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 analyze the relevant studies on blood donor cohort and explore the current research status, research hotspots and development trends of blood donor cohort studies abroad. 【Methods】 Based on the Web of Science Core Collection, the literature related to blood donor cohort was searched. After screening and data processing, bibliometric analysis was carried out from the volume of literature trends, disciplines, authors, institutional distribution and other aspects of the included literature. At the same time, CiteSpace 5.6R5 software was used to carry out visual analysis of countries/regions, literature co-citation, keyword co-occurrence, keyword clustering and keyword emergence. Results A total of 672 papers (654 research papers, 18 review papers) were included. The total number of papers published in the field of blood donor cohort study showed a steady upward trend since 1991, the fastest growth was between 2019 and 2020. The top three cited authors were Kaaks R (1 301 citations), Rinaldi S (1 186 citations) and Riboli E (1 130 citations); the top three institutions were RLUK library in the UK, the University of California and the University of Copenhagen; the top three countries/regions in the volume of literature were the United States (176 papers), Germany (64 papers) and France (54 papers), and they all co-operated closely with other countries. The top five keywords were "blood donor" , "prevalence" , "infection" , "risk" and "antibody" . A total of 19 clusters were obtained by keyword cluster analysis, it was reflected in the immune mechanism and prevalence of blood-borne diseases, the relationship between blood donation behavior and non-communicable disease and its influencing factors, and the classification of the characteristics of blood donors. "Non-hepatitis B" was the keyword with the greatest burst intensity. The keywords that have burst out in recent years and continue to this day include "donation" , "seroprev-alence" , "donor" and "management" . Conclusion At present, the cohort study of blood donors has been paid more and more attention in the world, and its research trends mainly focus on the study of transfusion-transmitted disease risk. However, more researches begin to pay attention to the health problems and influencing factors of blood donors or recipients, which provides the research ideas and directions for establishing cohort study among blood donors in China.

Objective:To explore the value of octreotide suppression test(OST) in predicting the efficacy of somatostatin receptor ligands(SRLs) in the treatment of active acromegaly.Methods:The clinical data of 76 patients with active acromegaly from 2011 to 2020 was retrospectively analyzed. OST was carried out as follows: After an overnight fasting and baseline sampling of growth hormone(GH), 100 μg octreotide was subcutaneously injected, and sampling for GH was obtained every 2 hours for 8 hours. All patients were treated with SRLs for at least 3 months. A good GH response is defined as a post-treatment random GH<1 μg/L or >80% fall compared with the baseline GH. A good insulin-like growth factor Ⅰ(IGF-Ⅰ) response is defined as IGF-Ⅰ<1.3 upper limit of normal(ULN) or >50% reduction compared with the baseline. If both GH and IGF-Ⅰ fulfill the criteria of a good response, it is defined as a good GH and IGF-Ⅰ response.Results:The baseline level of GH during OST was 15.00(6.38, 34.20) μg/L, the median time to reach the nadir GH was(3.65±1.65) hours, and the nadir GH level was 1.47(0.50, 4.19) μg/L. The median GH suppression rate was 89.12%(72.71%, 95.09%). When the cutoff value of GH suppression rate in predicting a good GH response was 89.32%, the area under the curve(AUC) was 0.74, with a sensitivity of 81.80% and specificity of 66.00%. When the cutoff value of GH suppression rate in predicting a good IGF-Ⅰ response was 93.14%, the AUC was 0.64, with a sensitivity of 50.00% and specificity of 75.60%. When the GH suppression rate was 90.71%, the AUC was 0.78, with the sensitivity of 83.30% and specificity of 70.00% in predicting a good GH and IGF-Ⅰ response. Compared with GH/IGF-Ⅰ non-responders, GH/IGF-Ⅰ responders displayed lower nadir GH during OST, higher GH suppression rate and IGF-Ⅰ reduction rate, and lower ratio of IGF-1 to ULN( P<0.05). Conclusion:GH suppression rate during the OST is a valuable predictor to evaluate the efficacy of SRLs in patients with acromegaly, with the highest sensitivity and specificity when the cutoff value is 90.71%.

Objective: To investigate the key factor(s) of hepatitis B virus X protein (HBx) promoting B7-H6 gene activation. Methods: The DNA fragments of the B7-H6 promoter were amplified from the human genomic DNA using polymerase chain reaction(PCR). Products of PCR were digested by KpnI and HindⅢ, and inserted into luciferase reporter vector (pGL3-Basic). The correctness of the recombinant plasmid pGL3-B7-H6 was confirmed by sequencing. Human hepatoma cell line HepG2 were co-transfected with pGL3-B7-H6 and the eukaryotic expression vectors (pCMV-HBs、pCMV-HBc and pCMV-HBx), and the relative luciferase activity was detected.The different dose of HBx expression plasmids were transfected into the HepG2 cells, and the expression of B7-H6 protein were determined by Western blot. Results: A period of 2.2 Kb of B7-H6 promoter region were successfully cloned into pGL3-Basic, which was confirmed by DNA sequencing. The relative luciferase activity was significantly higher in the cells transfected with pGL3-B7-H6 than that in the cells transfected with the empty vector pGL3-Basic (5.24±1.25 vs. 1.12±0.31, P=0.005). The relative luciferase activity in HepG2 cells co-transfected with pGL3-B7-H6 and pCMV-HBx was remarkably increased compared with the control group (17.60±3.36 vs. 6.73±1.36, P=0.001). Western blot further demonstrated that HBx protein can significantly enhance B7-H6 protein expression. Conclusions Hepatitis B Virus X proteins enhanced B7-H6 promoter activity and promoted B7-H6 protein expression.

