Effects of optimizing target volume on oral mucosal reaction and salivary gland function in oropharyngeal cancer patients undergoing intensity-modulated radiotherapy / 中国医学物理学杂志

Objective To analyze the effects of target volume optimization on oral mucosal reaction and salivary gland function in oropharyngeal cancer patients receiving intensity-modulated radiotherapy(IMRT).Methods A total of 120 patients with oropharyngeal cancer admitted to Affiliated Hospital of Jiangsu University from April 2020 to August 2022 were selected and randomly grouped into control group(n=60,conventional IMRT)and treatment group(n=60,cervical region Ⅱ and the oral target region were optimized during IMRT).The therapeutic efficacy,parotid gland dose,incidence of acute oral mucosal reaction,dry mouth and oral pain at 3 months after IMRT were compared between two groups.The resting-state apparent diffusion coefficient(ADC)values of parotid and submandibular glands at different time points(before radiotherapy,the 4th week of radiotherapy,the end of radiotherapy and 3 months after radiotherapy)were recorded.Results The difference in the objective reaction rate between two groups was trivial[80.00％(48/60)vs 75.00％(45/60),P>0.05].The mean dose(Dmean)and V34 of the unaffected parotid gland and the Dmean and V30 of the oral cavity in treatment group were lower than those in control group(P<0.05).The incidences of acute oral mucosal reaction,dry mouth and oral pain at 3 months after radiotherapy in treatment group were 41.67％,50.00％,and 58.33％,lower than those in control group(75.00％,78.33％,and 85.00％)(P<0.05).The resting-state ADC values of parotid and submandibular glands at the 4th week of radiotherapy,the end of radiotherapy,and 3 months after radiotherapy in both two groups were higher than those before radiotherapy(P<0.05).At the 4th week of radiotherapy,the end of radiotherapy,and 3 months after radiotherapy,the resting-state ADC values of parotid and submandibular glands in treatment group were lower than those in control group(P<0.05).Conclusion Optimizing target volume during oropharyngeal IMRT can effectively prevent the occurrence of radiation-induced mucositis,alleviate oral mucosal reaction,oral pain and dry mouth,reduce parotid gland dose,and diminish the effects of IMRT on salivary gland function in patients.

A novel interlamellar oral mucosa graft surgery technique using fibrin glue for the treatment of trichiasis / Nova técnica cirúrgica de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase

ABSTRACT Purpose: The purpose of this study was to evaluate the long-term outcomes of patients with trichiasis treated with a modified interlamellar oral mucosa graft surgery technique using fibrin glue. Methods: A prospective study was conducted at the Oculoplastic Department of Ouro Verde Hospital Complex. Patients with recurrent trichiasis without entropion who did not respond to conventional therapy, underwent intermarginal lamellar splitting of the eyelid and oral mucous graft insertion with fibrin glue replacing sutures. They were then evaluated at 1-day, 1-week, 1-month, 6-month, and 4-year follow-ups. Graft adherence, symptom resolution, esthetic satisfaction, overall patient satisfaction, and trichiasis recurrence were assessed at 6-month and 4-year follow-ups. Results: Fifteen patients (a total of 19 eyes) were included, of whom 10 (66.7%) were female and 5 (33.3%) were male. The mean age was 75.4 ± 10.5 years (range, 54-98 years). Acquired trichiasis was the main cause. Of the patients with acquired trichiasis, 12 (86.7%) had chronic blepharitis, 2 (13.3%) had an undetermined cause, and one (6.7%) had trachomatous trichiasis. Most cases involved only one eyelid segment (89.4%) and =5 lashes (84.2%; minor trichiasis). No adverse reactions from the fibrin glue were reported and no sutures were required after graft placement. At 6 months, no graft failures occurred, 17 eyes of 13 patients (89.4%) showed good graft adherence, 2 eyes of 2 patients (10.5%) showed partial graft adherence, and 2 eyes of 1 patient (10.5%) had trichiasis recurrence. At 4-year follow-up, no graft failure occurred, 3 patients (3 eyes) were lost to follow-up, and 2 eyes of 2 patients (14.2%) had trichiasis recurrence. The 4-year cumulative success rate was 78.9%. Conclusions: The modified interlamellar surgery with fibrin glue showed a good long-term success rate. This technique reduces surgical time, facilitates smaller graft insertion, and therefore, should be considered for recalcitrant minor trichiasis without entropion.>

