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*

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.

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.

AIM: To investigate the effect of electroacupuncture on the expression of matrix metalloproteinase-3(MMP-3), tissue inhibitor of metalloproteinase-3(TIMP-3)and collagen type III alpha 1(Col3α1)in the retina of guinea pigs with lens-induced myopia.METHODS:A total of 80 guinea pigs were randomly divided into the normal control(NC)group, negative lens-induced myopia(LIM)group, electro-acupuncture(EA)group, and sham group, with 20 guinea pigs in each group. The NC group did not receive any intervention, the LIM, EA and the sham groups were all wearing -6.0 D lens in the right eye and no lens in the left eye. The EA group was given electroacupuncture stimulation at Hegu Point and temple, and guinea pigs in the sham group were given intervention at false points. The refraction was measured by optometry, the axial length was measured by A-ultrasound, and the changes in retinal tissue structure were observed by HE staining. Quantitative polymerase chain reaction(Q-PCR)and western blot(WB)were used to detect the expression of MMP-3, TIMP-3, and Col3α1 at mRNA and protein levels before modeling and at 2 and 4 wk after modeling. RESULTS:The axial length of the negative LIM group was significantly increased compared with the NC group at 2 and 4 wk after modeling(all P<0.05), and the diopter was significantly decreased(all P<0.05); the axial length of the eye in the EA group was decreased compared with the negative LIM group(all P<0.05), and the diopter was increased(all P<0.05). HE staining showed that the boundaries of retinal tissue in the NC group were obvious and arranged regularly. The retinal thickness, the thickness of the inner and outer nuclear layers, and the number of cells were reduced and irregularly arranged in the negative LIM group. The overall structure of the retina in the group EA was relatively perfect, the arrangement was more regular, and the morphological structure of each layer of the tissue did not appear obvious abnormalities. Q-PCR and WB detection results showed that the mRNA and protein relative expression levels of MMP-3, TIMP-3, and Col3α1 in the negative LIM group were significantly higher than those in the NC group(all P<0.05); the expression levels of the EA group was significantly decreased after intervention compared with the negative LIM group(all P<0.05).CONCLUSION: Electroacupuncture can delay axial growth in negative LIM guinea pigs, and downregulate negative LIM induced expression of MMP-3, TIMP-3, and Col3α1 in the retina.

Objective To explore the risk factors for vaginal stump recurrence after early cervical cancer surgery.Methods A total of 243 patients who underwent radical cervical cancer surgery in the First Affiliated Hospital of Henan University of Science and Technology from January 2018 to March 2020 were selected as the research subjects and divided into recurrence group(n=21)and non-recurrence group(n=22)based on whether vaginal stump recurrence occurred within 3 years after surgery.The clinical data of patients in the two groups,including age,pathological type,International Federation of Gynecology and Obstetrics(FIGO)staging of cervical cancer,degree of tissue differentiation,surgical approach,distance between surgical margin and tumor,muscle layer infiltration,presence or absence of lymph node involvement at diagnosis of cervical cancer,number of tumor budding,presence or absence of vascular cancer thrombus,vaginal resection length,and postoperative radiotherapy site were collected.One-way analysis of variance and binary logistic regression were used to analyze the risk factors for vaginal stump recurrence after early cervical cancer surgery.Results The recurrence rate of vaginal stumps within 3 years after early cervical cancer surgery was 8.64％(21/243).There were statistically significant differences in the pathological types,distance between surgical margin and tumor,muscle layer infiltration,number of tumor budding,vaginal resection length,and postoperative radiotherapy site of patients between the recurrence group and non-recurrence group(P＜0.05);there was no statistically significant difference in the age,FIGO stage,degree of tissue differentiation,surgical approach,presence or absence of lymph node involvement at diagnosis of cervical cancer,presence or absence of vascular cancer thrombus of patients between the two groups(P＞0.05).The binary logistic regression analysis showed that the distance between the surgical margin and the tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm were risk factors for vaginal stump recurrence after early cervical cancer surgery(P＜0.05),while postoperative pelvic radiotherapy combined with vaginal brachytherapy was a protective factor for vaginal stump recurrence after early cervical cancer surgery(P＜0.05).Conclusion The risk of vaginal stump recurrence after early cervical cancer surgery is high.The distance between the surgical margin and tumor≤3.5 mm,the number of tumor budding＞5,and the vaginal resection length≤2 cm are risk factors for vaginal stump recurrence after early cervical cancer surgery;pelvic radiotherapy combined with vaginal brachytherapy can reduce the risk of vaginal stump recurrence after early cervical cancer surgery.

Objective:To identify species type and analyze the homology of Brucella in a family cluster infection. Methods:Two patients with brucellosis from the same family who were treated at the First People's Hospital of Lianyungang City, Jiangsu Province in May 2022 were selected as the research subjects. Brucella strains (H4LYG01 and H2LYG02) were isolated through blood culture. The isolated strains were identified for species type and homology analysis using a fully automated microbial mass spectrometry detection system. Molecular typing of the isolated strains was performed using multiple locus variable-number tandem-repeat analysis (MLVA) and multilocus sequence typing (MLST). Results:H4LYG01 and H2LYG02 were both Brucella Maltese, and the credibility scores were 9.745 and 9.627, respectively, and the homology was 100%. The MLVA results showed that the gene loci of H4LYG01 and H2LYG02 were completely identical, with the same genotype. The MLST results showed that the sequence type (ST) of H4LYG01 and H2LYG02 were both ST8 types. Conclusion:The two isolated strains of Brucella from a family with clustered infections are both Brucella Maltese and from the same source.

