Objective: To explore the clinical manifestations, diagnosis, differential diagnosis, and treatment of granulomatous cheilitis complications after treatment in patients with upper lip venous malformations, as well as to provide a reference for their clinical diagnosis and treatment. Methods: This report provides details on the clinical manifestations, diagnosis, differential diagnosis, and treatment of a case of granulomatous cheilitis after the treatment of upper lip venous malformation, and then analyzes granulomatous cheilitis alongside the related literature. The patient, a 30-year old male, was first seen in the dermatology department of another hospital with bright red spots on his lips, diagnosed with allergic dermatitis and received symptomatic treatment, and the erythema did not improve. He was diagnosed with ‘cavernous hemangioma’ and was treated with polydocanol and bleomycin injections. The bright red spots on his lips improved, but the swelling worsened for more than half a year. He then sought treatment at the oral mucosal department of our hospital. At the time of consultation, the swelling of the upper lip and perilabial skin was obvious, and there was a red patch on the right side of the upper lip, that was congested with blood. The upper lip was tough, with hard nodules, unclear borders, and poor mobility. Pathological examination showed epithelial hyperplasia of the upper lip mucosa, surface hyperkeratosis, subepithelial fibrous tissue hyperplasia, and chronic inflammation of the mucosa and minor salivary glands. Focal histiocyte, lymphocyte, and plasma cell infiltration was seen in the submucosal layer, with granulomatous inflammatory manifestations. Based on the patient's medical history, clinical manifestations, and histopathological manifestations, the diagnosis of granulomatous cheilitis was made. Tretinoin 0.3 mL (40 mg/mL, 1 mL/vial) was injected into the deep layer of the mucosa of the right and left upper lips for local block treatment. Prednisone acetate tablets (10 mg/Qd) were taken orally, and after 1 week of follow-up, the symptoms improved, so the original treatment was continued. After 2 weeks of follow-up, the swelling of the lips improved significantly, and the oral prednisone acetate tablets were adjusted to 5 mg/Qd. After 4 weeks of follow-up, the shape of the lips was largely back to normal, and the color and suppleness of the lips had improved significantly. The local block treatment and oral medication were stopped, and the patient was instructed to apply the topical tretinoin ointment Bid on the upper lip. Results: The patient had a follow-up visit 8 weeks later, at which their lip color, shape, and texture remained normal, and the patient was instructed to stop the medication and follow up. A review of the literature suggests that the etiology of granulomatous cheilitis is unknown and that it is associated with genetic predisposition, odontogenic infections, allergic factors, microbial infections, and immunological factors. It needs to be clinically differentiated from diseases such as lip venous malformations, lip angioneurotic oedema, Crohn's disease, and tuberculosis. At present, the clinical treatment of granulomatous cheilitis is still based on local glucocorticoid block therapy or a combination of oral glucocorticoid drugs. In this case, the area of erythema on the lips decreased in size, but swelling occurred and continued to worsen after polydocanol and bleomycin injection treatment. Pre-existing venous malformation should be considered as a complication associated with injectable drugs that can produce granulomatous cheilitis. Conclusion The injection-based treatment of lip venous malformation may be complicated by granulomatous cheilitis, and in the process of clinical diagnosis and treatment, it is necessary to be aware to the existence of drug-related factors in the occurrence and development of granulomatous diseases.

