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 evaluate function of human neutrophil peptides(HNPs)for the severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods From December 2021 to December 2023,80 ARDS patients were enrolled in the study from the intensive care unit(ICU)of Shenzhen Qianhai Shekou Free Trade Zone Hospital.Plasma samples were taken within 24 hours after admission to ICU,HNPs concentration was then measured with enzyme-linked immunesorbent assay.Differences in HNPs concentration and acute physiology and chronic health evaluation-Ⅱ(APACHE Ⅱ)score etc.Clinical index parameters were compared in survival group(n=48)and death group(n=32)based on their 28-day outcomes.The correlation between HNPs concentration and APACHE Ⅱ score were calculated by Spearman correlation analysis.We analyzed the risk factors for 28 days death of ARDS patients by single-factor Logistic regression,then used the significant risk factors to analyze death odds ratio by multivariate Logistic regression analysis.Results HNPs concentration and APACHE Ⅱ score of death group was significantly increased than those of survival group(P<0.001).HNPs concentration has a positive correlation with APACHE Ⅱ score(r=0.344,P<0.001).HNPs and APACHE Ⅱ were independent prognosis factor of 28-day mortality of ARDS patients.Conclusion Plasma HNPs concentration may be early used to evaluate the severity and prognosis of ARDS patients.

Objective To evaluate function of human neutrophil peptides(HNPs)for the severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods From December 2021 to December 2023,80 ARDS patients were enrolled in the study from the intensive care unit(ICU)of Shenzhen Qianhai Shekou Free Trade Zone Hospital.Plasma samples were taken within 24 hours after admission to ICU,HNPs concentration was then measured with enzyme-linked immunesorbent assay.Differences in HNPs concentration and acute physiology and chronic health evaluation-Ⅱ(APACHE Ⅱ)score etc.Clinical index parameters were compared in survival group(n=48)and death group(n=32)based on their 28-day outcomes.The correlation between HNPs concentration and APACHE Ⅱ score were calculated by Spearman correlation analysis.We analyzed the risk factors for 28 days death of ARDS patients by single-factor Logistic regression,then used the significant risk factors to analyze death odds ratio by multivariate Logistic regression analysis.Results HNPs concentration and APACHE Ⅱ score of death group was significantly increased than those of survival group(P<0.001).HNPs concentration has a positive correlation with APACHE Ⅱ score(r=0.344,P<0.001).HNPs and APACHE Ⅱ were independent prognosis factor of 28-day mortality of ARDS patients.Conclusion Plasma HNPs concentration may be early used to evaluate the severity and prognosis of ARDS patients.

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*

Objective To analyze the potential factors affecting the prognosis of patients with sepsis and evaluate their values in predicting the disease outcome. Methods A clinical prospective study was conducted. Fifty-three septic patients admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangzhou Medical University from October 17th, 2012 to August 8th, 2013 were enrolled, and in the same term 35 volunteers having passedphysical check-up were assigned in the healthy control group. According to the severity of the patients, they were divided into sepsis, severe sepsis and septic shock groups. Furthermore, based on the difference in scores of acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), the patients were divided into low-risk (APACHE Ⅱ scores < 10), middle-risk (APACHE Ⅱ scores 10 - 19) and high-risk groups (APACHE Ⅱ scores≥ 20 ). According to whether the coagulation dysfunction occurred or not and whether the dysfunction was adjusted or not at the end of observation, the septic patients were divided into non-coagulation defect group, and adjusted and non-adjusted coagulation defect groups. After entrance of groups, the clinical data, including gender, age, body temperature, blood pressure, prothrombin time (PT), prothrombin time activity (PTA), activated partial thromboplastin time (APTT), international normalized ratio (INR), levels of D-dimer, fibrinogen (Fib), blood lactate, and serum procalcitonin (PCT) were recorded, and APACHEⅡscore was calculated. In 24 hours after admission, blood samples were collected, and the levels of interleukins (IL-6, IL-8) were tested by Bio-Plex 200 System. The prognostic factors related to sepsis were screened by binary multivariate logistic regression analysis. The receiver operating characteristic curve (ROC) were used to evaluate the prognostic values of blood lactate, PCT, IL-6, IL-8 and APACHE Ⅱ scores for patients with sepsis. Results Fifty-three patients were enrolled, including 17 patients in sepsis group in which blood coagulation dysfunction occurred in 8 cases, of them 7 being adjusted, and 5 died; 15 patients in severe sepsis group, in which blood coagulation dysfunction occurred in 7 cases, of them 2 being adjusted, and 7 died;21 patients in septic shock group in which blood coagulation dysfunction occurred in 18 cases, of them 4 being adjusted, and 18 died. Both IL-6 and IL-8 levels of sepsis group were significantly higher than those in healthy control group (both P<0.01). Univariate logistic regression analysis showed that the grade of sepsis severity, APACHEⅡscore, IL-6, IL-8, blood lactate, PCT and coagulation dysfunction were related to the prognosis of septic patients. Multivariate logistic regression analysis confirmed that blood lactate concentration [β=0.891,χ2 = 5.872, P = 0.015, odds ratio (OR) = 2.438, 95% confidence intervals (95%CI) was 1.186 - 5.013] and coagulation function status (non-adjusted coagulation defect group:β=3.563,χ2=9.980, P=0.002, OR=35.286, 95%CI was 3.868-3.563) were independent prognostic factors of septic patients. The ROC curve analysis showed:for the level of blood lactate, the area value under ROC curve (AUC) was 0.767, the best cutoff value was 2.15 mmol/L with the Youden index of 0.386;for PCT, the AUC was 0.698, the best cutoff value was 9.39μg/L with the Youden index of 0.406;for IL-8, AUC was 0.686, the best cutoff value was 20.06 ng/L with the Youden index of 0.312;and for IL-6, AUC was 0.681, the best cutoff value was 45.44 ng/L with the Youden index of 0.406. Multivariate logistic regression analysis confirmed that the plasma levels of IL-6 and IL-8 were the independent risk factors of septic patients' coagulation function. The IL-6 concentration of non-coagulation defect group was significantly lower than that in adjusted coagulation defect group (ng/L:29.26 vs. 67.98, P<0.05) and non-adjusted coagulation defect group (ng/L:29.26 vs. 128.00 P<0.05). There was no significant difference in IL-6 level between the adjusted and non-adjusted coagulation defect groups (P>0.05). The IL-8 level of non-coagulation defect group was significantly lower than that of adjusted (ng/L:24.67 vs. 27.23, P<0.05) and non-adjusted coagulation defect groups (ng/L:24.67 vs. 60.14, P<0.05). There was no statistically significant difference in IL-8 concentration between adjusted and non-adjusted coagulation defect groups (P>0.05). Conclusions The grade of sepsis severity, APACHEⅡscore, whether existence of coagulation dysfunction being present or not and whether its presence being adjusted or not during the septic patients' stay in ICU, the levels of blood lactate, PCT, IL-6 and IL-8 on the first day in ICU are significantly correlated to the prognosis of septic patients. Whether the existence of coagulation dysfunction being present or not, whether coagulation dysfunction being adjusted or not and the blood lactate level are the independent prognostic factors of septic patients, and the plasma concentrations of IL-6 and IL-8 are the independent affecting factors of whether coagulation dysfunction occurring or not, therefore they have predicting value concerning the occurrence of coagulation dysfunction in septic patients.