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 relationship between hemoglobin(Hb) level on admission and survival prognosis of patients with hip fracture. METHODS: From February 2016 to October 2018, 249 elderly patients with hip fracture were surgically treated including 62 males and 187 females;the age ranged from 60 to 91(73.67±10.52) years;the time from injury to operation was (6.79±2.27) d. The clinical and laboratory examination results were collected. The Hb level at admission and the mortality at 30, 90, 180 and 360 days after operation were observed. According to the Hb level at admission, the patients were divided into Hb<120 g/L and Hb≥120 g/L groups. The survival conditions of the two groups at 30, 90, 180 and 360 days after operation were compared and analyzed. Logistic regression was used to analyze the effect of Hb level on death 30, 90, 180 and 360 days after operation. RESULTS: The mortality rates at 30, 90, 180 and 360 days after operation were 5.22%, 9.24%, 16.87% and 20.48% respectively. The level of Hb at admission was a risk factor for prognosis and death 30, 90, 180 and 360 days after operation(P<0.05). The OR(95% CI) were 2.431(1.475-4.006), 2.625(1.468-4.695), 2.276(1.320-3.925) and 2.082(1.221-3.551) respectively. CONCLUSION The level of Hb at admission can affect the survival and prognosis of elderly patients with hip fracture. We should further study how to manage the level of Hb before operation.
Aged ; Aged, 80 and over ; Female ; Hemoglobins/analysis* ; Hip Fractures/surgery* ; Hospitalization ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors

Objective:To observe the clinical effect of Traditional Chinese Medicine (TCM) collapsibility combined with pressure therapy in the treatment of eczema.Methods:From January 2021 to August 2021, 60 patients with lower extremity venous ulcers who were treated in Wangjing Hospital, China Academy of Chinese Medical Sciences were selected and randomly divided into the control group (30 patients) and observation group (30 patients). The control group was treated by the routine pressure therapy, and the observation group was by the TCM nursing intervention on the basis of the control group. Both groups were treated for 2 weeks. The visual analogy scale (VAS),chronic Venous Insufficiency Questionnaire (CIVIQ), Self-rating Anxiety Acale (SAS), and Self-rating Depression Scale (SDS) were measured and evaluated at baseline and after treatment.Results:The total response rate was 100.0% (30/30) in the observation group and 86.7% (26/30) in the control group, and the difference was statistically significant ( χ2=4.29, P=0.038). The VAS (2.47±0.68 vs. 2.97±0.14, t=3.95), SAS (40.31±11.93 vs. 55.87±4.53, t=4.73), SDS (44.30±5.38 vs. 47.61±5.33, t=2.39) scores were significantly lower than those in the control group ( P<0.05), CIVIQ score (86.63±2.74 vs. 84.67±3.23, t=2.54) was significantly higher than that of the control group ( P<0.05). Conclusion:TCM combined with pressure therapy can promote the healing of ulcers in patients with eczema, relieve pain, and improve the quality of life of patients.

