Difficult and complicated oral ulceration: an expert consensus guideline for diagnosis / 国际口腔科学杂志·英文版

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.

Status and prospect of reproductive protection in patients with lymphoma / 白血病·淋巴瘤

At present, chemotherapy combined with radiotherapy or targeted therapy is the key method for the treatment of lymphoma. However, clinical treatment measures are not only effective for patients to obtain disease remission and long-term survival, but also have a negative impact on reproductive function of patients. For young patients with good curative effects, long-term survival and remission, normal childbearing becomes an important aspect of long-term prognosis evaluation of lymphoma, and it is also a concern of lymphoma patients. This article will systematically present the epidemiology of lymphoma, the impact of lymphoma on reproductive function, the status and challenges of reproductive function protection in lymphoma patients, the ethical issues of human reproduction, and the principles and selection of reproductive protection for patients with lymphoma. The analysis and discussion are expected to provide reference for the reproductive protection and eugenics of lymphoma patients in China.

Early Prediction of Disease Progression in 2019 Novel Coronavirus Pneumonia Patients Outside Wuhan with CT and Clinical Characteristics

ObjectiveTo determine the predictive value of CT and clinical characteristics for short-term disease progression in patients with 2019 novel coronavirus pneumonia (NCP). Materials and Methods224 patients with confirmed 2019 novel coronavirus (COVID-19) infection outside Wuhan who had chest CT examinations were retrospectively screened. Clinical data were obtained from electronic medical records. CT images were reviewed and scored for lesion distribution, lobe and segment involvement, ground-glass opacities, consolidation, and interstitial thickening. All included patients with moderate NCP were observed for at least 14 days from admission to determine whether they exacerbated to severe NCP (progressive group) or not (stable group). CT and clinical characteristics between the two groups were compared, and multivariate logistic regression and sensitivity analyses were performed to identify the risk factors for developing severe NCP. ResultsA total of 141 patients with moderate NCP were included, of which 15 (10.6%) patients developed severe NCP during hospitalization and assigned to the progressive group. Multivariate logistic regression analysis showed that higher neutrophil-to-lymphocyte ratio (NLR) (odds ratio [OR] and 95% confidence interval [CI], 1.26 [1.04-1.53]; P = 0.018) and CT severity score (OR and 95% CI, 1.25 [1.08-1.46]; P = 0.004) on admission were independent predictors for progression to severe NCP, and sensitivity analysis confirmed the consistent results in nonimported patients but not in imported patients. However, no significant difference in lung involvement was found on CT between imported and nonimported patients (all P > 0.05). Patients who were admitted more than 4 days from symptom onset tended to have more severe lung involvement. Spearman correlation analysis showed the close association between CT severity score and inflammatory indexes (r = 0.17[~]0.47, all P < 0.05). ConclusionCT severity score was associated with inflammatory levels and higher NLR and CT severity score on admission were independent risk factors for short-term progression in patients with NCP outside Wuhan. Furthermore, early admission and surveillance by CT should be recommended to improve clinical outcomes.

Application of intravoxel incoherent motion diffusion weighted imaging for assessment of early chronic allograft nephropathy / 中南大学学报(医学版)

To investigate the feasibility and clinical application of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) technique in non-invasive assessment for early chronic allograft nephropathy (CAN).
 Methods: A total of 23 renal allograft recipients were recruited from inpatients or outpatients according to the inclusion and exclusion criteria for this study. Recipients were divided into a CAN group (n=12, pathologically confirmed early CAN patients) and a control group (n=11, volunteers with long-term stable renal function). Abdominal MRI was performed on patients of renal allograft with a multi-b value DWI sequence. IVIM2b-new software was used for obtaining the IVIM-DWI quantitative parameter pseudo-color maps and the values of IVIM-DWI of renal parenchyma, including the pure diffusion coefficient (D), perfusion correlation diffusion coefficient (D*) and perfusion fraction (f). The IVIM quantitative parameters between the two groups were compared using independent sample t test. ROC analysis was performed when the differences in parameter were statistically significant and the area under curve (AUC) was calculated.
 Results: In IVIM bi-exponential analysis, The D value was significantly decreased in the CAN group compared with the control group (P0.05). The AUC of D value for distinguishing the early CAN from the control were 0.784 with sensitivity and specificity at 58.3% and 90.9%, respectively.
 Conclusion: The IVIM-DWI quantitative parameter D can non-invasively assess early CAN to some extent. IVIM-DWI technique is expected to be an effective, easy and non-invasive method to detect early CAN, and assist early diagnose as well as dynamically monitor CAN.