Metabolism-related diseases are chronic diseases caused by genetic and environmental factors.The symptoms include insulin resistance,abnormal blood glucose and lipid levels,and elevated blood pressure.This type of illness has become a major threat to human health,and there is an urgent need to find effective treatments.Advanced glycation end products (AGE) are a group of complex and heterogeneous compounds that result from reduced interactions between the carbonyl groups of sugar and the free amino groups of proteins,lipids,and nucleic acids.Increasing evidence shows that AGE and its receptor (RAGE) are involved in the occurrence and development of such metabolism-related diseases as hypertension,diabetes,and atherosclerosis.AGE can have adverse effects on tissues through non-receptor and receptor-mediated mechanisms.In the receptor-mediated mechanism,AGE interacts with RAGE to increase the production of oxygen free radicals and activate NF-κB so that more pro-inflammatory cells are expressed and released,leading to cell damage.This article reviews the research progress in interventions with AGE and RAGE in the treatment of hypertension,diabetes,and atherosclerosis from a metabolic perspective in the hope of exploring the potential of AGE and RAGE as therapeutic targets for metabolism-related diseases.

Metabolism-related diseases are chronic diseases caused by genetic and environmental factors.The symptoms include insulin resistance,abnormal blood glucose and lipid levels,and elevated blood pressure.This type of illness has become a major threat to human health,and there is an urgent need to find effective treatments.Advanced glycation end products (AGE) are a group of complex and heterogeneous compounds that result from reduced interactions between the carbonyl groups of sugar and the free amino groups of proteins,lipids,and nucleic acids.Increasing evidence shows that AGE and its receptor (RAGE) are involved in the occurrence and development of such metabolism-related diseases as hypertension,diabetes,and atherosclerosis.AGE can have adverse effects on tissues through non-receptor and receptor-mediated mechanisms.In the receptor-mediated mechanism,AGE interacts with RAGE to increase the production of oxygen free radicals and activate NF-κB so that more pro-inflammatory cells are expressed and released,leading to cell damage.This article reviews the research progress in interventions with AGE and RAGE in the treatment of hypertension,diabetes,and atherosclerosis from a metabolic perspective in the hope of exploring the potential of AGE and RAGE as therapeutic targets for metabolism-related diseases.

Objective To investigate the prevalence and influencing factors of thyroid nodules in children aged 8-10 years in Suzhou , and to provide a scientific basis for the rational prevention and treatment of iodine deficiency disorders (IDD). Methods PPS sampling method was used in this study. Questionnaire survey, physical examination and thyroid B-ultrasound examination were conducted on students aged 8-10 years. Salt samples and urine samples were collected for laboratory detection of the salt iodine and urinary iodine. Univariate and multivariate logistic regression models were used to analyze the risk factors related to thyroid nodules. Results A total of 2 048 children aged 8-10 years were included in the present survey, and the prevalence of thyroid nodules was 23.34% (478/2 048). The prevalence of nodules in boys was 20.98% (218/1 039), and the prevalence of nodules in girls was 25.77% (260/1 009). Multivariate analysis showed that gender (OR=1.338, P=0.006), height (OR=1.993, P=0.001), frequency of iodine-rich food intake (OR=0.862, P=0.048) and nutritional supplements (OR=1.469, P=0.008) were correlated with the prevalence of thyroid nodules. Conclusion The prevalence rate of thyroid nodules in children aged 8-10 years old in Suzhou is 23.34%. Female gender, higher height, regular intake of iodine-rich foods and dietary supplements are statistically associated with the prevalence of thyroid nodules, which may be risk factors for the prevalence of thyroid nodules , but further research is needed to confirm.

Objective:To investigate the size of thyroid of children aged 8 - 10 in Suzhou City and explore its influencing factors.Methods:According to the requirements of the "Jiangsu Province Iodine Deficiency Disorders Monitoring Plan", a stratified multi-stage sampling method was conducted in 10 counties (cities, districts) under the jurisdiction of Suzhou City in five directions: east, west, south, north, and middle from May 2019 to July 2020. Forty children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school for thyroid volume examination, height and weight measurement, and questionnaire survey. At the same time, salt samples from children's homes and random urine samples were collected for iodine content testing, and explore the influencing factors of the thyroid volume.Results:A total of 2 046 children aged 8 - 10 were selected, including 1 038 boys and 1 008 girls. The thyroid volume of children was (3.183 ± 1.042) ml, while the total goiter rate (TGR) was 2.93% (60/2 046). Univariate analysis showed that there were statistically significant differences in thyroid volume among groups with different age, height, weight, body mass index (BMI), presence or absence of nodules, and different dietary frequencies (eating solid snacks, iodine-rich foods, cruciferous vegetables, and meat at different frequencies, P < 0.05). Correlation analysis showed that thyroid volume was positively correlated with age, height, weight, BMI, body surface area (BSA), thyroid nodules, consumption of iodine-rich foods and cruciferous vegetables ( r = 0.24, 0.34, 0.32, 0.21, 0.35, 0.19, 0.05, 0.04, P < 0.05), while negatively correlated with consumption of meat ( r = - 0.04, P = 0.047). Multivariate linear regression analysis showed that age, BSA, thyroid nodules, consumption of solid snacks and cruciferous vegetables entered the equation, with standardized partial regression coefficient values were 0.11, 0.30, 0.16, 0.05, 0.05, respectively. Conclusions:The thyroid volume of children aged 8 - 10 in Suzhou City is not only influenced by age, but also by factors such as BSA, thyroid nodules, consumption of solid snacks, and cruciferous vegetables.