RESUMO Objetivo: O objetivo deste estudo foi avaliar os resultados a longo prazo da técnica cirúrgica modificada de enxerto interlamelar de mucosa oral usando cola de fibrina para o tratamento de triquíase. Métodos: Um estudo prospectivo foi realizado no Departamento de Óculo-plástica do Complexo Hospital Ouro Verde. Pacientes com triquíase recorrente sem entrópio, que não responderam à terapia convencional, foram submetidos à cirurgia com separação intermarginal das lamelas das pálpebras e inserção de enxerto de mucosa oral usando cola de fibrina, substituindo a sutura. Pacientes foram avaliados 1 dia, 7 dias, 1 mês, 6 meses e 4 anos após a cirurgia. A aderência do enxerto, resolução dos sintomas, satisfação estética, satisfação geral do paciente e recorrência de triquíase foram avaliados aos 6 meses e aos 4 anos. Resultados: Quinze pacientes (total de 19 olhos) foram incluídos, dos quais 10 (66.7%) eram do sexo feminino e 5 (33.3%) do sexo masculino. A média de idade foi 75.4 ± 10.5 anos (intervalo 54-98 anos). Triquíase adquirida foi a principal causa, da qual 12 pacientes apresentaram blefarite crônica (86.7%), 2 pacientes com causa indeterminada (13.3%) e 1 paciente com triquíase tracomatosa (6.7%). A maioria dos casos envolveu apenas um segmento da pálpebra (89.4%) e com =5 cílios (84.2%; triquíase menor). Nenhuma reação adversa foi reportada com o uso da cola de fibrina e nenhum caso necessitou de sutura após inserção do enxerto. Aos 6 meses, não houve nenhuma falha de enxerto, 17 olhos de 13 pacientes (89.4%) apresentaram boa aderência de enxerto, 2 olhos de 2 pacientes (10.5%) mostraram aderência parcial do enxerto e 2 olhos de 1 paciente (10.5%) apresentaram recorrência da triquíase. Aos 4 anos, não houve nenhuma falha de enxerto, 3 olhos de 3 pacientes tiveram perda de seguimento e 2 olhos de 2 pacientes (14.2%) apresentaram recorrência da triquíase. A taxa de sucesso acumulativa após 4 anos foi de 78.9%. Conclusão: A cirurgia modificada de enxerto interlamelar de mucosa oral usando cola de fibrina mostrou uma boa taxa de sucesso a longo prazo. Esta técnica reduz o tempo cirúrgico, facilita a inserção de enxertos menores e, portanto, deve ser considerada em triquíase menor sem entrópio resistente ao tratamento convencional.

Analysis of the feasibility and safety of repair of ureteral stricture with oral mucosal graft / 中华泌尿外科杂志

Objective:To summarize and analyze the current application status of oral mucosal graft (OMG) technique in the repair of ureteral strictures in China, and clarify the feasibility, safety and effectiveness of this technique.Methods:The 175 patients who underwent repair of ureteral stricture using oral mucosal patches from June 2015 to February 2022 were etrospectively analyzed in 14 medical centers in China, including 49 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 32 cases in Affiliated Seventh Medical Center of PLA General Hospital, 3 cases in The Second Hospital of Anhui Medical University, 6 cases in The First Affiliated Hospital of Zhengzhou University, 56 cases in Peking University First Hospital, 3 cases in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 cases in Shanghai Sixth People' s Hospital, 4 cases in General Hospital of Estern Theater Command, 4 cases in Lanzhou University Second Hospital, 2 cases in Guizhou Province People 's Hospital, 2 cases in Peking University People' s Hospital, 5 cases in Jinzhou First People's Hospital, 5 cases in The First Affiliated Hospital of Wannan Medical College, 1 case in Shandong Provincial Hospital. In this study, 127 patients (72.6%) used lingual mucosal patches, 32(18.3%) labial mucosa, and 16(9.1%) buccal mucosa. The surgical approach for OMG ureteral reconstruction was mainly minimally invasive, with robot-assisted laparoscopy in 84 patients (48.0%), traditional laparoscopic surgery in 87 patients (49.7%), and open surgery in only 4 patients (2.3%). There were 133 males and 42 females with an average age of (35.0±17.2) years. The mean body mass index (BMI) and stenosis length were (23.1±4.1) kg/m 2 and (4.7±1.8) cm, respectively. The stricture was located in the left ureter in 116 patients, right ureter in 58 case and bilateral ureter in 1 case. The most common causes of ureteral stricture were endoscopic surgery in 88(50.3%)patients, congenital stricture in 55(31.4%)patients, failed ureteroplasty in 29(16.6%)patients, history of extracorporeal shock wave lithotripsy in 13(7.4%)patients, radiotherapy history in 3(1.7%)patients and other causes in 6(3.4%)patients. Strictures were mainly located in the upper ureter, accounting for 61.7% (108/175 cases), followed by 36.0% (63/175) at the ureteropelvic junction and 2.3%(4/175)in the middle ureter. According to the surgical methods, the patients were divided into robot-assisted laparoscopic surgery group ( n=84), traditional laparoscopic surgery group ( n=87)and open surgery group ( n=4). Subgroup analysis of patients in robot-assisted laparoscopic and traditional laparoscopic surgery groups was performed. There were no significant difference in preoperative data between the two groups except for age (32.0±18.3) years vs.(37.0±15.9)years, P=0.040], BMI[(22.5±4.3)kg/m 2 vs. (23.7±3.6)kg/m 2, P=0.028], and etiology of stenosis [endoscopic injury, 34(40.5%) vs. 53(60.9%), P=0.012]. Preoperative hydronephrosis and stricture length were assessed by CTU and ureterography. Ureterography 7-9 weeks after surgery showed patency of the reconstructed segment, or no recurrence of hydronephrosis was judged as success. Evaluate the operation method, operation time, success rate, length of OMG in repairing ureteral stricture between laparoscopic and robot-assisted groups. Results:The overall success rate of oral mucosal graft repair surgery reached 97.7%(171/175). The success rate of ureteral reconstruction in the two groups were 96.4%(81/84)and 98.9%(86/87), respectively ( P=0.351), and the difference was not statistically significant. There was no significant difference for operation time, intraoperative blood loss, and mean oral mucosal length between the robotic and laparoscopic groups[(244.7±85.8) min and (222.7±83.5)min ( P=0.116), (58.9±38.6) ml and (68.4±45.5) ml ( P=0.217), (5.0±2.0) cm and (4.6±1.5) cm ( P=0.350)], respectively.Postoperative complications were reported in 23 (13.1%) patients, such as fever, urinary leakage, lymphatic leakage, infection, but only 2 (1.4%) cases patients had complications of Clavien-Dindo score ≥ Ⅲ. The two patients developed urinary stricture after surgery with failed conservative treatment, and no urinary stricture occurred following endoscopic treatment.The short-term (three months after surgery)incidence of complications in the site where the oral mucosa was taken, such as difficulty in opening mouth, pain, and swelling, was 12.0% (21/175), and there was no significant difference for oral complications between patients harvesting different length of mucosal graft. Conclusions:Ureteroplasty with oral mucosal graft is a safe, feasible and reliable technique for ureteral reconstruction. At present, minimally invasive technology is the main surgical approach for ureteroplasty, and there is no significant difference in operation time and success rate between robotic surgery and laparoscopic surgery.