Combination of prostate imaging reporting and data system with the apparent diffusion coefficient map for the diagnosis of peripheral zone prostate cancer / 中南大学学报(医学版)

To explore the value of prostate imaging reporting and data system version 2 (PI-RADS V2) combined with quantitative parameters derived from apparent diffusion coefficient (ADC) map in the diagnosis of peripheral zone prostate cancer.
 Methods: A total of 50 patients who underwent prostate multiparametric MRI (mpMRI) with suspicious peripheral nodules were retrospectively enrolled, and all patients were biopsy-proven histologically. Two radiologists analyzed the position and category of peripheral zone lesions based on PI-RADS V2. Then 12 ADC quantitative parameters were calculated regarding each lesion on the ADC map by post-processing software. The lesions were divided into malignant group and benign group according to histopathological findings. The ADC quantitative parameters between groups were compared, and stepwise logistic regression analysis was used to build a discriminative model. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were performed to evaluate the diagnostic power and clinical benefit.
 Results: Twenty-eight peripheral zone prostate malignant lesions and 25 benign lesions were obtained finally. The area under the ROC curve, sensitivity and specificity to differentiate peripheral zone prostate malignant from benign lesions were as follows: 0.803, 60.71%, 92.00% (PI-RADS V2 score), 0.857, 89.29%, 76.00% (ADC model), and 0.891, 71.43%, 92.00% (combined model), respectively. The discriminative power of the combined model was significantly improved compared with PI-RADS V2 score (P=0.012). The combined model had relatively optimal overall net benefit, which outperformed the PI-RADS V2 score when threshold probability varied in the range of 0.05-0.27 and 0.46-0.81.
 Conclusion: PI-RADS V2 combined with quantitative analysis of ADC map improve the power in discriminating peripheral zone prostate cancer from benign lesions, and the clinical benefit as well.

Gongylonema pulchrum infection in the human oral cavity: A case report and literature review.

Gongylonema infection is a zoonotic disease occurring throughout the world and is mainly caused by consumption of contaminated water and raw food. Adult Gongylonema worms can exist as parasites in the human body for up to 10 years and cause symptoms of local irritation in the oral cavity, esophagus, and pharynx. Herein, we report a rare case in which live Gongylonema pulchrum was detected and extracted from the oral cavity of a woman. The pathogen was confirmed as G. pulchrum on the basis of microscopic examination and morphologic analysis. The patient's symptoms resolved immediately after surgical removal of the parasite, and the patient has been advised not to drink water that has not been boiled and to avoid consuming unwashed raw vegetables.

Value of multi-slice spiral CT image texture analysis in diagnosing lymphatic metastasis of rectal cancer / 中华放射学杂志

Objective To investigate the value of multi-slice spiral CT image texture analysis in differentiating metastatic (MLN) from non-metastatic lymph nodes (NLN) in patients with rectal cancer.Methods Thirty five patiets with rectal cancer who were pathologically confirmed by total mesorectum excision were included retrospectively,with regional lymph nodes (short-axis diameter of larger than 3 mm)found in preoperative CT images.All the patients underwent preoperative abdominal and pelvic dynamic contrast-enhanced CT scan.Regional lymph nodes were identified according to pathological findings,and were divided into MLN and NLN groups.The short-axis diameter,short-to long-axis diameter ratio of lymph nodes were manually measured and calculated,and the texture features,including skewness,kurtosis,variance,entropy and inverse difference moment,were analyzed.The above parameters between MLN and NLN groups were compared using independent sample t test or Mann-Whitney U test.ROC curve analysis was performed regarding the statistically significant parameters and the areas under curve (AUC) were calculated.Multivariate Logistic regression analysis was accomplished to obtain the independent predictive factor of diagnosing regional lymph nodes.Results A total of 68 regional lymph nodes were obtained and consisted of 31 MLNs and 37 NLNs.The short-axis diameter,kurtosis,and entropy of the MLN group were significantly higher than those of the NLN group (all P＜0.05).Whereas,the short-to long-axis diameter ratio,skewness,variance,and inverse difference moment did not differ significantly between the two groups (all P＞0.05).The AUC for distinguishing MLN from NLN of the short-axis diameter,kurtosis and entropy were 0.79,0.67,and 0.85,respectively.Multivariate logistic regression analysis showed that only entropy (odds ratio=8.48,95％ confidence interval was 3.01 to 23.92,P＜0.01) was screened out as the independent variable,which suggested that the entropy was the unique predictor for characterizing regional lymph nodes of rectal cancer.Conclusion Multi-slice spiral CT images texture analysis can facilitate the accurate differentiation between MLN and NLN in patients with rectal cancer,and especially the entropy has the optimal reference significance.

