Oral lichen planus (OLP) is a common chronic inflammatory disease and potentially malignant disorder of the oral mucosa. Clinical manifestations include bilateral symmetrical distributions of pearly white reticular streaks, and its subtype erosive oral lichen planus (EOLP) is often accompanied by local congestion, erosion, obvious pain, and other symptoms, which affects the patient's eating and swallowing. Oral hygiene and environmental factors, lifestyle and dietary factors, psychological factors, medication factors, and systemic disease factors all contribute to the recurrence of EOLP lesions, which increases the cancer potential of this condition. Therefore, measures to prevent the recurrence and cancerous transformation of EOLP have attracted much attention. In the clinical treatment strategy for EOLP, attention should be given to its influencing factors for comprehensive management. Patients should be provided with multidisciplinary and multifaceted oral comprehensive management measures across the following strategies: maintaining a good oral hygienic environment, dietary therapies and healthy living habits, psychological therapies, systemic/local therapeutic guidance, and active follow-up and treatment of systemic diseases. This article provides multidisciplinary and multifaceted comprehensive oral management measures for patients with the goal of cancer prevention, minimizing recurrence, and improving the quality of life of patients.

Objective To explore the application of plasma 7 microRNA (miR7) testing in the differential diagnosis of very early-stage hepatocellular carcinoma (HCC). Methods This study is a multicenter real-world study. Patients with single hepatic lesion (maximum diameter≤2 cm) who underwent plasma miR7 testing at Zhongshan Hospital, Fudan University, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Anhui Provincial Hospital, and Peking University People’s Hospital between January 2019 and December 2024 were retrospectively enrolled. Patients were divided into very early-stage HCC group and non-HCC group, and the clinical pathological characteristics of the two groups were compared. The value of plasma miR7 levels, alpha-fetoprotein (AFP), and des-gamma-carboxy prothrombin (DCP) in the differential diagnosis of very early-stage HCC was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). In patients with both negative AFP and DCP (AFP＜20 ng/mL, DCP＜40 mAU/mL), the diagnostic value of plasma miR7 for very early-stage HCC was analyzed. Results A total of 64 528 patients from 4 hospitals underwent miR7 testing, and 1 682 were finally included, of which 1 073 were diagnosed with very early-stage HCC and 609 were diagnosed with non-HCC. The positive rate of miR7 in HCC patients was significantly higher than that in non-HCC patients (67.9% vs 24.3%, P＜0.001). ROC curves showed that the AUCs for miR7, AFP, and DCP in distinguishing HCC patients from the non-HCC individuals were 0.718, 0.682, and 0.642, respectively. The sensitivities were 67.85%, 43.71%, and 44.45%, and the specificities were 75.70%, 92.78%, and 83.91%, respectively. The pairwise comparison of AUCs showed that the diagnostic efficacy of plasma miR7 detection was significantly better than that of AFP or DCP (P＜0.05). Although its specificity was slightly lower than AFP and DCP, the sensitivity was significantly higher. Among patients negative for both AFP and DCP, miR7 maintained an AUC of 0.728 for diagnosing very early-stage HCC, with 67.82% sensitivity and 77.73% specificity. Conclusions Plasma miR7 testing is a potential molecular marker with high sensitivity and specificity for the differential diagnosis of small hepatic nodules. In patients with very early-stage HCC lacking effective molecular markers (negative for both AFP and DCP), miR7 can serve as a novel and effective molecular marker to assist diagnosis.

Mitochondria are one of the oldest and most important endomembrane systems in eukaryotic cells and serve as the hubs of multiple cellular processes. Mitophagy (mitochondrial autophagy), a major way to maintain mitochondrial homeostasis, is closely linked to antiviral immune regulation. Depending on whether ubiquitination is required for the involved receptors or adaptors, mitophagy can be classified into ubiquitin-dependent and ubiquitin-independent types. Viruses can directly or indirectly regulate mitophagy and mitochondrial dynamics through various pathways. Through these processes, they can affect innate and adaptive immunity, so as to achieve immune escape, aggravate cell damage or promote the formation of adaptive immunity. This review summarizes the latest research progress on the role of viral infection-regulated mitophagy in the regulation of immune response.
Mitophagy/immunology* ; Humans ; Animals ; Virus Diseases/immunology* ; Mitochondria/metabolism* ; Immunity, Innate ; Adaptive Immunity