Research progress on oral mucosal epithelial culture and ocular surface transplantation / 中华实验眼科杂志

Human corneal epithelial cells are continuously replenished by limbal stem cells to maintain ocular homeostasis and normal visual function.Some ocular surface injuries or diseases, such as thermochemical burns and Stevens-Johnson syndrome, can result in limbal stem cell deficiency, severely compromising patients' visual acuity.Non-limbal autologous epithelial tissue transplantation should be considered when both eyes are affected.Oral mucosal epithelial cells are an important source of seed cells for ocular surface reconstruction.What's more, cell sheets constructed ex vivo have achieved good results in clinical applications.This article reviews the research progress on the use of oral mucosal epithelial cells for the treatment of limbal stem cell deficiency, focusing on various factors including carriers, culture conditions, and techniques that may affect the culture of oral mucosal epithelial sheets.In addition, the strengths and weaknesses of the application of cell sheets in clinical ocular surface transplantation are also discussed, so as to provide a research direction for the safe and effective reconstruction of ocular surface epithelium.

Application of narrative medicine in the clinical teaching of oral mucosal diseases / 中华医学教育探索杂志

Objective:To investigate the effect of teaching practice under the concept of narrative medicine on improving the empathy level of interns in oral mucosal diseases.Methods:The interns of stomatology in the class of 2018 in School of Stomatology, Shanghai Jiao Tong University, were divided into narrative medicine teaching group (27 interns receiving narrative medicine concepts and methods before and during internship) and traditional teaching group (21 interns received patients directly under the guidance of teachers without the addition of narrative medicine concepts and methods). A questionnaire was used to collect the general information of students, and the Chinese version of Jefferson Scale of Physician Empathy (JSPE) (the version for medical students) was used to measure the empathy level of students. After the end of internship, a statistical analysis was performed for the scores of both groups, and a questionnaire survey was conducted to investigate the acceptance of internship under the guidance of narrative medicine among the students in the narrative medicine teaching group. GraphPad Prism 9.3.0 was used to perform the t-test and the rank sum test. Results:There was a significant difference in JSPE score between the traditional teaching group and the narrative medicine teaching group (92.26±8.23 vs. 104.20±15.65, t=2.70, P=0.005), and in addition, 88.89% (24/27) of the students in the narrative medicine teaching group were interested in participating in internship under the guidance of narrative medicine. However, there was no significant difference in the score of internship between the narrative medicine teaching group and the traditional teaching group (87.28±2.77 vs. 85.47±4.31, t=1.68, P=0.100). Conclusions:Incorporating the concepts and methods of narrative medicine into clinical teaching of oral mucosal diseases can significantly improve the empathy ability of interns and raise the awareness that empathy is as important as scientific literacy among students.