Evaluation of the rapid trehalose test for the identification of the Candida glabrata / 北京大学学报(医学版)

Objective:To explore a rapid and cost-effective method for identification of Candida gla-brata through the comparison of two different methods , using molecular methods of sequencing as gold standard.Methods:From our clinic, 200 strains of suspected Candida glabrata were collected during the last 3 years and selected after incubation in CHROMagar Candida medium for 48 h.By comparing the results of the CHROMagar Candida medium, the identification of the rapid trehalose test for different kinds of strains were analyzed under incubation in the tubes for 3 h, 6 h, and 24 h at 37 ℃and 42 ℃, respectively .All the strains were identified to species level by methods of sequencing .The optimal time and temperature of the trehalose test for the identification of Candida glabrata were assessed .Two different methods, CHROMagar Candida medium and the rapid trehalose test , in identification of Candi-da glabrata were compared.Results:In all the 200 strains, Candida glabrata ferment trehalose with 3 h incubation under 42 ℃ were the optimal time and temperature for fermenting trehalose .The accuracy , sensitivity, and specificity of the rapid trehalose test were 99.00% (198/200), 98.66% (147/149) and 100.00%(51/51).The accuracy rate of CHROMagar Candida medium was 79.50%(159/200), the sensitivity and specificity were only 89.93%(134/149) and 49.02%(25/51), however, compared with the domestic current popular methods , the rapid trehalose test had better time efficiency ratio .Con-clusion:The evaluation results suggest that the rapid trehalose test has advantages in terms of operational convenience and low cost , and the results can be obtained in 3 h.Therefore, it has application value in clinical laboratory .

Effect of basic fibroblast growth factor on osteogenic differentiation and cell proliferation of human gingival fibroblasts in vitro / 天津医药

Objective To observe the effects of basic fibroblast growth factor (bFGF) on osteogenic differentiation abili?ty and cell proliferation of human gingival fibroblasts (HGFs), and to explore the role of bFGF on the process of osteogenic differencitiaion in vitro. Methods HGFs were cultured in vitro until the 3rd passage when they were divided into four groups:normal medium as group 1, normal medium with 10μg/L bFGF as group 2, osteogenic medium as group 3 and osteo?genic medium with 10μg/L bFGF as group 4. MTT assay was used to evaluate the proliferation of HGFs. Alkaline phospha?tase (ALP) staining and Alizarin red staining were applied to investigate osteogenic potential of HGFs under different culture conditions. Results bFGF at concentration of 10 μg/L could increase HGFs proliferation in both normal and osteogenic medium (P<0.01). HGFs could be induced towards osteogenic differentiation and form mineralized nodule in osteogenic me?dium. However, 10μg/L bFGF had no effects on ALP activity and mineralized nodule formation of HGFs during osteogenic differentiation. Conclusion bFGF could promote the proliferation of HGFs but show no effects on osteogenic differentiation of HGFs at concentration of 10μg/L.

Genetic diversity in Fluconazole-resistant and -susceptible oral Candida albicans isolated from patients with Sjgren's syndrome / 实用口腔医学杂志

Objective:To analyze genetic diversity of Fluconazole(FLZ)-resistant and -susceptible Candida albicans(C. albicans) strains isolated from patients with Sjgren's Syndrome (SS). Methods:30 C.albicans strains were isolated from the patients with SS and identified using standard criteria. Microdilution method was performed to determine the minimum inhibitory concentrations (MICs) of C.albicans to FLZ. A composite genotype was generated for each strain through random amplification of polymorphic DNA (RAPD) using three different primers, RSD10, RSD11 and RSD12. Results:The DNA fingerprinting profiles indicated genetic diversity amongst both the FLZ-resistant as well as -susceptible isolates, and no specific features emerged distinguishing the drug-resistant and -susceptible groups. Conclusion:These observations cast doubt on the theory of a clonal origin of FLZ-resistant C. albicans isolates. The emergence of FLZ resistance in SS patients may be associated with continuous exposure to FLZ.