 0.05). In human MNT1 melanoma cells, miR-25-5p overexpression could suppress TYR mRNA expression, whereas co-overexpression of miR-25-5p and RAB11B could reverse this suppression. Conclusion:Overexpression of miR-25-5p could alleviate UVB-induced post-inflammatory hyperpigmentation and inhibit melanogenesis, likely by targeted suppression of RAB11B expression.

OBJECTIVE To explore the distribution and drug resistance of the pathogens causing the abdominal(pelvic)soft tissue infections in secondary or above medical institutions of Suzhou so as to provide bases for pre-vention and control of the infections.METHODS The surveillance data of abdominal(pelvic)soft tissue infections that were reported regularly from 58 member institutions of Suzhou from Jan.2020 to Dec.2023 were collected from the regional nosocomial infection surveillance platform by Suzhou nosocomial infection management and qual-ity control center.Totally 26 tertiary hospitals and 32 secondary hospitals were involved.RESULTS Most of the 1178 strains of pathogens were isolated from the tertiary hospitals,the proportion of gram-negative bacteria was the highest;Escherichia coli,Klebsiella pneumoniae and Enterococcus faecium ranked the top 3 species.The constituent ratio of carbapenem-resistant Klebsiella pneumoniae(CRKP)strains the was highest among the mul-tidrug-resistant organisms.The K.pneumoniae and CRKP strains were sensitive to tigecycline;the E.coli strains were highly sensitive to carbapenems,minocycline and piperacillin-tazobactam;Stenotrophomonas maltophilia strains were highly resistant to most of the antibiotics;Enterobacter cloacae strains were highly resistant to ampi-cillin-sulbactam but were highly sensitive to carbapenems;the drug resistance rate of the A.baumannii strains to tigecycline was less than 5％;the drug resistance rate of Pseudomonas aeruginosa strains to ticarcillin-clavulanic acid was highest.CONCLUSIONS The abdominal(pelvic)soft tissue infection is always mixed infections.The pathogens show severe drug resistance.It is necessary to strengthen the surveillance of etiological spectrum and drug resistance and conduct targeted guidance for clinical practice of diagnosis and treatment.

Objective To explore the epidemiological characteristics and differences in antimicrobial resistance be-tween catheter-associated urinary tract infection(CAUTI)and non-CAUTI of healthcare-associated infection(HAI),and provide scientific basis for precise clinical prevention and control.Methods Based on the regional HAI surveillance platform in Suzhou City,urinary tract infection(UTI)surveillance data reported by 61 member units from January 2020 to December 2024 were analyzed retrospectively.Pathogen distribution,detection rate of multi-drug-resistant organisms(MDROs),and antimicrobial resistance spectrum characteristics of patients in the CAUTI group and non-CAUTI group were compared.Results The incidence of CAUTI in patients in CAUTI group was 0.99‰,the incidence of healthcare-associated UTI in patients in non-CAUTI group was 0.14％.There was statis-tically significant difference in the distribution of UTI pathogens between the two groups(P＜0.05).The patho-gens of the CAUTI group were mainly Gram-negative bacteria(56.1％),with high proportions of Escherichia coli(19.6％)and Klebsiella pneumoniae(15.0％).In the non-CAUTI group,the proportion of Gram-negative bacteria was higher(64.7％).Antimicrobial susceptibility testing results showed that the resistance rates of Escherichia co-li to tobramycin,cephalosporins,and carbapenems in the CAUTI group were all higher than those in the non-CAU-TI group(all P＜0.05).Except for tigecycline,the resistance rates of Klebsiella pneumoniae to other antimicrobial agents in the CAUTI group were all significantly different from the non-CAUTI group(all P＜0.05).The resis-tance rates of Acinetobacterbaumannii to ticarcillin/clavulanic acid,quinolones,most cephalosporins,carbapenems,and aminoglycosides in the CAUTI group were higher than those of the non-CAUTI group(all P＜0.05).The de-tection rates of MDROs were higher in the CAUTI group,especially that of carbapenem-resistant Klebsiella pneu-moniae,accounting for 57.8％.Conclusion There are significant differences in pathogen distribution and antimi-crobial resistance of UTI between the CAUTI group and the non-CAUTI group.It is necessary to establish a re-gional antimicrobial resistance surveillance system for pathogens in UTI,and provide basis for the rational use of an-timicrobial agents in clinical practice.

Adenosine monophosphate-activated protein kinase(AMPK),acting as a"molecular switch"for cellular energy status,regulates multiple metabolic pathways to maintain energy balance and plays a crucial role in the development of various ocular diseases.This article summarizes the mechanisms of AMPK in several ophthalmic diseases and the pro-gress of related research,with a focus on age-related macular degeneration,diabetic retinopathy,and ocular surface disea-ses.By reviewing the pathogenesis of these diseases and the regulatory role of the AMPK signaling pathway,we explore the potential applications of the AMPK signaling pathway in the treatment of ophthalmic diseases and analyze the limitations and deficiencies of current research.With further investigation,regulatory strategies targeting the AMPK signaling pathway are expected to provide new ideas and potential therapies for the treatment of ophthalmic diseases in the future.

Objective:To explore the effect of evidence-based care model based on the need satisfaction theory in postoperative care of patients with intraspinal tumors.Methods:From August 2022 to August 2024, convenience sampling was used to select 150 patients with intraspinal tumors who underwent surgical treatment at Henan Provincial People's Hospital as research subjects. Patients enrolled from August 2022 to August 2023 were assigned to control group ( n=72), while those enrolled from September 2023 to August 2024 were assigned to intervention group ( n=78). Control group received routine postoperative care for intraspinal tumors, while intervention group received an evidence-based care model intervention based on the need satisfaction theory. Patients were surveyed using the Numerical Rating Scale (NRS), Chinese version of the Connor-Davidson Resilience Scale (CD-RISC), Self-Perceived Burden Scale (SPBS), and Nursing Satisfaction Scale. Two groups of patients were compared in terms of the time to first ambulation after surgery, time to bowel movement recovery, hospital stay, pain levels at 1, 3, and 5 days postoperatively, psychological status, self-perceived burden, and patient satisfaction. Results:After intervention, patients in intervention group demonstrated shorter times to first ambulation after surgery, shorter times to bowel movement recovery, and shorter hospital stays compared to control group. Patients in intervention group had lower NRS scores than those in control group on both postoperative days 3 and 5. Patients in intervention group had higher CD-RISC scores across all dimensions and higher total scores compared to control group. Intervention group scored lower than control group on all dimensions of the SPBS and on the total score. Patients in intervention group reported higher satisfaction with nursing than those in control group. All differences were statistically significant ( P<0.05) . Conclusions:Evidence-based care model based on the need satisfaction theory accelerate postoperative recovery, alleviate postoperative pain, improve psychological status, reduce self-perceived burden in patients with intraspinal tumors, and enhance patient satisfaction.