Adverse drug reactions induced by hydroxychloroquine in the treatment of oral lichen planus: a report of 13 cases / 口腔疾病防治

Objective @# To analyze the adverse drug reaction（ADR） reports of hydroxychloroquine for clinical medication safety. @* Methods@#The ADR reports of hydroxychloroquine between May 2019 and May 2021 were analyzed. Age, reasons for drug use, time of ADR, combined drug use, and ADR outcomes were statistically analyzed. @*Results@# No severe ADR was reported. Patients over 60 years old accounted for 53.85% of the total cases, and the time of ADR appearance was significantly earlier among those under 60 years old. A total of 61.54% of ADRs were involved in multiple organs, and optic neurotoxicity was reported in 46.15% of cases. @*Conclusion@# In the treatment of oral lichen planus with hydroxychloroquine, adverse drug reactions should be monitored, and increased attention should be given to patients over 60 years old to ensure the safety of this medication.

Application status and prospects of topical drug therapy in oral mucosal diseases / 口腔疾病防治

@#Oral mucosal disease is a general term for a type of disease that mainly affects the oral mucosa and surrounding soft tissues. In the treatment of oral mucosal diseases, due to the particularity of the anatomical location, the use of topical administration is relatively simple and convenient; drugs can easily accumulate in the lesions, and at the same time, they can also avoid adverse reactions caused by systemic drug delivery. Topical administration has become an important and even preferred option for the treatment of oral mucosal diseases. There are various types of topically used drugs for oral mucosal diseases, such as glucocorticoids (triamcinolone acetonide), immunomodulatory drugs (tacrolimus), antiseptic drugs (chlorhexidine), pain relievers (lidocaine) and proprietary Chinese medicines (aloe vera gel). Among these drugs, although the most widely used liquid formulations such as gargles and sprays are easy to use, they are not conducive to local retention of drugs due to the particularity of the oral environment and function. Based on this, researchers have continuously improved the dosage form of the drug, and developed a series of semi-solid pharmaceutical preparations such as gels and ointments, some of which have exerted good curative effects in clinical work. In addition, although films, patches and other solid oral mucosal topical pharmaceutical preparations have few clinical applications, they have also been widely researched and described and are expected to become the mainstream dosage form in the future. In general, with the improvement of dosage forms, topical administration is playing an increasingly important role in the treatment of oral mucosal diseases. Therefore, combined with basic research and clinical reports, this article reviews the application of topical drug delivery in the treatment of oral mucosal diseases

Research progress on the role of T helper cells 17 and interleukin 17 in oral mucosal diseases / 口腔疾病防治

@#T helper 17 (Th17) cells are a new type of CD4+ T helper cell. They participate in the immune and inflammatory response by secreting specific interleukin-17 (IL-17). In oral mucosal diseases, oral lichen planus (OLP), recurrent aphthous ulcer (RAU) and Behcet′s disease (BD) are associated with Th17 cells and IL-17. There were 17 kinds of proteins in the saliva of patients with OLP that could upregulate the expression of Th17 cells and induce the secretion of IL-17. IL-17 can stimulate epithelial cells, endothelial cells and fibroblasts to produce a variety of cytokines, such as IL-6, IL-8, granulocyte macrophage colony-stimulating factor and cell adhesion molecule-1, leading to the production and aggravation of inflammation. Th17/Tc17 cell-targeted therapy can significantly improve the clinical symptoms of OLP patients′ mucosa and skin. IL-17 can stimulate oral keratinocytes through the IL-17RA or IL-17RE receptor and produce proinflammatory effects in RAU. Th17 cells in the peripheral blood of BD patients are significantly increased, while Treg cells are significantly decreased.

Toxicity of Chemotherapeutics Based on Viscera-state doctrine / 中国实验方剂学杂志

Malignant tumors are important diseases that threaten human health. Although targeting and immunotherapy have been gradually applied in the treatment of malignant tumors in recent years， which can alleviate the suffering of patients to a certain extent， there are still problems of large adverse reactions and easy drug resistance. At present， chemotherapy is still the main method for the treatment of malignant tumors. While killing tumor cells， chemotherapy also damages normal cells， which often leads to drug toxicity， such as bone marrow suppression， gastrointestinal adverse reactions， liver and kidney function damage， and oral mucosal reactions. Although modern medicines have a certain effect on the toxicity of chemotherapy drugs， there are still limitations. Traditional Chinese medicine（TCM） has a long history of treating malignant tumors， and considers that chemotherapy is a drug with toxin invading the body， exacerbating the "deficiency"， "toxin" and "stasis" of the body， causing damage to Qi， blood and organs， especially in spleen， stomach， liver and kidney， and leading to bone marrow suppression， liver and kidney function injury and other adverse reactions. Studies have confirmed that the use of TCM treatment has a better clinical efficacy. Therefore， new therapies shall be explored based on the basic theory of traditional Chinese medicine. As the core part of the theoretical system of TCM， Viscera-state doctrine is closely related to looking， listening， questioning and feeling the pulse of TCM， and has constantly developed and improved. It has important significance in guiding diagnosis and treatment of diseases. This study is guided by viscera-state doctrine of TCM and based on the etiology and pathogenesis of TCM. It starts with the clinical manifestations of common drug toxicity of chemotherapy drugs， such as bone marrow suppression， gastrointestinal adverse reactions， liver and kidney function damage， oral mucosal reactions， which are external signs of the toxicity of chemotherapeutic drugs， and associates pathological manifestations of viscera to physiological functions. From elephants and Tibetans， it systematically summarizes the viscera characteristics of various common chemotherapeutic drugs and provides new ideas and methods for clinical use of TCM in treating the toxicity of chemotherapeutic drugs， so as to promote the application of viscera-state doctrine in diagnosis and treatment of diseases.

