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Recurrent aphthous ulcer (RAU) is one of the most common diseases of the oral mucosa. At present, no effective method is available for RAU treatment, especially for refractory RAU, which significantly affects patients’ oral health and quality of life. Research shows that combination with systemic diseases greatly increases the difficulty of curing refractory RAU, making conventional oral ulcer treatment harder to perform effectively. This is probably because dentists commonly only focus on handling oral ulcers but neglect to think about the etiology of oral ulcers from a holistic perspective. Thus, we summarized some conditions of refractory RAU accompanied by systemic diseases, including inflammatory bowel disease, iron deficiency anemia, diabetes mellitus, Behçet’s disease, Reiter’s syndrome, sprue syndrome, Sutton syndrome, and acquired immunodeficiency syndrome. We also outlined the treatment principles of these patients. To be specific, on the one hand, dentists should cooperate with the relevant specialists to treat the systemic diseases, while on the other hand they should take measures including topical/general use of medicine, local physical therapy, Traditional Chinese medicine treatment, and psychotherapy for RAU management. This paper aims to provide clinicians with a more comprehensive understanding of the diagnosis and treatment of refractory RAU, in order to make personalized treatment plans for patients and improve the clinical efficacy of refractory RAU.

Objective A model was built by neural network analysis to study the relationship between different degrees of vitamin B12 and folic acid deficiency and malnutrition-induced stomatitis. Methods Data from 30 healthy volunteers and 30 patients with malnutrition-induced stomatitis were collected. The distribution of lesions, the number of affected sites and clinical manifestations were recorded, and the severity was scored. The levels of vitamin B12 and folic acid in the peripheral blood of the two groups were simultaneously measured. The SPSS software was used to analyze the correlation between vitamin B12 and folic acid levels in the peripheral blood of patients with malnutrition-induced stomatitis and healthy volunteers, and the MATLAB software package was used to analyze the data via a neural network. Results The levels of vitamin B12 and folic acid significantly correlated with the grade of malnutrition-induced stomatitis. Simultaneous B12 and folic acid deficiency linearly correlated with the occurrence and severity of malnutrition-induced stomatitis. Based on this correlation, a thermogram model of malnutrition-induced stomatitis was constructed. Conclusion Malnutrition-induced stomatitis is closely related to vitamin B12 and folic acid deficiency. Their synergistic effect may promote the occurrence and development of malnutrition-induced stomatitis. The construction of the malnutrition-induced stomatitis model aids the targeted etiological treatment of patients with moderate and severe deficiency to prevent malnutrition-induced stomatitis.

Objective To investigate the classification of atrophic glossitis and to study the correlation between the classification and changes of VitB12, folic acid (FOL) and blood cell parameters.Methods A total of 70 patients with atrophic glossitis (AG) were divided into complex type and simple type according to whether they had ulcer or erosion on the tongue mucosa or not. Another 65 healthy subjects during the same period were collected as the control group. The levels of vitamin B12, FOL and blood cell parameters were statistically analyzed using SPSS 25.0 software package.Results The levels of vitamin B12, red blood cell count (RBC) (3.52 ± 0.69) × 1012·L-1, hemoglobin (HGB)(11.97 ± 1.70) g·dL-1, white blood cell count (WBC) (4.85 ± 1.16) × 109·L-1, neutrophil count (NEUT) (2.76 ± 0.99) × 109·L-1, lymphocyte count (LYMPH) (1.48 ± 0.44) × 109·L-1 in complex type AG group were lower than those in simple type AG group (P0.05). The levels of VitB12, MCV, MCH, MCHC, WBC, lymph and neut were correlated with the classification of atrophic glossitis (P < 0.05). Conclusion VitB12 deficiency was more apparent in complex AG, especially in large cell anemia, which correlated with the levels of WBC, NEUT, and LYMPH.

