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*

Flavonoids, the key active compounds in Epimedii Folium, have both protective and toxic effects on the liver. Their hepatoprotective effects are associated with reducing lipid accumulation and oxidative stress, which contribute to the management of various liver conditions. In contrast, the mechanisms driving Epimedii Folium-induced hepatotoxicity are less understood but likely involve oxidative stress and pyroptosis. Pharmacokinetic studies, especially on icaritin, indicate that it undergoes isopentenyl dehydrogenation, glycosylation, and glucuronidation in vivo, contributing to its pharmacological effects. However, intermediate metabolites of icaritin may interact with biomolecules, potentially leading to liver toxicity. This review offers a detailed examination of the dual effects of Epimedii Folium flavonoids on liver function, emphasizing recent discoveries in their hepatoprotective and hepatotoxic pathways. We also summarize and discuss the pharmacokinetics of these flavonoids, highlighting how their metabolism affects therapeutic efficacy and toxicity. Lastly, we propose strategies to mitigate liver injury, providing new perspectives on the safe use of Epimedii Folium.

Objective To investigate the correlation of Wnt5a expression and vasculogenic mimicry (VM) in prostate cancer tissues, and analyze their relationships with cancer stem cells (CSCs) characteristics and epithelial–mesenchymal transition (EMT). Methods Immunohistochemistry was conducted to detect the expression of Wnt5a in 50 prostate cancer tissues and 50 benign prostatic hyperplasia tissues. The expression levels of CD133, vimentin, and E-cadherin were detected in the prostate cancer tissues, and CD34/PAS double staining was used to detect VM structures. We analyzed the difference in Wnt5a level between prostate cancer and benign prostatic hyperplasia tissues, the clinical significance of Wnt5a and VM, the relationship of Wnt5a expression and VM, and the relationships of Wnt5a expression and VM with CD133, Vimentin, E-cadherin. Results The expression of Wnt5a was significantly higher in prostate cancer tissues than in benign prostatic hyperplasia (P < 0.05). A positive correlation was observed between Wnt5a expression and VM (P < 0.05). The expression levels of Wnt5a and VM were positively correlated with those of CD133 and vimentin (P < 0.05). Wnt5a expression and VM were positively correlated with Gleason score, vas deferens invasion and lymphatic metastasis (P < 0.05) of prostate cancer, and VM was also positively correlated with T stage of prostate cancer (P < 0.05). Conclusion The expression level of Wnt5a in prostate cancer tissues is elevated and positively related with VM formation. Wnt5a expression and VM are correlated with cancer stem cells characteristics and the expression of epithelial–mesenchymal transition marker proteins.

Objective This article takes a cosmetics factory in Yichang City as an example, uses a variety of methodologies to explore methods of health impact assessment and provides methodological references for future health evaluation of related public policies. Methods By analyzing the environmental assessment report of the cosmetic renovation project, an indicator system was established and expert consultation meetings were conducted to score the impact of the corresponding indicators on health. The impact of the renovation project of the factory on the factory workers, surrounding residents and the sustainable development of the environment was analyzed by means of the Kaiser model with the risk matrix and the Borda value. Results The risk values of the five influencing factors of industrial wastewater, domestic wastewater, industrial waste gas, industrial waste and noise were 5.11%, 5.43%, 10.6%, 6.71% and 7.02% respectively. All the influencing factors were in the green zone of the risk matrix. The Borda values of the five influencing factors of industrial waste water, domestic waste water, industrial waste gas, industrial waste residue and noise were 4, 5, 10, 7 and 5 respectively. Conclusion The multiple methodologies adopted in the factory renovation project are feasible, and can provide new ideas for the health impact assessment of public policies in the future.