Application of medical magnifying loupes in diagnosis of oral mucosal diseases / 浙江大学学报·医学版

: To evaluate the application of medical magnifying loupes in diagnosis of oral mucosal diseases. Twenty-four patients with plaque-type oral lichen planus or homogeneous oral leukoplakia were inspected by naked eyes or assistance with magnifying loupes. Histopathological results were used as the gold standard to evaluate the sensitivity, specificity and accuracy of the two methods in clinical diagnosis. Questionnaires were used to evaluate the subjective effect of magnifying loupes on the diagnosis efficiency of oral mucosal diseases and to explore the most suitable parameters for application. The sensitivity, specificity and accuracy of medical magnifying loupes for the identification of plaque-type oral lichen planus and homogeneous oral leukoplakia were 94.74%, 100.00% and 95.83%, respectively, which were significantly higher than those of naked eye inspection (89.47%, 80.00% and 87.50%). The effective rate of magnifying loupes assisted diagnosis was 91.76% according to physicians' subjective evaluation. The most suitable parameters were 3.5 times magnification and working distance. The medical magnifying loupes can effectively improve the efficiency of the inspection and diagnosis of oral mucosal diseases, and have the characteristics of convenience and real-time. The recommended clinical parameters are 3.5 times magnification and working distance.

A relação da prematuridade e baixo peso ao nascer com lesões de mucosa oral em recém-nascidos e prevalência de anquiloglossia de acordo com critérios diagnósticos / The relationship of prematurity and low birth weight with oral mucosal lesions in newborns and prevalence of ankyloglossia according to diagnostic criteria

Objetivo: 1) verificar a associação da prematuridade e baixo peso ao nascimento (BPN) com a ocorrência de lesões de mucosa oral em recém-nascidos (RN), fatores de saúde materno-infantil e socioeconômicos, por meio de um estudo transversal; e 2) avaliar a prevalência de anquiloglossia em bebês, crianças e adolescentes de acordo com diferentes critérios diagnósticos, por meio de uma revisão sistemática. Métodos: 1) O estudo contou com uma amostra de 431 pares de mães e recémnascidos. A coleta foi realizada no período de agosto de 2016 a abril de 2017. Após o nascimento, os bebês tiveram a cavidade bucal examinada para lesões de mucosa. A regressão logística bivariada e multivariada foi utilizada para a análise dos dados. O nível de significância foi de 5%. 2) Foram realizadas buscas eletrônicas em nove bases de dados até 2021. Por meio da meta-análise de efeitos aleatórios, foi avaliada a prevalência bruta de anquiloglossia e para sexo. Uma metaanálise de efeitos mistos foi usada para análise de sugrupos por critérios diagnósticos e idade. Calculamos a RP e o IC de 95% da ocorrência de anquiloglossia em meninos, em comparação com meninas e avaliamos a certeza das evidências usando a abordagem GRADE. Resultados: 1) Prematuridade e BPN foram associados com pérolas de Epstein (odds ratio [OR]: 1,7; intervalo de confiança de 95% [IC]: 1,03­3,0; OR: 1,8; IC95%: 1,1­3,2, respectivamente) e mucocele (OR: 4,6; IC95%: 1,3­16,1; OR: 3,7; IC95%: 1,1­13,1, respectivamente), mas não à anquiloglossia (OR: 1,0; IC95%: 0,5­2,1; OR: 0,7; IC95%: 0,3 -1,6, respectivamente) ou amamentação (OR: 0,5; IC95%: 0,1-2,1; OR: 1,9; IC95%: 0,2- 15,6, respectivamente). A prematuridade foi associada à gravidez de alto risco (OR: 2,3; IC 95%: 1,3­3,9), estar na incubadora (OR: 3,2; IC 95%: 1,7­5,9) e baixo nível socioeconômico (OR: 2,4; IC de 95%: 1,1-5,2). 2) Setenta e três estudos observacionais foram incluídos (72 na meta-análise). Havia cinco diferentes critérios diagnósticos validados. A prevalência geral bruta de anquiloglossia foi de 4% (IC95%: 3% - 4%) variando de 67% para o critério de Coryllos (IC95%: 40% - 94%) a 2% para estudos que usaram critérios próprios (2%; IC95% : 2% - 2%). A prevalência foi similar entre faixas etárias e sexos. Entretanto, meninos tiveram 1,29 mais risco de ter anquiloglossia do que meninas (95%IC: 1,04-1,59) com muito baixa certeza de evidência. Conclusão: 1) Recém-nascidos prematuros e com BPN foram mais propensos a ter pérolas de Epstein e mucocele do que RN à termo e com peso normal. Amamentação e anquiloglossia não foram associadas à prematuridade e BPN. A prematuridade também foi associada à gravidez de alto risco, estar na incubadora e baixo nível socioeconômico. 2) A prevalência de anquiloglossia geral foi baixa, e maior para critérios diagnósticos validados comparado aos critérios próprios usados pelos autores. A prevalência de anquiloglossia foi semelhante para grupos de idade e sexo. Com muita baixa certeza da evidência, não podemos afirmar que meninos têm mais anquiloglossia que meninas.