Objective: To investigate the predictive value of EZH2 expression for malignant transformation in oral leukoplakia (OLK) and to provide a reference for clinical practice. Methods: This study was approved by the institutional ethics committee, and informed consent was obtained from all participants. A total of 114 patients diagnosed with OLK by pathological examination and treated at our hospital between November 2020 and July 2022 were initially enrolled. After excluding those with incomplete data or follow-up, 105 participants were included in the final analysis, comprising 14 in the high EZH2 expression group and 91 in the low EZH2 expression group. Histopathological examination of oral mucosa and immunohistochemical detection of EZH2 protein expression were performed. The follow-up period was 30 months; participants were followed until malignant transformation occurred or until the end of follow-up, at which point they were withdrawn from the study. The exposure factor was the level of EZH2 protein expression, and the outcome was the malignant transformation rate of OLK. Differences in EZH2 expression levels and transformation outcomes were analyzed. Results: There were no statistically significant differences between the high and low EZH2 expression groups in terms of age, sex, history of systemic disease, lifestyle habits, psychological status, diet, and sleep conditions (P > 0.05). Lesions in the high EZH2 expression group were mainly located on the ventral tongue, while in the low EZH2 expression group, they were more commonly found on the dorsal tongue and buccal mucosa. The malignant transformation rate was 28.6% (4/14) in the high expression group and 8.8% (8/91) in the low expression group; these differences were not statistically significant (P=0.053). In univariate Cox regression analysis, the risk of malignant transformation in the high EZH2 expression group was 3.647 times that of the low EZH2 expression group (HR = 3.647, 95% CI: 1.097-12.120, P<0.05). Kaplan-Meier survival analysis showed that over the 30-month follow-up period, the cancer-free survival rate in the high EZH2 expression group was 19.8% lower than in the low expression group, and the difference was statistically significant (P<0.05). In multivariate Cox regression analysis, only moderate and severe epithelial dysplasia were identified as independent risk factors for malignant transformation. The risk of malignant transformation in the moderate and severe dysplasia groups was 10.695 and 13.623 times higher, respectively, than in the mild dysplasia group (HR = 10.695, 95% CI: 2.270-50.396, P<0.05; HR=13.623, 95% CI: 1.918-96.774, P<0.05). EZH2 high expression was not an independent risk factor in the multivariate model (HR= 2.528, 95% CI: 0.752-8.500, P = 0.134). Conclusion High EZH2 protein expression is a risk factor for the malignant transformation of OLK but does not have independent predictive value.

Oral lichenoid drug reactions(OLDRs)are inflammatory reactions of the oral mucosa caused by the use of specific drugs in sensitive individuals and are classified as oral lichenoid lesions(OLLs).Its clinical and pathological manifestations do not have significant specificity compared to other types of OLL.Various types of drugs have been re-ported to induce OLDR,including antihypertensive drugs,nonsteroidal anti-inflammatory drugs,hypoglycemic drugs,an-tipsychotics,and immunosuppressants,among other drugs.Apart from local or systemic administrate glucocorticoids,the most effective treatment measure is to stop using suspicious drugs.Most patients can achieve significant relief from mu-cosal ulcers and erosion,but white lines may still remain.OLDR has been widely reported in the literature.However,due to a lack of systematic understanding,we do not have a recognized standard for the diagnosis and treatment of this disease.There are still doubts about the causal relationship between related drugs and oral lichen-like lesions.In re-sponse to the abovementioned problems,we searched the literature on drug-related oral lichen planus and lichen-like le-sions at home and abroad over the past 20 years,most of which were case reports and only a few of which were case-con-trol studies.This article describes the current research status of lichenoid lesions from four perspectives:concepts,sus-picious drugs,clinical and pathological manifestations,and treatment prognosis.We hope to provide a theoretical refer-ence for the prevention,diagnosis,and clinical treatment of related lichenoid lesions.A literature review demonstrated that there are still many unclear issues related to the etiology,pathogenesis,clinical diagnosis and treatment,treatment prognosis,and other aspects of this disease,and further clinical and basic research is needed for in-depth exploration.

Objective: To observe the clinical effects of auricular point therapy on burning mouth syndrome (BMS) and its effect on the psychological state of patients and plasma β-endorphin. Methods : A total of 105 patients diagnosed with BMS were randomly divided into an auricular acupoint application group (50 cases) and a drug treatment group (55 cases). The treatment course lasted one month. The patients in the auricular acupoint application group selected 3 points on their tongue, heart and Shenmen through traditional Chinese medical dialectics used for patients with BMS. Wangbuliu seeds were applied, two ears were pressed alternately and one ear was applied each time. The patient was instructed to press the treatment site three times a day, 1-2 min each time, until the auricle skin became reddish and hot. The patients in the drug treatment group took vitamin E 100 mg+oryzanol 10 mg+vitamin B2 10 mg orally three times a day. Before and after treatment, the pain intensity and mental and psychological state of the patients were evaluated. The patient's plasma was detected before and after β-endorphin treatment. Results: The pain sensation intensity of the two groups decreased after treatment (P<0.001). After treatment, the scores of somatization (t = 2.118, P = 0.037), fear (t = 2.084, P = 0.039) and diet and sleep (t = 2.047, P = 0.043) in the auricular acupoint application group were significantly improved compared with the level before treatment. The level of β-endorphin in plasma was increased, and the difference was statistically significant (t = 2.247, P = 0.027) in the auricular acupoint application group after treatment. Conclusion Auricular point therapy is an effective method for patients with BMS, improving psychological state and promoting the synthesis of plasma β-endorphin may be one of its mechanisms.