Objective: To explore the clinical epidemiological characteristics of oral lichen planus (OLP) and risk factors for erosive/ulcerative OLP. Materials and Methods: Patients diagnosed with OLP from 11 different hospitals were included in the study. Descriptive statistical methods were used to explore the clinical epidemiological characteristics and logistic regression, sensitivity analysis, and subgroup analysis were utilized to explore the risk factors for erosive/ulcerative OLP. Results: The average age of patients was 49.2 ± 13.3 years, and 61.4% of the patients were women. The ratios of patients with reticular, hyperemic/erythematous, and erosive/ulcerative lesions were 47.9%, 27.8%, and 24.2%, respectively. Analysis of risk factors for erosive/ulcerative OLP identified the following variables: age, course of disease of 12 months or more, II°–III° dental calculus, hypertension, diabetes, and heart disease, as well as regions of habitation. Subgroup analysis showed significant differences in risk factors for erosive/ulcerative OLP in patients with and without risk behaviors. Conclusion: The clinical epidemiological characteristics of patients with OLP in the Chinese population in this study are basically consistent with existing reports in developed countries. And we identified clinical characteristics associated with erosive/ulcerative OLP through clinical epidemiological analysis. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinicopathological features, treatment and prognosis of oralmucosal malignant melanoma to provide a reference for clinical practice. Methods Data from 19 patients with oralmucosal malignant melanoma were collected, and their clinical manifestations, treatment methods and follow-up results were retrospectively analyzed. Results Among the 19 patients, 11 cases (58%) had lesions in the gingiva, 7 cases (37%) had lesions in the palate, and 1 case (5%) had lesions in the tongue, the difference was statistically significant (P

Objective To investigate the pathogenic factors and clinical manifestations of contact stomatitis, and to provide references for its clinical diagnosis and prevention. Methods The data of 55 subjects with contact stomatitis were analyzed retrospectively, including age, gender, pathogenic factors, type of lesions and site of occurrence. Results Among the 55 patients, contact stomatitis occurred at all ages, 19 were male, 36 were female, and the ratio of males to females was 1∶1.89. Among 55 patients, 78.18% (43/55) were caused by oral mucosal contact with dental materials: amalgam fillings accounted for 52.73% (29/55), metal crowns accounted for 9.09% (5/55), removable denture plastic bases accounted for 9.09% (5/55), resin fillings accounted for 5.45% (3/55), and alginate impression materials accounted for 1.82% (1/55); 21.82% (12/55) were caused by oral mucosal contact with food and daily necessities. The clinical manifestations of contact stomatitis include lichenoid reaction, erythema and erosion. The most common site of contact stomatitis was the cheek, followed by the tongue, and the lips, and the gingival and palatal areas were relatively rare. In the buccal mucosa, the incidence of lichenoid reaction was 55% (22/40), which was higher than that of erosion (20%) and erythema (25%), and the difference was statistically significant (P < 0.05). For tongue, lip, gingiva and palate, there was no significant difference in the incidence of the three lesion types（P > 0.05）. Conclusion Contact stomatitis occurred at all ages, and there are more female patients than males with contact stomatitis. Dental materials, especially metal and acrylic materials (such as the plastic base of removable dentures, resin fillings, adhesives, and self-setting plastics), are the main pathogenic factors. In buccal mucosa, the incidence of lichenoid reaction is higher.

Chloroquine and hydroxychloroquine are both classic 4-aminoquinoline antimalarial drugs with similar chemical structures and mechanisms of action. As the toxicity and side effects of hydroxychloroquine are lower than those of chloroquine, hydroxychloroquine is the main clinical application at present, with good efficacy and safety. Chloroquine and hydroxychloroquine are widely used in the clinic because of their immunosuppressive, anti-inflammatory, antiviral, antitumor and photoprotective effects. The main mechanisms by which chloroquine/hydroxychloroquine inhibits immunity include inhibiting lysosome activity, autophagy, immune response signaling pathways production of proinflammatory cytokines. Chloroquine stabilizes the lysosomal membrane and reduces the release of lysosomal enzymes. As a prostaglandin antagonist, chloroquine can reduce the production of prostaglandins and leukotrienes, thus playing an anti-inflammatory role. Chloroquine/hydroxychloroquine can inhibit virus proliferation in the early stage of virus replication by inhibiting the glycosylation of the angiotensin converting enzyme 2 receptor. At present, hydroxychloroquine has been found to have significant efficacy in discoid lupus erythematosus, oral lichen planus, chronic cheilitis, pemphigus foliaceus, Sjögren’s syndrome and other stomatological diseases. However, eye damage is the most important adverse reaction of hydroxychloroquine, and its occurrence is related to the cumulative dose of drugs.