Background: Peste des petits ruminants (PPR) is an infectious disease caused by the peste des petits ruminants virus (PPRV) that mainly produces respiratory symptoms in affected animals, resulting in great losses in the world's agriculture industry every year. Singledomain variable heavy chain (VHH) antibody fragments, also referred to as nanobodies, have high expression yields and other advantages including ease of purification and high solubility. Objectives: The purpose of this study is to obtain a single-domain antibody with good reactivity and high specificity against PPRV. Methods: A VHH cDNA library was established by immunizing camels with PPRV vaccine, and the capacity and diversity of the library were examined. Four PPRV VHHs were selected, and the biological activity and antigen-binding capacity of the four VHHs were identified by western blot, indirect immunofluorescence, and enzyme-linked immunosorbent assay (ELISA) analyses. ELISA was used to identify whether the four VHHs were specific for PPRV, and VHH neutralization tests were carried out. ELISA and western blot analyses were used to identify which PPRV protein was targeted by VHH2. Results: The PPRV cDNA library was constructed successfully. The library capacity was greater than 2.0 × 106 cfu/mL, and the inserted fragment size was approximately 400 bp to 2000 bp. The average length of the cDNA library fragment was about 1000 bp, and the recombination rate was approximately 100%. Four single-domain antibody sequences were selected, and proteins expressed in the supernatant were obtained. The four VHHs were shown to have biological activity, close affinity to PPRV, and no cross-reaction with common sheep diseases. All four VHHs had neutralization activity, and VHH2 was specific to the PPRV M protein. Conclusions The results of this preliminary research of PPRV VHHs showed that four screened VHH antibodies could be useful in future applications. This study provided new materials for inclusion in PPRV research.

Objective: To understand school physician in primary and secondary schools in Yichang City, Hubei Province from 2019 to 2020, and to provide a reference for strengthening the school physician team in primary and secondary schools. Methods: 149 and 102 primary and secondary schools from 6 municipal districts in Yichang City, Hubei Province, were randomly selected in November 2019 and November 2020, respectively, and were administered by questionnaire survey. Results: The proportion of school physicians increased from 39.6% in 2019 to 65.7% in 2020. In the past two years, the equipment rate of school physician in both central and fringe urban areas increased, especially the fringe urban areas, number of school physician increased from 38 to 96. A total of 93 and 141 school physicians were selected to pariticipate in questionaire survey in 2019 and 2020 respectively. The survey showed that more than 90% of school physicians in primary and secondary schools in Yichang received training, and 74.5% had college education level. However, most of them lack professional qualification and medical background. Conclusion School physician of primary and secondary of Yichang is well development over the past two years, and the proportion substantially increased. However, there is still room for improvement in the quantity and quality of school physicians, and professional qualification needs to be improved. More attention should be paid to the marginal urban areas to achieve a balance between quantity and quality.

Background: Peste des petits ruminants (PPR) is an infectious disease caused by the peste des petits ruminants virus (PPRV) that mainly produces respiratory symptoms in affected animals, resulting in great losses in the world's agriculture industry every year. Singledomain variable heavy chain (VHH) antibody fragments, also referred to as nanobodies, have high expression yields and other advantages including ease of purification and high solubility. Objectives: The purpose of this study is to obtain a single-domain antibody with good reactivity and high specificity against PPRV. Methods: A VHH cDNA library was established by immunizing camels with PPRV vaccine, and the capacity and diversity of the library were examined. Four PPRV VHHs were selected, and the biological activity and antigen-binding capacity of the four VHHs were identified by western blot, indirect immunofluorescence, and enzyme-linked immunosorbent assay (ELISA) analyses. ELISA was used to identify whether the four VHHs were specific for PPRV, and VHH neutralization tests were carried out. ELISA and western blot analyses were used to identify which PPRV protein was targeted by VHH2. Results: The PPRV cDNA library was constructed successfully. The library capacity was greater than 2.0 × 106 cfu/mL, and the inserted fragment size was approximately 400 bp to 2000 bp. The average length of the cDNA library fragment was about 1000 bp, and the recombination rate was approximately 100%. Four single-domain antibody sequences were selected, and proteins expressed in the supernatant were obtained. The four VHHs were shown to have biological activity, close affinity to PPRV, and no cross-reaction with common sheep diseases. All four VHHs had neutralization activity, and VHH2 was specific to the PPRV M protein. Conclusions The results of this preliminary research of PPRV VHHs showed that four screened VHH antibodies could be useful in future applications. This study provided new materials for inclusion in PPRV research.

