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Difficult and complicated oral ulceration:an expert consensus guideline for diagnosis

International Journal of Oral Science 2022年第2期14卷 140-144页

作者： Xin Zeng Xin Jin Liang Zhong Gang Zhou Ming Zhong Wenmei Wang Yuan Fan Qing Liu Xiangmin Qi Xiaobing Guan Zhimin Yan Xuemin Shen Yingfang Wu Lijie Fan Zhi Wang Yuan He Hongxia Dan Jiantang Yang Hui Wang Dongjuan Liu Hui Feng Kai Jiao Qianming Chen State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management West China Hospital of StomatologySichuan UniversityChengduChina College of Stomatology Chongqing Medical UniversityChongqingChina Department of Oral Medicine School and Hospital of StomatologyWuhan UniversityWuhanChina Department of Stomatology Xiang’an Hospital of Xiamen UniversitySchool of MedicineXiamen UniversityXiamenChina Department of Oral Medicine Nanjing Stomatological HospitalMedical School of Nanjing UniversityNanjingChina Department of Oral Medicine The Affiliated Stomatological Hospital of Nanjing Medical UniversityNanjingChina The Third Affiliated Hospital of Air Force Medical University Xi’anChina School and Hospital of Stomatology Cheeloo College of MedicineShandong UniversityJinanChina Beijing Stomatological Hospital Capital Medical UniversityBeijingChina Department of Oral Medicine Peking University School and Hospital of StomatologyBeijingChina Department of Oral Mucosal Diseases Shanghai Ninth People’s HospitalCollege of StomatologyShanghai Jiao Tong University School of MedicineShanghaiChina Centre of Stomatology Xiangya HospitalCental South UniversityChangshaChina Stomatology Hospital Zhejiang University School of MedicineZhejiang Provincial Clinical Research Center for Oral DiseasesCancer Center of Zhejiang UniversityHangzhouChina Guanghua School of Stomatology Guangdong Provincial Key Laboratory of StomatologyStomatological HospitalSun Yat-Sen UniversityGuangzhouChina Shanghai Engineering Research Center of Tooth Restoration and Regeneration Department of Oral MedicineSchool of StomatologyTongji UniversityShanghaiChina Department of Oral Medicine Hospital of StomatologyZunyi Medical UniversityZunyiChina Department of Oral Medicine School of StomatologyCapital Medical UniversityBeijingChina Department of Emergency and Oral Medicine School and Hospital of Stomatology

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral *** 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 *** 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.

关键词： ulceration diagnosis diseases

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Role of dietary phospholipids and phytosterols in protection against peptic ulceration as shown by experiments on rats

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World Journal of Gastroenterology 2015年第5期21卷 1377-1384页

作者： Frank I Tovey Division of Surgery and Interventional Science University College LondonLondon W1W 7EJUnited Kingdom

Geographically the prevalence of duodenal ulceration is related to the staple foods in the diet in regions of developing countries where the diet is *** is higher in regions where the diet is based on milled rice,refined wheat or maize,yams,cassava,sweet potato,or green bananas,and is lower in regions where the staple diet is based on unrefined wheat or maize,soya,certain millets or certain *** on rat gastric and duodenal ulcer models showed that it was the lipid fraction in staple foods from low prevalence areas that was protective against bothgastric and duodenal ulceration,including ulceration due to non-steroidal anti-inflammatory drugs(NSAIDs).It also promoted ulcer *** lipid from the pulse,Dolichos biflorus,horse gram which was highly protective was used to identify the fractions with protective activity in the *** protective activity lay in the phospholipid,sterol and sterol ester *** the phospholipid fraction phosphatidyl choline(lethicin) and phosphatidyl ethanolamine(cephalin) were *** the sterol fraction the sub-fractions showing protective activity contained β-sitosterol,stigmasterol,and an unidentified isomer of β-*** evidence from animal models shows that certain dietary phospholipids and phytosterols have a protective action against gastroduodenal ulceration,both singly and in *** supports the protective role of staple diets in areas of low duodenal ulcer prevalence and may prove to be of importance in the prevention and treatment of duodenal ulceration and management of recurrent ulcers.A combination of phospholipids and phytosterols could also play an important role in protection against ulceration due to NSAIDs.