OBJECTIVES: This cross-sectional study aims to explore the association between oral health status and cognitive function in Chinese elderly individuals. METHODS: The survey participants were composed of elderly people aged≥60 who were admitted to West China Hospital of Stomatology, Sichuan University from August 2022 to March 2024. They were divided into a cognitive impairment (CI) group and a healthy control (HC) group according to the Montreal Cognitive Assessment (MoCA) score. General information and oral health indicators of all elderly people were collected. Independent sample t-test and chi-square test were used for inter-group comparison, and multiple linear regression model was applied for multivariate analysis of MoCA scores. RESULTS: A total of 402 elderly people were included in the study, and the number of remaining teeth in the CI group was significantly lower than that in the HC group. The decayed, missing, filled teeth index, debris index-simplified, gingival index, probing depth (PD), and clinical attachment loss in the CI group were all significantly higher than those in the HC group. There was no difference in denture wearing between the two groups. The results of multiple linear regression showed that there was a correlation between the number of remaining teeth and PD and MoCA scores after correcting for confounding factors. CONCLUSIONS Elderly individuals with CI have more prominent oral health issues compared to those with normal cognitive function. There may be a bidirectional relationship between the number of remaining teeth, PD, and cognitive function in elderly people.
Humans ; Oral Health ; Aged ; Cross-Sectional Studies ; Cognitive Dysfunction/epidemiology* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Linear Models ; Aged, 80 and over ; Periodontal Index ; Cognition

AIM:To observe the effect of Pingwei capsule on the precancerous lesions of gastric cancer(PLGC)cell model induced by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG),and to preliminarily explore its mecha-nism.METHODS:Blank serum and Pingwei capsule-containing serum were prepared for later use.A PLGC cell model was established by MNNG-induced human gastric mucosal epithelial cell line GES-1.To evaluate the model,cell morpho-logical changes were observed under inverted microscope,and the expression of proliferating cell-related antigen Ki67 was detected by immunofluorescence staining.CCK-8 assay was used to screen the optimal intervention concentration and time of serum containing drugs.Reactive oxygen species(ROS)content in cells was detected using a fluorescent probe DCFH-DA.Malondialdehyde(MDA)content was detected by ELISA,and the activity of superoxide dismutase(SOD)and gluta-thione peroxidase(GSH-Px)was detected using biochemical reagents.A novel fluorescent probe JC-10 was used to detect mitochondrial membrane potential.The mRNA expression levels of Ki67 and melanoma differentiation-associated gene-7(MDA-7)were detected by real-time fluorescence quantitative PCR.The protein expression levels of Ki67,interleukin-6(IL-6)and MDA-7 were detected by Western blot.RESULTS:Compared with normal group,the ROS and MDA levels in model group and blank serum group were significantly increased(P<0.01),while the activity of SOD and GSH-Px was significantly decreased(P<0.01).The mitochondrial membrane potential was significantly decreased(P<0.01).The protein expression levels of Ki67 and IL-6 were significantly increased(P<0.01),while the protein expression level of MDA-7 was significantly decreased(P<0.01).There were no significant differences of the above indicators between model group and blank serum group(P>0.05).Compared with blank serum group,the Pingwei capsule-containing serum group showed significantly decreased ROS and MDA levels(P<0.01),significantly increased activity of SOD and GSH-Px(P<0.05),significantly increased mitochondrial membrane potential(P<0.01),significantly decreased protein expres-sion levels of Ki67 and IL-6(P<0.01),and significantly increased protein and mRNA expression levels of MDA-7(P<0.01).CONCLUSION:Pingwei capsule can significantly alleviate MNNG-induced oxidative damage and inflammatory response,and regulate the expression of oncogenes and tumor suppressor genes,thereby playing a role in prevention and treatment of PLGC.

Objective To explore the effect of multimodal exercise combined with enteral nutrition dur-ing radiotherapy in the patients with esophageal cancer complicating diabetes.Methods A total of 52 patients with esophageal cancer complicating diabetes in Zhejiang Provincial Tumor Hospital from January to Decem-ber 2021 were selected as the study subjects and divided into the control group(n=27)and intervention group(n=25)by using the random number table method.The control group implemented the routine exercise scheme,while the intervention group was given the multimodal exercise intervention on the basis of routine exercise.The blood glucose metabolism indicators,related biochemical indicators during radiotherapy and the incidence rate of adverse events during exercise were compared between the two groups.Results The levels of fasting blood glucose,random blood glucose and blood glucose before sleep in the intervention group during radiotherapy were(7.79±1.61)mmol/L,(9.47±1.77)mmol/L and(9.97±3.02)mmol/L,which were lower than(11.84±3.47)mmol/L,(14.18±5.42)mmol/L and(14.62±3.83)mmol/L in the control group with statistically significant differences(P<0.05).During the radiotherapy period,the levels of albumin,total protein and prealbumin in the intervention group were(37.96±2.13)g/L,(68.13±5.02)g/L and(232.89±41.11)g/L,which were lower than(36.05±2.89)g/L,(64.96±5.95)g/L and(207.76±47.59)g/L in the control group with statistically significant differences(P<0.05).The incidence rates of adverse e-vents such as falls,hypoglycemia and accidental extubation during multimodal exercise in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The multimodal exercise could significantly improve the nutritional status during radiotherapy in the patients with esophageal cancer complicating diabetes,stabilize the blood glucose level of the patients,and has good feasibility and safety.