Objective:To explore the health status of occupational benzene exposure workers, and to provide a scientific basis for the development of reasonable health monitoring and effective protective measures.Methods:In March 2019, the occupational health surveillance data were collected including blood pressure, electrocardiogram, blood routine, urine routine, liver function, etc of 7810 benzene contact workers in 150 enterprises in Jiangxi Province in 2017, to analyze and assess their health status.Results:Among the 7810 benzene workers, there were 5451 males and 2359 females; the average age was (40.5±9.9) years; and the median benzene working age was 3.5 years. The detection rate of hypertension was 17.0% (734/4317) , the abnormal rate of urine routine was 15.7% (1227/7810) , the abnormal rate of liver function was 8.6% (356/4147) , and the abnormal rate of electrocardiogram was 12.3%(963/7810). The detection rates of low count number of leukocytes, platelets, neutrophils and occupational contraindications were 4.6%(360/7810) , 1.4%(108/7810) , 4.2%(330/7810) and 1.4%(110/7810) , respectively. The detection rates of low count number of leukocytes, platelets and neutrophils in female were all higher than those in male ( P<0.05). The detection rates of low count number of platelets, neutropenia and occupational contraindications increased with age and working age ( P<0.05 ). There were significant differences in the detection rates of low count number of leukocytes, platelets, neutrophils and occupational contraindications among benzene workers in different economic types ( P<0.05) , and the highest among foreign companies, followed by private enterprise. There were statistically significant differences in the detection rates of low count number of platelets, neutrophils and occupational contraindications in benzene workers of different enterprise sizes ( P<0.05) , and the highest was found in micro enterprises, followed by small enterprises. Conclusion:In 2017, the occupational health status of workers exposed to benzene in Jiangxi province is not optimistic. It is necessary to strengthen the occupational health supervision of small and micro-sized enterprises, foreign enterprises and private enterprises, take the initiative to improve health surveillance, and effectively protect the physical and mental health of workers.

Objective:To explore the health status of occupational benzene exposure workers, and to provide a scientific basis for the development of reasonable health monitoring and effective protective measures.Methods:In March 2019, the occupational health surveillance data were collected including blood pressure, electrocardiogram, blood routine, urine routine, liver function, etc of 7810 benzene contact workers in 150 enterprises in Jiangxi Province in 2017, to analyze and assess their health status.Results:Among the 7810 benzene workers, there were 5451 males and 2359 females; the average age was (40.5±9.9) years; and the median benzene working age was 3.5 years. The detection rate of hypertension was 17.0% (734/4317) , the abnormal rate of urine routine was 15.7% (1227/7810) , the abnormal rate of liver function was 8.6% (356/4147) , and the abnormal rate of electrocardiogram was 12.3%(963/7810). The detection rates of low count number of leukocytes, platelets, neutrophils and occupational contraindications were 4.6%(360/7810) , 1.4%(108/7810) , 4.2%(330/7810) and 1.4%(110/7810) , respectively. The detection rates of low count number of leukocytes, platelets and neutrophils in female were all higher than those in male ( P<0.05). The detection rates of low count number of platelets, neutropenia and occupational contraindications increased with age and working age ( P<0.05 ). There were significant differences in the detection rates of low count number of leukocytes, platelets, neutrophils and occupational contraindications among benzene workers in different economic types ( P<0.05) , and the highest among foreign companies, followed by private enterprise. There were statistically significant differences in the detection rates of low count number of platelets, neutrophils and occupational contraindications in benzene workers of different enterprise sizes ( P<0.05) , and the highest was found in micro enterprises, followed by small enterprises. Conclusion:In 2017, the occupational health status of workers exposed to benzene in Jiangxi province is not optimistic. It is necessary to strengthen the occupational health supervision of small and micro-sized enterprises, foreign enterprises and private enterprises, take the initiative to improve health surveillance, and effectively protect the physical and mental health of workers.

Objective: To observe the effect of combining whole body vibration with botulinum neurotoxin A injections on tiptoe and the gross motor function of children with spastic diplegic cerebral palsy. Methods: Sixty spastic diplegic children with tipped foot aged between 2 to 5 were equally divided into a control group and an experimental group randomly. The control group received 3 IU/kg botulinum neurotoxin A injections to the medial and lateral heads of the gastrocnemius muscle. Then 5 daily courses of conventional training were administered 5 days a week for 3 weeks beginning 24 hours after the injections. The experimental group additionally received 2min of whole body vibration 3 or 4 times per day with one-minute rests, 5 days per week for 5 weeks. All of the children were assessed before the experiment and 1, 3 and 6 months later using the modified Tardieu scale (MTS) and the R1 and R2 ankle and dimensions D and E of the gross motor function measurement scale (GMFM-88). Results: There were no significant differences between the two groups before the treatment. Afterward, the average MTS, R1, R2 and GMFM-88 scores of both groups were significantly improved. The average MTS, R1 and R2 scores of the experimental group after treatment were significantly better than the control group′s averages. The average GMFM-88 score of the experimental group was not significantly different from that of the control group after 1 month, but after 3 and 6 months significant differences emerged. Conclusion Whole body vibration improves the effectiveness of botulinum neurotoxin A injections in relieving tiptoe and improving the gross motor function of children with spastic diplegic cerebral palsy.