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 explore the effect of follow-up management based on the digital information platform on the compliance of early screening and follow-up of liver cancer in patients with chronic liver diseases,and to provide a management method for clinical practice.Methods Convenience sampling was adopted to include 3,959 patients who had chronic liver diseases and visited the outpatient clinic of the Department of Infectious Liver Diseases in our hospital from January 2022 to December 2023.Before the application of the digital information platform for management,it was the medical staff of the Infectious Liver Disease Department who conducted telephone follow-ups and handwritten registrations for patients with chronic liver diseases within one week after their visits.After management,A liver cancer prediction model installed in the digital information platform of the hospital automatically collected data of the patients,including information about the diseases and results of examinations for intelligent risk stratification of liver cancer.The nurses who were in charge of the follow-up performed individualised follow-up reviews based on the levels of risk.Follow-up re-visit rate of the patients in very high-and high-risks were calculated.Scores of chronic disease self-efficacy and medication compliance were compared before and at 3 months after the follow-up management.Results A total of 3,860 patients completed the study.After the follow-up management,the total follow-up re-visit rate of the patients was 88.2%(1,818/2,062)and that of the high-risk patients was 95.3%(246/258)in 2022,while those in 2023 were 94.0%(1,691/1,798)and 98.3%(232/236),respectively.After 3 months of follow-up management,scores for medication compliance and chronic disease self-efficacy showed significant improvement in comparison with those before the implementation of follow-up management(P<0.001).Conclusion The follow-up management based on a digital information platform is suitable for screening of early liver cancer in the patients with chronic liver diseases,as it improves the re-visit rate of patients for follow-up,medication compliance and self-efficacy.

BACKGROUND:It has been found that anterior knee pain is related to the biomechanics of the lower limbs,but there is still a lack of research on the effects of gluteal muscle training on the knee joint and daily activities of the lower limbs.OBJECTIVE:To investigate the effects of gluteal muscle activation exercise therapy on the muscle strength of hip and knee joint muscle groups and pain in young male patients with anterior knee pain.METHODS:Twenty-five young male patients with anterior knee pain were enrolled and randomly divided into two groups:gluteal muscle activation group(n=12)and blank control group(n=13).The gluteal muscle activation group performed gluteal muscle activation exercises,40 minutes each,3 times/week,for 6 weeks.The blank control group did not perform any intervention.Assessments were conducted at the time of enrollment and again after 6 weeks.The relative peak torque,total work,ratio of flexors and extensors,and muscle endurance values of the affected hip and knee joints were evaluated through isokinetic flexion and extension tests at 60(°)/s and 180(°)/s.At the same time,floors at which climbing was stopped in the stair-climbing test were detected and the visual analog scale score was assessed.RESULTS AND CONCLUSION:(1)Isokinetic knee extension and flexion test:For the hip joint,the gluteal muscle activation group showed a significant increase in the relative peak torque at 60(°)/s and 180(°)/s by 29.74%and 25.95%respectively after intervention(P=0.022,P=0.024);the blank control group showed a 12.12%decrease in muscle endurance at 180(°)/s compared to before intervention(P=0.000).For the knee joints,the gluteal muscle activation group had a significant increase in the relative peak torque at 60(°)/s and 180(°)/s by 18.69%and 7.27%respectively after intervention(P=0.006,P=0.033);there were no significant changes in the blank control group before and after intervention(P>0.05).(2)Stair-climbing test:The number of floors climbed to cessation in the gluteal muscle activation group was(6.41±6.1)floors,which was higher than that in the blank control group(P=0.024),and increased by 33.11%compared with before intervention(P=0.016);there were no significant changes in all the indicators of the blank control group before and after intervention(P>0.05).(3)Pain assessment:After intervention,the visual analogue scale score of the gluteal muscle activation group was significantly lower than that of the blank control(P=0.036),and also decreased compared to before intervention(P=0.000);there were no significant changes in the blank control group before and after intervention(P>0.05).To conclude,the 6-week gluteal activation exercise therapy can improve the explosive power and endurance of the lower limb muscles,and reduce the degree of anterior knee pain.For patients with anterior knee pain,gluteal muscle training is necessary to promote recovery.