Surgical operation is the main treatment of oral and maxillofacial tumors.Dysphagia is a common postoperative complication.Swal-lowing disorder can not only lead to mis-aspiration,malnutrition,aspiration pneumonia and other serious consequences,but also may cause psychological problems and social communication barriers,affecting the quality of life of the patients.At present,there is no systematic evalua-tion and rehabilitation management plan for the problem of swallowing disorder after oral and maxillofacial tumor surgery in China.Combining the characteristics of postoperative swallowing disorder in patients with oral and maxillofacial tumors,summarizing the clinical experience of ex-perts in the field of tumor and rehabilitation,reviewing and summarizing relevant literature at home and abroad,and through joint discussion and modification,a group of national experts reached this consensus including the core contents of the screening of swallowing disorders,the phased assessment of prognosis and complications,and the implementation plan of comprehensive management such as nutrition management,respiratory management,swallowing function recovery,psychology and nursing during rehabilitation treatment,in order to improve the evalua-tion and rehabilitation of swallowing disorder after oral and maxillofacial tumor surgery in clinic.

Objective:To study the current status of longitudinal extrauterine growth restriction (EUGR) in extremely preterm infants (EPIs) and to develop a prediction model based on clinical data from multiple NICUs.Methods:From January 2017 to December 2018, EPIs admitted to 32 NICUs in North China were retrospectively studied. Their general conditions, nutritional support, complications during hospitalization and weight changes were reviewed. Weight loss between birth and discharge > 1SD was defined as longitudinal EUGR. The EPIs were assigned into longitudinal EUGR group and non-EUGR group and their nutritional support and weight changes were compared. The EPIs were randomly assigned into the training dataset and the validation dataset with a ratio of 7∶3. Univariate Cox regression analysis and multiple regression analysis were used in the training dataset to select the independent predictive factors. The best-fitting Nomogram model predicting longitudinal EUGR was established based on Akaike Information Criterion. The model was evaluated for discrimination efficacy, calibration and clinical decision curve analysis.Results:A total of 436 EPIs were included in this study, with a mean gestational age of (26.9±0.9) weeks and a birth weight of (989±171) g. The incidence of longitudinal EUGR was 82.3%(359/436). Seven variables (birth weight Z-score, weight loss, weight growth velocity, the proportion of breast milk ≥75% within 3 d before discharge, invasive mechanical ventilation ≥7 d, maternal antenatal corticosteroids use and bronchopulmonary dysplasia) were selected to establish the prediction model. The area under the receiver operating characteristic curve of the training dataset and the validation dataset were 0.870 (95% CI 0.820-0.920) and 0.879 (95% CI 0.815-0.942), suggesting good discrimination efficacy. The calibration curve indicated a good fit of the model ( P>0.05). The decision curve analysis showed positive net benefits at all thresholds. Conclusions:Currently, EPIs have a high incidence of longitudinal EUGR. The prediction model is helpful for early identification and intervention for EPIs with higher risks of longitudinal EUGR. It is necessary to expand the sample size and conduct prospective studies to optimize and validate the prediction model in the future.

Objective:To analyze the current status of Alzheimer's disease(AD)treatment costs under different co-morbid states in Sichuan,and to provide references and basis for prioritizing the formulation of related health policies.Methods:Based on the System of Health Accounting 2011(SHA 2011).Results:The total treatment cost of Alzheimer's disease patients in Sichuan Province in 2019 was 277 280 400 yuan,accounting for 0.13%of the province's disease treatment cost in 2019.There were significant differences in treatment costs among different co-morbidity groups,with family health expenditure being the main financing option(54.44%).The higher the co-morbidity index,the greater the share of family health expenditure.Treatment costs mainly flowed to hospitals,with the proportion of treatment costs going to general hospitals gradually increasing as the co-morbidity index increased.The treatment cost of women is higher than that of men,and the treatment cost of low,middle and high co-morbidity groups were mainly concentrated in the age groups of 55～69,70～89 and 80 years old and above respectively.Conclusion:It is recommended to optimize the financing scheme and build a multi-level medical insurance system.Continuously improve the protection mechanism to narrow the difference in treatment between outpatient and inpatient;improve the service capacity of primary health care institutions;pay attention to key populations and do a good job of preventing AD,so as to alleviate the overall burden of Alzheimer's disease in China,and promote the realization of healthy aging.