Objective: To find any differentially expressed circRNAs in oral leukoplakia (OLK) and oral lichen planus (OLP), to investigate the possible role of circRNAs in the pathogenesis of these two diseases. Methods: This study obtained hospital ethical approval. High-throughput sequencing was used to detect differentially expressed circRNAs in OLK, OLP, oral squamous cell carcinoma and normal oral mucosal tissues. CircRNAs were verified by qRT-PCR, enzyme tolerance assays and Sanger sequencing. GO functional analysis and KEGG pathway analysis were performed to predict the functions of circRNAs in OLP. TargetScan and miRanda were applied to predict targeted miRNAs and mRNAs of circRNAs, and ceRNA networks were mapped. Results: A total of 49 circRNAs were differentially expressed in OLK and OLP together, including 30 upregulated and 19 downregulated circRNAs. The five circRNAs confirmed with RT-qPCR, including circHLA-C, circRNF13, circTTN, circSEPN2 and circALDH3A2, were all abnormally expressed in OLK and OLP, among which circHLA-C was a key circRNA with trans splice sites, which was validated by expanding the sample size. ROC curve analysis showed that the area under the circHLA-C curve for predicting OLK was 0.955, and the area under the circHLA-C curve for predicting OLP was 0.988. GO functional analysis showed enrichment of many biological processes related to the immune process. The KEGG pathway with the highest enrichment score was "Natural killer cell mediated cytotoxicity". HLA-C was significantly enriched in these processes/pathways. CeRNA network analysis showed that circHLA-C interacted with a variety of miRNAs, such as hsa-miR-26a-5p, hsa-miR-129-5p, and hsa-miR-29a-3p. Conclusion Many circRNAs were differentially expressed in both OLK and OLP, circHLA-C being the most elevated. CircHLA-C is valuable for the early diagnosis of OLK and OLP and may serve as a potential biomarker for the diagnosis and prognosis of OLK and OLP.

Objective: To evaluate the clinical efficacy of auricular acupoint application in the treatment of burning mouth syndrome(BMS). Methods: A total of 155 patients diagnosed with BMS were randomly divided into the auricular acupoint application group (50 patients), drug treatment group (55 patients), and auricular acupoint application combined with drug treatment group (50 patients). One month represented one course of treatment. The changes in pain intensity were evaluated before treatment as well as one month and three months after treatment. Results: The VAS scores in the auricular acupoint application group (t=8.949), the drug treatment group (t=10.52) and the auricular acupoint application combined with drug treatment group (t=19.33) all decreased 1 month after treatment, with a statistically significant difference compared with the scores before treatment (P < 0.01). The VAS scores of the auricular acupoint application combined with drug treatment group decreased significantly, and the difference was statistically significant compared with the scores in the drug treatment group (t=3.91, P=0.000 2). 3 months after treatment, the VAS scores of the three group decreased compared with that before treatment, but increased compared with that 1 month after treatment, and the VAS score of the drug treatment group increased most obviously, but the difference was not statistically significant compared with that of the auricular acupoint application group (t=2.047, P=0.043), other pairwise comparison differences were not statistically significant. There was no statistically significant difference in VAS score in the auricular acupoint application group (t=1.752) and in the drug treatment group (t=0.174) compared with that before treatment (P > 0.05). Compared with before treatment, the VAS score in the auricular acupoint application combined with drug treatment group also decreased significantly (t=3.282, P < 0.05). Conclusion Auricular point application is a safe and effective treatment for burning mouth syndrome, and the long-term effect is better when combined with drugs.

Oral lichen planus (OLP) is a chronic inflammatory disease of the mucosa, some of which will develop into oral squamous cell carcinoma (OSCC). However, the pathogenesis of OLP remains unknown, but autoimmunity has been suggested as a potential cause. MicroRNAs (miRNAs), which are small noncoding RNAs, have been reported to be involved in a series of physiological events as well as the progression of diseases. The evidence indicates that miRNAs may be highly related to both the initiation and malignant progression of OLP. MiR-146a, miR-26b, miR-155, miR-19a and miR-125a are able to trigger OLP by regulating autoimmunity, and miR-137, miR-125b, and miR-27b may accelerate the carcinogenesis of OLP. These miRNAs may be potential targets for prognosis and treatment. Subsequent studies are expected to focus on a more comprehensive exploration of the role of miRNAs in OLP (including specific action pathways and other OLP-related miRNAs), as well as the potential for miRNAs to predict the treatment outcome of OLP. This review provides an updated summary of the roles of miRNAs in OLP to provide new ideas and approaches to OLP research.