Objective: To explore the application of photodynamic therapy (PDT) combined with orally administered retinoic acid in the treatment of proliferative verrucous leukoplakia (PVL) and provide a reference for clinical practice. Methods: A case of sequential treatment of PVL with PDT and orally administered retinoic acid was reported. The characteristics, diagnosis, treatment of PVL, and the application of PDT and retinoic acid in oral leukoplakia were retrospectively analyzed based on the literature. Results: After four PDT sessions, a majority of the oral lesions were eliminated in a patient clinically diagnosed with PVL, but the lesions recurred two months later. Subsequently, the patient was treated with retinoic acid at a dose of 10 mg, once a day, orally before bedtime. After continuous treatment for 2 weeks, the oral lesions were significantly reduced. The dose was then adjusted to 10 mg, twice a day, and the treatment was extended for 3 months until the lesions completely disappeared. Following this, a periodic regimen was adopted to continue the administration of retinoic acid at a dose of 10 mg, twice a day (3 weeks of treatment followed by 1 week of drug withdrawal as one cycle), for a total of 6 cycles. No recurrence was observed during the 5-month follow-up after drug withdrawal. A review of the literature indicates that PVL is an oral potentially malignant disorder (OPMD) characterized by multifocality, high recurrence rate, and high malignant transformation rate. Currently, there is no ideal treatment method for PVL. PDT is advantageous because of its low toxicity. Furthermore, it is strongly selective, minimally invasive, and patients experience no scarring. Thus, it has been recommended as the first-line therapy for PVL. However, due to the limitations of local application of photosensitizers in terms of effectiveness, targeting, and penetration depth, the efficacy of PDT in treating PVL remains uncertain. There are a few reports on the treatment of oral leukoplakia with retinoic acid given by oral, but no literature has reported the combination of PDT and retinoic acid given by oral for PVL. Conclusion The sequential combination of PDT and oral retinoic acid therapy is an effective treatment for PVL.

Objective To explore the effect of follow-up management based on the digital information platform on the compliance of early screening and follow-up of liver cancer in patients with chronic liver diseases,and to provide a management method for clinical practice.Methods Convenience sampling was adopted to include 3,959 patients who had chronic liver diseases and visited the outpatient clinic of the Department of Infectious Liver Diseases in our hospital from January 2022 to December 2023.Before the application of the digital information platform for management,it was the medical staff of the Infectious Liver Disease Department who conducted telephone follow-ups and handwritten registrations for patients with chronic liver diseases within one week after their visits.After management,A liver cancer prediction model installed in the digital information platform of the hospital automatically collected data of the patients,including information about the diseases and results of examinations for intelligent risk stratification of liver cancer.The nurses who were in charge of the follow-up performed individualised follow-up reviews based on the levels of risk.Follow-up re-visit rate of the patients in very high-and high-risks were calculated.Scores of chronic disease self-efficacy and medication compliance were compared before and at 3 months after the follow-up management.Results A total of 3,860 patients completed the study.After the follow-up management,the total follow-up re-visit rate of the patients was 88.2%(1,818/2,062)and that of the high-risk patients was 95.3%(246/258)in 2022,while those in 2023 were 94.0%(1,691/1,798)and 98.3%(232/236),respectively.After 3 months of follow-up management,scores for medication compliance and chronic disease self-efficacy showed significant improvement in comparison with those before the implementation of follow-up management(P<0.001).Conclusion The follow-up management based on a digital information platform is suitable for screening of early liver cancer in the patients with chronic liver diseases,as it improves the re-visit rate of patients for follow-up,medication compliance and self-efficacy.