Objective: This thesis describes two studies with the following objectives: 1) one cross-sectional study that aimed to associate prematurity and birth weight with the occurrence of oral mucosal lesions in newborns and associated factors, and 2) one systematic review that evaluated the prevalence of ankyloglossia in babies, children and adolescents according to different diagnostic criteria. Methods: 1) In the crosssectional study, the sample comprised 431 pairs of mothers and newborns born at the University Hospital of Federal University of Minas Gerais. The study included mothers and newborns present in the hospital from August 2016 to April 2017. We excluded newborns with congenital anomalies or syndromes. A trained and calibrated dentist examined the mouth of the newborns for oral mucosal lesions (Kappa = 0.90). The lesions evaluated were dental lamina cysts, Bohn's nodules, Epstein's pearls, mucocele and ankyloglossia. Mothers answered a self-administered questionnaire related to socioeconomic indicators and prenatal habits. Medical records were evaluated to collect information about prematurity, low birth weight (LBW), pregnancy, childbirth, postpartum, maternal and newborn health conditions. Bivariate and multivariate logistic regression were used for data analysis. The level of significance was 5%. 2) For the systematic review, nine electronic databases were searched from interception up to May 2021 with no restrictions imposed regarding on year of publication or language. Paired independent reviewers selected studies, extracted data, and assessed the risk of bias. Using random-effects meta-analysis, we pooled the crude prevalence of ankyloglossia in general and by sex. Using mixed effect-meta-analysis, we subgrouped by diagnostic criteria and age. We calculated the PR and 95%CI of the occurrence of ankyloglossia in boys compared to girls, and assessed the certainty of evidence using the GRADE approach. Results: 1) Prematurity and LBW were associated with Epstein pearls (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.03­3.0; OR: 1.8; 95%CI: 1.1­3.2, respectively) and mucocele (OR: 4.6; 95%CI: 1.3­16.1; OR: 3.7; 95%CI: 1.1­13.1, respectively), but not to ankyloglossia (OR: 1.0; 95%CI: 0.5­2.1; OR: 0.7; 95%CI: 0.3­1.6, respectively) or breastfeeding (OR: 0.5; 95%CI: 0.1-2.1; OR: 1.9; 95% CI: 0.2­ 15.6, respectively). Prematurity was associated to high-risk pregnancy (OR: 2.3; 95% CI: 1.3­3.9), being in the incubator (OR: 3.2; 95% CI: 1.7­5,) and low socioeconomic status (OR: 2.4; 95% CI: 1.1-5.2). 2). 2) Seventy-three observational studies were included in the systematic review (72 in the meta-analysis). There were five different validated diagnostic criteria for ankyloglossia. The overall crude prevalence of ankyloglossia was 4% (95%CI: 3%-4%) varying from 67% for Coryllos criteria (40%- 94%) to 2% for those studies using own criteria (2%; 95%CI: 2%-2%). There was a similar prevalence for age groups and both sexes. Boys had 1.29 more risk of having ankyloglossia (95%CI: 1.04-1.59) with very low certainty. Conclusion: 1) Preterm and LBW newborns were more likely to have Epstein pearls and mucocele than full terms. Breastfeeding and ankyloglossia were not associated with prematurity and LBW. Prematurity was also associated with high-risk pregnancy, being in the incubator and low socioeconomic status. 2) The prevalence of ankyloglossia varied among all instruments used; with validated diagnostic criteria showing higher prevalence and non-validated or own criteria showing low prevalence. With low certainty, we could not affirm that boys are more prone to have ankyloglossia compared to girls.

Research progress of sonodynamic therapy in the field of stomatology / 口腔疾病防治

@#Sonodynamic therapy (SDT) is a cutting-edge method for the biological effects of ultrasound combined with sound-sensitive agents. In recent years, SDT has been a concern of experts and scholars in the oral field, and a series of experimental studies has been carried out. We will introduce the progress of SDT in the field of stomatology from three aspects: the therapeutic mechanism of SDT, the application of SDT in the oral field, and the current situation and future of SDT in the treatment of oral diseases. It is currently believed that singlet oxygen theory, cavitation effects, and induction of apoptosis are the main therapeutic mechanisms. The research of SDT on oral disease prevention mainly focuses on oral tumors (especially squamous cell carcinoma and osteosarcoma) and infectious diseases (such as periodontitis, maxillofacial infection, and oral mucosal disease). Although the current research is still in the experimental stage, with the continuous exploration of sonosensitizers and nanotechnology, SDT will provide great help for the clinical prevention and treatment of oral diseases in the future.