Objective To explore the potential association between particular living habits and recurrent aphthous ulcers (RAU), and provide some references for RAU prevention among the young and middle-aged. Methods The multistage random sampling method was adopted to select 850 young and middle-aged people in Nanjing. The disease status and living habits of young and middle-aged people with RAU in Nanjing were investigated by a questionnaire, and the influencing factors were analyzed by univariate and multivariate logistic regression analysis. Results The prevalence of RAU was 20.5% among 799 individuals, including 357 men and 442 women. The risk of RAU at medium and low stress levels was 0.533 times and 0.419 times that at high stress levels, respectively (P > 0.05), indicating that high stress was an independent risk factor for RAU. The risk of RAU in patients with low exercise levels was 1.513 times that in patients with high exercise levels (P > 0.05), indicating that high exercise levels were a protective factor for RAU. There were no statistically significant differences in age, sex, smoking, drinking or bedtime (P < 0.05). Conclusion Multivariate logistic regression showed that mental stress and physical activity were independent influencing factors for the development of RAU. The living habits of RAU patients and RAU susceptible populations should be treated with corresponding interventions to prevent RAU.

Objective To explore the relationship between psychological factors and recurrent aphthous ulcer (RAU), oral lichen planus (OLP), and burning mouth syndrome (BMS) and to provide a reference for clinical diagnosis and treatment of the disease. Methods From July to October 2018, 50 patients with common RAU, refractory RAU, OLP and BMS were selected as the observation group, and 50 healthy participants without major systemic diseases and oral mucosal diseases matched for age and sex served as the control group. The psychological status of the subjects in each group was investigated by questionnaires, including the generalized anxiety disorder 7⁃item scale(GAD⁃7) and the patient health questionnaire⁃9 (PHQ⁃9). Results Compared with the control group, the PHQ⁃9 scores in the refractory RAU, common RAU, OLP and BMS groups were higher than those in the control group (P < 0.05), and the GAD⁃ 7 scores in the refractory RAU, OLP and BMS groups were higher than those in the control group (P < 0.05). In the RAU group, the GAD⁃7 score of intractable RAU was higher than that of common RAU (P < 0.05), and there was no signifi⁃ cant difference in the PHQ⁃9 score (P > 0.05). Conclusion RAU, OLP and BMS are common psychosomatic diseases presented by patients in the Department of Oral Mucosal Diseases. Their occurrence and development are related to the psychological status of patients. A tendency toward anxiety is significantly more common among refractory RAU patients than common RAU patients

Objective To explore the etiology, clinical manifestations, diagnosis and treatment of verruciform xan⁃ thoma (VX) in adolescents to provide a reference for clinical diagnosis and treatment. Methods The clinical data of a case of a palatal mass in a juvenile were analyzed, and the related literature was reviewed. Results The palatal mass was proven to be VX by histopathological examination. Surgical resection was performed, and the prognosis was good. A review of the literature shows that VX is a rare benign mucosal skin lesion of an unknown etiology, with an incidence of approximately 0.025%⁃0.094%; VX is mostly found in middle⁃aged people, with no significant difference by sex. The clinical manifestations are similar to those of a variety of diseases, such as squamous papilloma, verruca vulgaris, fibro⁃ ma, warty carcinoma and squamous cell carcinoma, which are not easy to distinguish and require histopathological diag⁃ nosis. The treatment of choice is surgical excision, with a low recurrence rate. Conclusion In the clinical experience of solitary mucosal masses in juveniles, it is necessary to send biopsy for pathological examination and avoid overtreat⁃ ment.

Grape white rot is a destructive fungal disease caused by the pathogenic fungus Coniella vitis. The sensitivity of C. vitis to fluazinam was tested to select an efficient fungicide to control this disease. Furthermore, the baseline sensitivity of C. vitis populations to fluazinam was established based on the EC50 of 62 C. vitis strains collected from different regions in which grapevines are grown in China. The C. vitis populations were extremely sensitive to fluazinam. The efficiency of fluazinam to grape white rot was determined with detached grapevine leaves. Fluazinam was highly effective in controlling this disease. Moreover, the risk of the C. vitis strains developing resistance to fluazinam was assessed with five mutant strains resistant to fluazinam obtained by a fungicide selection method in the laboratory. The fluazinam‐resistant mutant strains were deficient in their hyphal growth, stress and virulence compared with the parental strain. This led to the conclusion that the C. vitis populations are highly sensitive to fluazinam, and C. vitis is unlikely to develop resistance to fluazinam under natural conditions. Thus, fluazinam is a potential fungicide to efficiently control grape white rot. [ABSTRACT FROM AUTHOR]