BACKGROUND:It has been found that anterior knee pain is related to the biomechanics of the lower limbs,but there is still a lack of research on the effects of gluteal muscle training on the knee joint and daily activities of the lower limbs.OBJECTIVE:To investigate the effects of gluteal muscle activation exercise therapy on the muscle strength of hip and knee joint muscle groups and pain in young male patients with anterior knee pain.METHODS:Twenty-five young male patients with anterior knee pain were enrolled and randomly divided into two groups:gluteal muscle activation group(n=12)and blank control group(n=13).The gluteal muscle activation group performed gluteal muscle activation exercises,40 minutes each,3 times/week,for 6 weeks.The blank control group did not perform any intervention.Assessments were conducted at the time of enrollment and again after 6 weeks.The relative peak torque,total work,ratio of flexors and extensors,and muscle endurance values of the affected hip and knee joints were evaluated through isokinetic flexion and extension tests at 60(°)/s and 180(°)/s.At the same time,floors at which climbing was stopped in the stair-climbing test were detected and the visual analog scale score was assessed.RESULTS AND CONCLUSION:(1)Isokinetic knee extension and flexion test:For the hip joint,the gluteal muscle activation group showed a significant increase in the relative peak torque at 60(°)/s and 180(°)/s by 29.74%and 25.95%respectively after intervention(P=0.022,P=0.024);the blank control group showed a 12.12%decrease in muscle endurance at 180(°)/s compared to before intervention(P=0.000).For the knee joints,the gluteal muscle activation group had a significant increase in the relative peak torque at 60(°)/s and 180(°)/s by 18.69%and 7.27%respectively after intervention(P=0.006,P=0.033);there were no significant changes in the blank control group before and after intervention(P>0.05).(2)Stair-climbing test:The number of floors climbed to cessation in the gluteal muscle activation group was(6.41±6.1)floors,which was higher than that in the blank control group(P=0.024),and increased by 33.11%compared with before intervention(P=0.016);there were no significant changes in all the indicators of the blank control group before and after intervention(P>0.05).(3)Pain assessment:After intervention,the visual analogue scale score of the gluteal muscle activation group was significantly lower than that of the blank control(P=0.036),and also decreased compared to before intervention(P=0.000);there were no significant changes in the blank control group before and after intervention(P>0.05).To conclude,the 6-week gluteal activation exercise therapy can improve the explosive power and endurance of the lower limb muscles,and reduce the degree of anterior knee pain.For patients with anterior knee pain,gluteal muscle training is necessary to promote recovery.

Objective:To investigate the factors influencing the decision to delivery interval (DDI) in emergency cesarean section in Guangzhou and the impact of DDI on maternal-infant outcomes.Methods:A retrospective study was conducted on clinical data of pregnant women who underwent emergency cesarean section at municipal and district maternal and child health hospitals in Guangzhou city in 2021. Per the classification method of emergency cesarean section and recommendations for DDI provided by National Institute for Health and Clinical Excellence guidelines, these subjects were classified into Category Ⅰ and Category Ⅱ cesarean sections. Each category was further divided into two subgroups based on DDI: the Category Ⅰ group into >30 min and ≤30 min subgroups, and the Category Ⅱ group into >75 min and ≤75 min subgroups. Chi-square test or Fisher's exact test, two independent samples t-test, Mann-Whitney U test, and logistic regression were used to analyze the potential factors influencing DDI and the impact of DDI on maternal-infant outcomes. Results:(1) Totally 502 women underwent urgent cesarean section, including 304 (60.6%) Category Ⅰ and 198 (39.4%) Category Ⅱ, were analyzed. Among the Category Ⅰ group, 30.3% (92/304) achieved a DDI of ≤30 min, while 37.4% (74/198) of Category Ⅱ cases had a DDI of ≤75 min. (2) For the Category Ⅰ cases, multivariate logistic regression showed that more patients under intravertebral anesthesia, than those under general anesthesia, had a DDI >30 min ( OR=14.04, 95% CI: 6.14-32.10) as well as more with ward-based emergencies than those with delivery room emergencies ( OR=3.21, 95% CI: 1.72-6.00, both P=0.001). Among the Category Ⅱ cases, logistic regression revealed that cesarean section during routine working hours was more likely to achieve DDI >75 min than that during resting hours ( OR=3.93, 95% CI: 2.03-7.63, P=0.001). The risk of DDI >75 min was higher in tertiary maternal and child health hospitals compared with secondary maternal and child health hospitals ( OR=2.45, 95% CI: 1.06-5.70, P=0.037). (3) Among the Category Ⅰ cases, compared with the DDI ≤30 min group, the DDI >30 min group had a lower risk of neonatal Apgar score ≤7 at 1 min ( OR=0.31, 95% CI: 0.14-0.69, P=0.004), but there was no significant difference in the risk of neonatal Apgar score ≤7 at 5 min ( OR=0.21, 95% CI: 0.04-1.17) or neonatal asphyxia ( OR=0.32, 95% CI: 0.07-1.44) between the two subgroups. In cases of Category Ⅱ cesarean sections, there was no significant difference in any maternal-infant outcomes between DDI ≤75 min and DDI >75 min subgroups. Conclusions:The location of emergency and types of anesthesia are the influencing factors of DDI for Category Ⅰ cesarean sections, while the operation time and level of maternal and child health hospital are the influencing factors of DDI for Category Ⅱ cesarean sections. We did not find any impact of DDI on maternal or infant outcome.