Objective:To study whether aspirin has inhibitory effect on microglia activation induced by Poly-IC and its mechanism.Methods:Microglia cell line BV2 were cultured in vitro to establish a Poly-IC stimulation-induced microglia cell immune activation model. The experiment groups were divided into control group (no treatment), model group (Poly-IC 10 μg/ml), high dose aspirin group (1 mmol/L aspirin), low dose aspirin group (0.1 mmol/L aspirin), high dose aspirin pretreatment group (Poly-IC 10 μg/ml + 1 mmol/L aspirin) and low dose aspirin pretreatment group (Poly-IC 10 μg/ml + 0.1 mmol/L aspirin). The phagocytosis ability of microglia cells, reactive oxygen species (ROS) and Iba1 protein expression were detected by using immunofluorescence method. The expression of the inflammatory cytokines Il-1β, Il-6, Il-10, TNF-α and cox-2 mRNA in microglia cells were detected by real-time quantitative PCR (RT-qPCR).Results:Compared with the control group, the morphology of microglia cells in model group changed significantly, and the phagocytosis ability and production of reactive oxygen species (ROS) increased. At the meantime, the expression of Iba1 protein was strongly decreased. In the model group, The mRNA expressions of IL-1β(20.55±1.92), IL-6 (63.98±7.83), TNF-α (16.84±3.19), COX-2 (6.78±0.42) were higher than IL-1β(1.01±0.14), IL-6 (0.95±0.17), TNF-α (1.22±0.38), COX-2 (0.87±0.11) in the control group. (Il-1β ( t=26.14), Il-6 ( t=10.22), TNF-α ( t=17.06) and COX-2 ( t=37.07), all P<0.01). In the aspirin pretreatment group, the phagocytic ability of microglia cells was inhibited compared with the model group, and the production of reactive oxygen species (ROS) reduced. The expression of Iba1 protein was also partly recovered. Meanwhile, the effect of the high aspirin dose pretreatment group on pro-inflammatory factors IL-1β(9.95±0.52), IL-6 (39.64±6.89), TNF-α(1.57±0.42), COX-2 (2.47±0.14)were lower than those in the model group significantly.(IL-1β: t=14.18, IL-6: t=3.69, TNF-α: t=16.68, COX-2: t=27.03, all P<0.01). Conclusion:Aspirin has an inhibitory effect on microglial activation induced by Poly-IC, which may be related with inhibiting the expression of inflammatory factors.

Neonatal infectious diseases (NIDs) are the main cause of neonatal death worldwide. Since the neonatal immune system is not fully developed, its pathogenic factors are more complex than adults and the clinical manifestations are more diverse. Early, rapid and comprehensive detection of infectious pathogens is of great significance for timely clinical treatment, and therefore can reduce mortality and complications. Traditional pathogen diagnosis methods are limited in small detection flux, long detection time and low screening efficiency. With the development of high-throughput sequencing technology, metagenomic next-generation sequencing (mNGS) is gradually widely applied in NIDs diagnosis. Not only can acquire the genetic information of pathogens in the samples, but also can be used to excavate the relationship between pathogens and host flora. In particular, mNGS has important reference value for the diagnosis of rare infectious diseases. In this study, the latest research progress and application of mNGS in detecting the pathogens of NIDs have been reviewed.

Objective? To explore the status quo of plaque removal in adolescent patients undergoing fixed orthodontics in a ClassⅢ stomatology hospital in Shanghai, and to provide a reference for formulating precise oral health education measures and improving patients' health self-management ability. Methods? Totally 220 patients undergoing fixed orthodontics in a ClassⅢ stomatology hospital in Shanghai between September and November 2018 were selected by convenient sampling. The plaque disclosing agent was used to stain the plaque. A 5-degree method was used to collect and record the patients' orthodontic plaque index which was calculated according to the plaque area on the dental face. Statistical analysis was employed to analyze the differences in the plaque index between different locations, quadrants, tooth positions, teeth in different shapes and different areas on the dental or lip face in patients with different characteristics. Results? The orthodontic plaque index of the 220 patients undergoing fixed orthodontics was (1.58±0.66), ranging 0.31-3.33. There were statistically significant difference in the plaque index between different locations, quadrants, tooth positions, teeth in differents shapes and different areas on the dental or lip face (F=99.432, 6.552, 3.862, 25.887; P＜0.05). There were statistically significant differences in the plaque index between patients with different gender, age or time of orthodontics (F/t=5.681, 3.159, 2.947; P＜0.05). Compared with the teeth in the other 3 shapes, grinded teeth showed the highest plaque index. The plaque removal effect of mandibular teeth was better than that of maxillary teeth. The plaque removal of lateral incisors and areas under the arch wire on both right and left orthodontic brackets as well as the mesial and distal areas of the gingiva was not satisfactory. Conclusions? The plaque removal in adolescent patients undergoing fixed orthodontics is not satisfactory. Targeted health education should be provided based on the collected orthodontic plaque index.

Clinical skill competition based on objective structured clinical examination could evalu-ate students' clinical abilities effectively and fairly in a comprehensive way. The competition results not only reflected the learning effectiveness of the competitors but all the medical students. Analysis and exploration of the inspiration from the competition could promot the all-round development of students and boost the continuous growth and progress of clinical teaching.