Objective To retrospectively investigate the relapse rates of different duration of extended consolidation after withdrawal of nucleos(t) ide analogues (NAs) treatment in patients with chronic hepatitis B (CHB) who met NAs cessation criteria.Methods 102 CHB patients discontinued treatment according to NAs cessation criteria or extended duration of consolidation therapy after meeting the cessation criteria.30 patients meeting the cessation criteria were Group A.72 patients extending consolidation therapy after meeting the cessation criteria were Group B.Based on different duration of extended consolidation therapy,72 patients were divided into 3 groups.Patients with a duration of extended 12 months after meeting NAs cessation criteria were Group B1.Patients with a duration of extended 24 months were Group B2.Patients with duration of extended 36 months were Group B3.After cessation of NAs treatment,the cumulative relapse of different group was calculated by the Kaplan-Meier method.The cumulative relapses between the selected groups were analyzed with Log-rank test.Results The cumulative relapse rates after 6,12,18,24,36 and 48 months after cessation of NAs treatment were 52.3％,70.0％,74.3％,76.7％,82.4％ and 88.4％ in Group A;24.0％,38.8％,40.6％,43.3％,43.3％ and 43.3％ in Group B;respectively.The relapse rate of Group B was much lower than that of Group A.The cumulative relapse rates after 6,12,18,24,36 and 48 months after cessation of NAs treatment were 35.0％,48.2％,51.9％,57.9％,57.9％ and 57.9％ in Group B1;18.1％,30.7％,30.7％,30.7％,30.7％ in Group B2;7.1％,21.4％,21.4％,21.4％ in group B3;respectively.The relapse rate of Group B1 was the highest,the following was of Group B2,and of Group B3 was the lowest one.The total amount of relapse in Group A,B1,B2 and B3 was 26,21,5 and 3 respectively.Conclusions A longer duration of extended consolidation therapy after meeting NAs cessation criteria may contribute to the lower relapse rates.

Objective To investigate short-term efficacy and security of transplantation of human umbilical cord mesenchymal stem cells (HUCMSCs)in the course of treatment of decompensated cirrhosis.Methods Ninety-six Hepatitis B patients with decompensated cirrhosis were enrolled,among which 50 were sbject to transplantation of HUCMSCs in addition to routine therapy (the treatment group) and the rest patients were underwent routine therapy(the control group).We observed the efficacy and security at 2,4,6 and 12 week of the treatment course.Results The symptoms of atigue,anorexia,bloating and edema were greatly relieved in both groups after 4 weeks,and sustained remission after 4-12 weeks.The overall survival rate was 96％ after 12 weeks of the treatment group,2 patients were died after 8 and 12 weeks of the HUCMSCs transplantation due to hepatic encephalopathy repecticely.Compared to the baseline,ALT,AST,TBil and ALB(albumin) were improved after 2,4,6 and 12 weeks in both groups(P ＜ 0.05),and the averages of ALB(albumin) of treatment group were higher than the control group.PT(prothrombin time) and PTA(prothrombin time activity) were improved after 4,6,12 weeks in the treatment group (P ＜ 0.05),however,there were no differences in the control group during the 4,6 and 12 weeks(P ＞0.05).During the course of HUCMSCs tranplantation,the security was satisfied and no special side effects were observed.Conclusion The transplantation of HUCMSCs for therapy of Hepatitis B patients with decompensated cirrhosis is a safety and effective therapy,and can improved ALB,PT,PTA,liver function and clinical symptoms within a short period,which is an alternative method of treatment recommended.

Objective To investigate the expression of chemokine receptors CCR4,CCR6,CXCR3 on Th17 cell,and analyze the correlation between chemokine receptors and serum biochemical parameters of liver function test and hepatitis B virus (HBV) DNA load in peripheral blood of chronic hepatitis B (CHB) patients.Methods Thirty patients with CHB (CHB group) and 15 healthy persons (control group) were enrolled in the study.CCR4,CCR6,CXCR3 expression levels on Th17 cell were assayed by flow cytometry.The correlation between chemokine receptors and alanine aminotransferase (ALT),total bilirubin (TBil),and HBV DNA load were analyzed using Pearson' s correlation analysis,respectively.Results CCR4,CCR6,CXCR3 expression levels on CD4 + Th17 cell in CHB group were higher than that of control group.Moreover,the difference between them was statistically significant (P ＜ 0.05).CCR4,CCR6 expression levels on CD8 + Th17 cell in CHB group were higher than that of control group (P ＜ 0.05).Although CXCR3 expression level on CD8 + Th17 cell in CHB group was higher than that of control group,there was no significant difference between them (P ＞ 0.05).CCR4,CCR6 expression levels were positively correlated with serum ALT,HBV DNA load,respectively (P ＜ 0.05),but were not correlated with TBil (P ＞ 0.05).Conclusion Expression levels of chemokine receptor on Th17 cell were increased in patients with CHB and were positively associated with degree of liver inflammation.Therefore,CCR4,CCR6 expression on Th17 cell might be involved in liver injury resulted from Th17 cell.