Oral submucous fibrosis (OSF) is one of the most common precancerous lesions of the oral mucosa, and its pathogenesis has not been fully elucidated. Small noncoding RNAs (SncRNAs), a class of RNA molecules that do not code for proteins, have been widely reported to be involved in the regulation of a variety of human diseases. An increasing number of studies have shown that a variety of SncRNAs play important roles in the pathogenesis of OSF. Current studies have shown that microRNAs (miRNAs) are involved in OSF disease progression by regulating the expression of related transcription factors and genes or epithelial mesenchymal transformation to regulate the activation of fibroblasts (FBs). Long noncoding RNAs (lncRNAs) that transform growth factor-β/suppressor of mothers against decapentaplegic (TGF-β/Smad) signaling pathways or interact with miRNAs are involved in the development of OSF. Circular RNAs (circRNAs) play a role in OSF by interacting with miRNAs. tRNA-derived small RNAs (tsRNAs) are involved in the progression of various fibrotic diseases, but their specific mechanism of action in OSF still needs to be further explored. In the future, it is still necessary to focus on the targets of SncRNAs mediating OSF progression and explore their function and molecular mechanism in OSF to provide new ideas for the diagnosis and treatment of OSF.

Objective:To investigate effects of short-term cigarette smoke exposure combined with poly(I:C)stimulation on lung immune response and interferon expression in mice.Methods:BALB/c mice were randomly divided into 4 groups:control group,smoke group,poly(I:C)group and smoke combined poly(I:C)group.Total cell number and cell classification count of bronchoalveo-lar lavage fluid(BALF)were detected,and cell morphology was observed under ordinary light.Cytokines,chemokines,interferon and interferon stimulating genes expressions in lung tissues were detected by fluorescence quantitative PCR.Results:Compared with control group,total cell count,macrophage count and neutrophil count in smoke combined poly(I:C)group were significantly increased(P<0.05),and macrophage count was higher than that in poly(I:C)group.Macrophages of airway lavage fluid of mice in smoke combined with poly(I:C)group were larger in size,round or irregular in shape,and had more vacuoles in cytoplasm.Com-pared with control group,mRNA expressions of neutrophil chemokine CXCL1(P<0.05),CXCL2(P<0.01)and lymphocyte chemo-kine CCL2(P<0.01)in lung tissues of mice in smoke combined with poly(I:C)group were increased.IL-1β,IL-6,TNF-α mRNA expressions were significantly increased(P<0.01),IFN-β(P<0.01),IFN-γ(P<0.05),MX2(P<0.01)and IP-10(P<0.01)expre-ssions in lung tissues were significantly increased,and compared with poly(I:C)group,mRNA expressions of CXCL2(P<0.05),TNF-α(P<0.01)and IFN-β(P<0.05)in lung tissues of mice in smoke combined with poly(I:C)group were significantly increased.Conclusion:Cigarette smoke combined with poly(I:C)induces lung inflammation and expressions of interferon and interferon stimu-lating genes in mice.Cigarette exposure also increases poly(I:C)-induced acute lung inflammation and type Ⅰ interferon expression in mice.

Objective To examine the expression of autophagy marker proteins LC3,P62 and apoptotic protein caspase-3 in oral submucous fibrosis(OSF)and investigate their relationship in epithelial mucosa.Methods To collect buccal mucosal specimens from 90 patients with OSF who underwent tissue pathological biopsy in the Department of Stomatology,Xiangya Hospital,Central South University from 2016 to 2019.There were divided into early stages of OSF group,moderately stages of OSF group,and advanced stages of OSF group.At the same time,30 healthy individuals without oral mucosal diseases were collected as control group.Compare the thickness of the epithelial cell layer using HE staining,and detect the expression of LC3,P62,and caspase-3 in the buccal mucosa epithelium of each group by immunohistochemistry.Results HE staining showed that compared to normal oral mucosa in control group,epithelial cell layer thickness of OSF patients was significantly reduce(P<0.05).Immunohistochemical staining showed that the expressions of LC3 and caspase-3 increased and P62 expression decreased significantly in the early stages of OSF group,moderately stages of OSF group,and advanced stages of OSF group(P<0.05).Their expressions were related to the mouth opening of patients with oral submucous fibrosis(P<0.05).In addition,the expression levels of LC3 and caspase-3 were positively correlated(r=0.320,P<0.05),the expression levels of P62 and caspase-3 were negatively correlated(r=-0.554 P<0.001),and the expression levels of LC3 and P62 were negatively correlated(r=-0.710,P<0.001).Conclusion Autophagy and apoptosis may be related to the occurrence and development of OSF,and the combined detection of LC3,P62,and caspase-3 is of great significance for the diagnosis of OSF.