Management strategy of oral mucosal diseases during the epidemic of Corona Virus Disease 2019 / 口腔疾病防治

Corona Virus Disease 2019 (COVID-19) has broke out in 29 countries and regions in the world in a short period since December 2019. Various measures of prevention and control have been taken all over China. At present, the epidemic situation shows a positive trend, however, there are still a few new comfirmed cases in some area of China. So the job and thinking of epidemic prevention still cannot be relaxed. As an important specialty of stomatology, the risk of cross infection is high in oral medicine. Establishing an effective system of pre- inspection and triage and adopting strict measures of prevention and control are essential. According to the prevention and control situation of COVID- 19, the characteristics of hospital infection, pre examination, protective measures, the home management strategies of oral mucosal diseases during the epidemic period and the differential diagnosis between COVID-19 and common oral muco- sal diseases with fever were summarized and recommended in this paper.

Progress in pharmacokinetics of oral transmucosal drug delivery systems / 药学学报

Oral transmucosal drug delivery can be defined as the administration of drug through the oral mucosa to achieve systemic effects. It has the advantages of high bioavailability and rapid drug response. In this review, we introduce the physiology of oral mucosa, and analyze the factors affecting the pharmacokinetic properties of oral transmucosal drug delivery in detail, such as physiological barriers, different administration sites, physicochemical properties of drugs, dosage forms, and formulation strategies. In addition, we describe the methods to evaluate the pharmacokinetic properties of this delivery systems, including in vitro permeability studies, buccal absorption studies, in vivo pharmacokinetic studies and physiologically based pharmacokinetics (PBPK) modeling, which provide methods and reference for the development of oral transmucosal drug delivery systems.

Assessment of long term outcomes after buccal mucosal graft urethroplasty: the impact of chronic kidney disease

ABSTRACT Objectives To compare and assess various outcomes and success of buccal mucosal graft urethroplasty (BMGU) in patients with CKD versus patients having normal renal function. Material and Methods This was a retrospective, single centre study, during period 2013 to 2017. Patients were grouped into two groups. Group 1 had patients with estimated Glomerular Filtration Rate (eGFR)>60mL/min/1.73m2 while group 2 had patients with eGFR <60mL/min/1.73m2. eGFR was calculated according to the MDRD equation. The two groups were compared with regard to various outcomes like length, location of stricture, technique of graft placement, intra-operative blood loss (haemoglobin drop), duration of hospital stay, post-operative complications and recurrence. Results A total of 223 patients were included in study with group 1 had 130 patients and group 2 had 93 patients. Mean age of patients with CKD were higher (47.49 years versus 29.13 years). The mean follow-up period was comparable between both groups (23.29 months and 22.54 months respectively). Patients with CKD had more post-operative Clavien Grade 2 or higher complications (p=0.01) and a greater recurrence rates (p<0.001) than in non-CKD patients. On multivariate analysis, age and CKD status was significant predictor of urethroplasty success (p=0.004) (OR= 14.98 (1.952-114.94, 95% CI). Conclusions CKD patients are more prone to post-operative complications in terms of wound infection, graft uptake and graft failure and higher recurrence rates following BMGU.

Study on the oral mucosal diseases in patients with cerebrovascular diseases / 中华流行病学杂志

Objective@#To investigate the prevalence of oral mucosal diseases (OMD) in patients with cerebrovascular disease.@*Methods@#A total of 182 patients with cerebrovascular disease and 166 controls were examined for OMD to compare the differences of prevalence rates.@*Results@#The prevalence of OMD in patients with cerebrovascular disease appeared higher than that in the control group. Oral candidiasis was most commonly seen (11.1%, 20/182), followed by fissured tongue (5.0%, 9/182), traumatic ulcer (2.8%, 5/182), herpes labialis (2.2%, 4/182), recurrent oral ulcer (1.6%, 3/182), chronic cheilitis (1.6%, 3/182) and oral leukokeratosis (1.6%, 3/182).@*Conclusion@#Patients with cerebrovascular diseases were susceptible to OMDs, especially to oral candidiasis that called for more attention.