Objective To investigate short-term efficacy and security of telbivudine as a sequential therapy in the HBeAg positive chronic hepatitis B (CHB) patients with pegylated IFNα-2a treatment failure.Methods 27 CHB patients with HBeAg positive and HBV DNA detectable after a 48-week pegylated IFNα-2a therapy were enrolled into this study,and were assigned to group A,with telbivudine as a sequential therapy.54 CHB patients with HBeAg positive were assigned to group B,with telbivudine as a naive treatment.To assessment the efficacy and security of telbivudine at week 48.Results At week 12,the rates of aminotransferases normalization,HBeAg seroconversion and HBV DNA undetectable (＜ 100 IU/ ml) among the two groups were 59.3％,14.8％,66.7％ vs 75.9％,5.6％,46.3％ respectively.At week 24,the rates among the two groups were 92.6％,25.9％,70.3％ vs 92.6％,7.4％,85.2％,respectively.At week 48,the rates among the two groups were 88.9％,29.6％,81.5％ vs 98.1％,28.0％,83.3％ respectively.All these were not statistically significant.But the rate of HBeAg seroconversion in group A is higher than that in group B.The virological breakthrough rate of group B at week 48 is 14.8％,no virological breakthrough was observed in group A.During the treatment,38.3％ of patients had creatine kinase(CK) elevation,but there was no case stopping treatment for severe adverse effect.Conclusion CHB patients with HBeAg positive after a 48-week pegylated IFNα-2a treatment failure can also achieve the same efficacy and security as the na(i)ve treatment,after receiving telbivudine as a sequential therapy.

Objective To investigate the efficacy of combined treatment of PEG IFNα-2a and recombinant hepatitis B vaccine in CHB patients with HBeAg positive.Methods 75 CHB patients with HBeAg positive were enrolled into this study.45 patients received the monotherapy of pegylated IFNα-2a (group A),and 30 patients were treated with PEG IFNα-2a combined with recombinant hepatitis B vaccine (group B).The two groups were compared clinical features,such as ALT,HBsAg levels and HBeAg seroconversion rates,HBV DNA suppression,at different time point(At 0,24,48,72 week).Results At week 0,levels of aminotransferases,HBsAg and HBV DNA were not statistically significant between the two groups(P ＞0.05).But the level of HBeAg in group B was much more than that in group A.This diversity show statistical significance(P ＜ 0.05).During week 24 to week 48,rates of aminotransferases normalization HBsAg seroconversion HBeAg seroconversion,and HBV DNA suppression were also not statistically significant between group A and B (P ＞ 0.05).At the 72 week of follow up,levels of aminotransferases,HBeAg seroconversion rate and HBsAg levels were not statistically significant among the two groups (P ＞0.05),but the negative conversion rate of HBV DNA drop in group B was much more than that in group A,the difference was statistically significant (P =0.032).Conclusion The combined treatment of PEG IFNα-2a and recombinant hepatitis B vaccine in CHB patients with HBeAg positive can improve the negative conversion rate of HBV DNA 72 weeks after the end of the 48 week of treatment,but wasn't associated with HBeAg seroconversion and HBsAg levels.

Objective To investigate the expression of IL-6 and IL-18 in serum and its correlation with aspartate aminotransferase (AST),alanine aminotransferase (ALT),total bilirubin (TBil),albumin (ALB),creatinine (Cr) and plasma ammonia in patients with hepatic encephalopathy.Methods Forty patients with liver cirrhosis complicated with hepatic encephalopathy were aligned to group A,where 18 patients with grade Ⅲ to grade Ⅳ were divided into group A1 and 22 patients with grade Ⅰ to grade Ⅱ were divided into group A2.Twenty liver cirrhosis patients were aligned to group B and 20 healthy persons were aligned to group C.The concentration of IL-6 and IL-18 in serum was detected by enzyme-linked immunosorbent assay (ELISA).The correlation between IL-6 or IL-18 and AST,ALT,TBil,ALB,Cr or plasma ammonia was analyzed by Pearson' s correlation analysis.Results Serum IL-6 and IL-18 levels in both A1 and A2 groups were significantly higher than those of group B and C.The difference was statistically significant (P ＜0.05).Both IL-6 and IL-18 levels were positively correlated with the ammonia,but there were no significant correlation with AST,ALT,TBil,ALB and Cr (P ＞ 0.05).Conclusion Serum IL-6 and IL-18 levels significantly increased in patients with hepatic encephalopathy.IL-6 and IL-18 may have a synergistic effect with ammonia,which were jointly involved in the pathogenesis of hepatic encephalopathy.