Objective To explore the clinical characteristics and perioperative treatment of chronic obstructive pulmonary disease (COPD) in patients with non-small-cell lung cancer (NSCLC) in department of thoracic surgery,and to guide the clinical diagnosis and treatment. Methods From January 2013 to December 2016,patients with newly diagnosed NSCLC treated in the thoracic surgical department of Lanzhou University Second Hospital were reviewed retrospectively. The patients were divided into the COPD group and non-COPD group. The clinical data,including the incidence and clinical characteristics of COPD in non-small-cell lung cancer,pulmonary complications after surgery,COPD diagnosis and perioperative pulmonary rehabilitation were analyzed retrospectively. Results A total of 726 NSCLC patients were reviewed,six hundred and seventy-five cases who took the full lung function test were included in the study,of which 95 cases received bronchial diastolic test,86 cases were accorded with COPD diagnosis and were included in incorporated COPD group,and 589 cases were in the non- incorporated COPD group. The proportion of men (69 cases,80. 2%,χ2 = 24. 032), age ≥65 (51 cases,59. 3%,χ2 = 6. 784),smoking history (55cases,64. 0%,χ2 = 29. 474) and a large number of smokers (43 cases,50. 0%,χ2 = 5. 802) and lung squamous cell carcinoma(47 cases,54. 7%,χ2 = 6. 241) in the incorporated COPD group were higher than those in differences were statistically significant (P<0. 05); the incidence of pulmonary complications after radical resection of lung cancer in the incorporated COPD group was 23. 9% (16/ 67),which was significantly higher than that in the unincorporated COPD group(13. 7% (78/568)) (χ2 = 4. 894,P<0. 05). The incidence of pulmonary complications in the lung rehabilitation group was 13. 5% ( 5/37) , lower than that of the non-lung rehabilitation group ( 36. 7% ( 11/30 ) ) (χ2 = 4. 886, P<0. 05);Among the 86 cases (12. 7%) of incorporated COPD,only 6 cases (8. 9 ‰) were diagnosed with COPD at the time of admission, and 23 cases ( 3. 4%) at discharge. No COPD guidelines were given. Conclusion NSCLC often combined wtith COPD,especially in males,elders (≥65 years old) ,smokers, squamous cell carcinoma patients. At present,the diagnosis and treatment of co-morbidity of COPD is seriously inadequate,which needs to be paid much attention to by the thoracic surgeons,in order to improve the diagnosis and treatment of COPD,and improve the prognosis of the patients with NSCLC and COPD.

Aim To explore the effect of activated SK channels(small conductance Ca2+-activated K+ channels) on morphine-induced hyperalgesia in the spinal cord in mice.Methods Adult C57BL6/N male mice were chosen to establish the model of morphine-hyperalgesia.The changes of tail withdrawal latency(TWL), mechanical withdrawal threshold(MWT) and the threshold of visceral pain were observed after intrathecal 1-EBIO, the agonist of SK channels.Results Compared with the control group, TWL, MWT and the threshold of visceral pain were decreased after morphine injection.After intrathecal 1-EBIO, the TWL, MWT and visceral pain threshold were increased.The level of spinal membrane SK2 expression in morphine-treated mice was decreased compared with that of control group.After intrathecal 1-EBIO, the level of spinal membrane SK2 expression was increased.Conclusion SK channels in the spinal cord are involved in morphine-induced hyperalgesia in mice.

Objective To investigate the effects of ropivacaine on proliferation,apoptosis and cell cycle of MDA-MB-231 Cells. Methods The cultured MDA-MB-231 cells were treated with different concentrations of ropivacaine. The proliferation of MDA-MB-231 cells was detected by MTT method. Cell apoptosis and cell cycle were detected by Annexin V-FITC/PI and flow cytometry. Results After ropivacaine administration,MDA-MB-231 cells proliferation inhibition ratio increased significantly.Annexin V-FITC/PI and flow cytometry showed ropiva-caine had no significant effects on cell apoptosis and cell cycle.Conclusion Ropivacaine can inhibit the prolifera-tion of MDA-MB-231 cells,but can′t induce apoptosis and block cell cycle.