Prevalence of oral mucosal lesions in geriatric patients in Universitas Airlangga Dental Hospital

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Population aged 60 years old and above are growing in number; a fact that will have an impact on general and oral health in the future. Oral health is often overlooked in the management of geriatric patients but it is vital to have a knowledged-based practice in order to increase the quality of life of elderly patients.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The purpose of this study is to determine the number and types of oral mucosal lesions in geriatric patients who come to the Universitas Airlangga Dental Hospital.</p><p style="text-align: justify;"><strong>METHODS:</strong> This is an observational descriptive study with cross-sectional design. Intraoral soft tissue examination was performed on geriatric patients coming to the hospital between March and December 2018.</p><p style="text-align: justify;"><strong>RESULTS:</strong> One hundred twenty-four (124) new geriatric patients came to the hospital. A total of 152 oral lesions from 63 geriatric patients (50.81%) were identified.  Overall, coated tongue (55.56%) was the most frequently detected lesion, followed by linea alba buccalis (31.74%) and lingual varicosities (26.98%).</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Coated tongue or white tongue is the most frequently detected oral mucosal lesion, often caused by poor oral hygiene. The dentist should be able to recognize and differentiate them from the worrisome lesions and decide on the appropriate treatment in geriatric patients.</p>

Placas protectoras de mucosa: su aplicación estomatológica / Occlusal splints for mucosal protection

El objetivo de esta comunicación es divulgar el uso de las placas de protectoras de mucosa (PPM) en el ámbito de la patología bucal, así como en la consulta odontológica diaria. Tomando como antecedente los primitivos protectores bucales diseñados para deportes de contacto, se desarrolló su uso en odontología con un diseño particular para el tratamiento de los desórdenes temporomandibulares. Describimos aquí la aplicación de las PPM en estomatología en el contexto de coadyuvancia terapéutica para diferentes entidades de muy frecuente consulta. Asimismo, se detallan la técnica de confección y las indicaciones de uso y cuidado para los pacientes (AU)

The aim of this report is to emphasize the usefulness of oral splints for mucosa protection in oral pathology as well as in every day dental practice. There is substantial evidence that mouthguards were first developed for use in boxing. The most common therapeutic use of occlusal splints in dentistry is the treatment of temporomandibular joint disorders. The present work describes the use of oral splints for mucosa protection in the context of adjuvant therapy as a protective device for many common disorders of the oral mucosa. At the same time it explains the fabrication technique and provides proper use and handling guidelines (AU)

Management of long segment anterior urethral stricture (≥ 8cm) using buccal mucosal (BM) graft and penile skin (PS) flap: outcome and predictors of failure

ABSTRACT Purpose To evaluate the surgical outcome and predictors of failure of substitution urethroplasty using either dorsal onlay buccal mucosal (BM) graft or ventral onlay penile skin flap (PS) for anterior urethral stricture ≥ 8cm. Patients and methods Between March 2010 and January 2016, 50 patients with anterior urethral stricture ≥ 8 cm were treated at our hospital. The surgical outcome and success rate were assessed. The predictors of failure were analyzed using multivariate analysis. Failure was considered when subsequent urethrotomy or urethroplasty were needed. Results Dorsal onlay BM graft was carried out in 24 patients, while PS urethroplasty in 26 patients. There was no significant difference between both groups regarding patients demographics, stricture characteristics or follow-up period. One case in the BM group was lost during follow-up. Stricture recurrence was detected in 7 (30.4%) patients out of BM group while in 6 (23.1%) patients out of PS group (p value= 0.5). No significant differences between both groups regarding overall early and late complications were observed. Occurrence of early complications and the stricture length were the only predictors of failure in univariate analysis, while in multivariate analysis the occurrence of early complications was only significant. Conclusion On short-term follow-up, both dorsal onlay BM graft and ventral onlay PS flap urethroplasty have similar success rates. However, BM graft has a potential advantage to reduce operative time and is also technically easier. The surgeon should avoid early local complications as they represent a higher risk for failure.

Feeder Cells Free Rabbit Oral Mucosa Epithelial Cell Sheet Engineering

The optimal cell culture method of autologous oral mucosal epithelial cell sheet is not well established for a safe transplantation on to the patients' ocular surface. Animal serum and 3T3 mouse feeder cells are currently being used to stimulate the growth of the epithelial cells. However, the use of animal compounds can have potential side effects for the patient after transplantation of the engineered cell sheet. In the present study, we focused on engineering a rabbit oral mucosal epithelial cell sheet without 3T3 mouse feeder cells using a mix of Dulbecco's Modified Eagle Medium/Bronchial Epithelial Cell Growth Medium culture media (DMEM/BEGM). Autologous oral mucosal epithelial cell sheets, engineered with DMEM/BEGM feeder cell free culture media, were compared to those cultured in presence of serum and feeder cells. Using a DMEM/BEGM mix culture media, feeder cell free culture condition, autologous oral mucosal epithelial cells reached confluence and formed a multilayered sheet. The phenotype of engineered cell sheets cultured with DMEM/BEGM were characterized and compared to those cultured with serum and feeder. Hematoxylin and eosin staining showed the formation of a similar stratified multilayer cell sheets, in both culture conditions. The expression of deltaN-p63, ABCG2, PCNA, E-cadherin, Beta-catenin, CK3, CK4, CK13, Muc5AC, was similar in both culture conditions. We demonstrated that rabbit autologous oral mucosal epithelial cell sheet can be engineered, in feeder cell free conditions. The use of the DMEM/BEGM culture media to engineer culture autologous oral mucosa epithelial cell sheet will help to identify key factors involved in the growth and differentiation of oral mucosal epithelial cells.