Objective: To establish a method for determining the content of dracorhodin as an indicator in the quality control with methodological studies to provide basis for the preparation process study of Qilisan gel. Methods: An HPLC method was used with a DiamonsilR C18 (250 mm ×4. 6 mm, 5 μm) column, the detection wavelength was set at 440 nm and the column temperature was 30 ℃. Acetonitrile-0. 05 mol·L-1 sodium dihydrogen phosphate solution (45 ∶ 55) was used as the mobile phase, and the flow rate was l. 0 ml·min-1 . Results: The content of dracorhodin was in a good linear relationship (r =0. 999 6) within the range of 1. 632-64. 250 μg·ml-1 , and the average recovery was 99. 02%(RSD =0. 77%, n =6). The number of theoretical plates was calculated as 7 100 according to the dracorhodin perchlorate peak without any interference from the negative sample. Conclusion: The method is objective, accurate and sensitive with high reliability, easy operation and fast process. The measurement results can be used as the quality control basis for the preparation process study of Qilisan gel.

Objective To study the relationship of Helicobacter pylori(Hp)infection degree with serum pepsinogen(PG)and the tumor markers related with gastric cancer .Methods Totally 342 cases of health physical check‐up in our hospital from January to June 2015 were selected .13 C‐UBT was performed to evaluate the Hp infection and infection severitys .The level of serum PG was detected by ELSIA and the levels of tumor markers were detected by luminescence immunoassay .Then the results were statistically analyzed with the SPSS statistical software .Results The positive rate of Hp in 342 research subjects was 49 .42% ,and there was no difference between the male and the female groups(P>0 .05) .The level of serum pepsinogen Ⅰ (PGⅠ )and pepsinogen Ⅱ (PGⅡ)in the Hp(+ + )and Hp(+ + + )groups was significantly higher than that in the Hp negative group ,while the PGⅠ /PGⅡ lev‐el was significantly lower than that in the negative group (P<0 .05) .The level of carbohydrate antigen 724(CA724)and carcino‐em‐bryonic antigen(CEA)had the statistical difference between the Hp(+ + + ) group and the Hp negative group(P= 0 .040 ,P=0 .010) .The Pearson correlation analysis displayed that Hp infection was related with PG Ⅰ ,PGⅡ ,PGⅠ /PGⅡ ,CA724 and CEA . There was a positive correlation between PG Ⅱ and CA50)(r=0 .116 ,P=0 .032);there was a negative correlation between PG Ⅰ /PGⅡ and CA50(r= -0 .193 ,P=0 .000) .Conclusion The combined detection of Hp ,PG and tumor markers could be used as one of methods for screening benign and malignant gastric diseases in the healthy physical check‐up population ,which has an important value for the prevention and intervention of related disease occurrence and development .

Objective To quantify the temporal changes in the volume of blood flow to the skin of the forearm and lower leg during static maximum inspiratory breath-holding of different durations.Methods Blood flow to the skin of the forearm and lower leg were continuously measured with laser Doppler flowmetry in 12 healthy subjects.They were randomly selected to hold their breath for 10,20 or 40 seconds,or as long as possible.The volume of skin blood flow,the onset latency and the recovery latency were measured before,during and after the breath holding.Results Blood flow decreased significantly during each breath-hold with any durations.The magnitude of the decrease and its latencies were similar with all the durations.The average volume of skin blood flow and it's minimum value during each breath-hold were significantly lower in the forearms than in the lower legs.However,the average onset latency (4.41 ±0.44 s) and the average recovery latency (5.95 ±0.59 s) in the forearms were significantly shorter than in the lower legs (4.83 ± 0.70 s for onset and 7.33 ± 0.91 s for recovery).Conclusion The volume of skin blood flow decreases during a static maximum inspiratory breath-hold,and the magnitude of the increase is not related to the duration of the breath-hold.The generalized increase in skin sympathetic vasoconstrictor activity during a static breath-hold is greater in the forearm than in the lower leg.