关键词： Peptic ulceration Mucosal protection Nonsteroidal

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Oral administration of hyperoxygenated solution for the prophylaxis of gastric ulceration induced by stress or Helicobacter pylori

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医学争鸣 2015年第6期6卷 28-34页

作者： MA Hong-Wei WU Ya-Qiong ZHANG Hai-Feng Experiment Teaching Center School of Basic Medicine Fourth Military Medical University School of Life Sciences Shaanxi Normal University

Oxygen was first discovered by Sweden chemist Scheele in 1773 and convinced as an essential factor for living by French scientists in *** tackle with different hypoxic emergencies,corresponding medical approaches,*** or nasal catheter oxygen inhalation,breathing machine,hyperbaric oxygen therapy etc.,have been contrived in ***,one mortal trouble exists in all these conventional ways,*** must rely on the ventilation and gas exchange via lungs,thus not being able to promptly render oxygen to specific hypoxia *** solution(HOS),a new kind of medical liquid which can be orally taken or intravenously administrated,has been widely applied as an auxiliary method of offering oxygen in China.A large number of experiments have proved its validity in the treatment of myocardial and cerebral ischemia/reperfusion injury,nerve lesions,shock,respiratory diseases,neonatal hypoxia and so *** findings suggest that HOS might not only play a role of increasing oxygen pressure in local region,but also conspicuously contribute to improving the pathologic process of hypoxia,which coincidently is the vital link in stress-induced lesions in the gastrointestinal ***,Helicobacter pylori(***),a kind of microaerophilic(anaerobic)bacterium which can hardly survive in an aerobic atmosphere,has also been identified as an independent risk factor for the occurrence and development of *** the etiology of peptic ulceration and the features of HOS,we hypothesize that drinking HOS might prevent gastric ulceration caused by stress or anaerobic ***.

关键词： hyperoxygenated solution gastric ulceration prophylaxis stress Helicobacter pylori

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Surgical Technique Affects the Incidence of Marginal ulceration after Roux-en-Y in Gastric Bypass

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Surgical Science 2013年第12期4卷 1-7页

作者： Yong Kwon Lee Corrigan McBride Valerie Shostrom Jon Thompson Department of Surgery College of Public Health University of Nebraska Medical Center Omaha USA

Background: Marginal ulceration (MU) is a recognized complication of Roux-en-Y gastric bypass (RYGB) surgery. While several possible risk factors have been reported, the mechanism of MU remains incompletely understood. The aim of this study was to compare the effect of surgical technique on the incidence of MU. Methods and Material: This was a retrospective study of 749 patients undergoing RYGB over a ten-year period with at least one year of follow-up. The diagnosis of MU was made based on clinical symptoms and confirmed by postoperative endoscopy (POE). We assessed four different gastric bypass (GBP) techniques: T1—Open, non-divided stomach, circular stapler, non-vagotomy (n = 332);T2—Open, divided stomach, circular stapler, vagotomy (n = 91);T3—Laparoscopic, divided, circular stapler, vagotomy (n = 152);T4—Laparoscopic, divided, linear stapler, vagotomy (n = 174). Results: The four groups were similar with respect to age and mean BMI. The frequency of POE was 16%, 25%, 28% and 27% in groups T1-T4 respectively (NS). The incidence of MU was significantly lower in T1 (2.1%) compared to T2 (5.5%), T3 (15.1%) and T4 (12.6%), p 0.05. MU occurred significantly more frequently with an antecolic Roux limb versus retrocolic (14.5% vs 5.6%, p 0.05). Conclusion: The incidence of MU after RYGB surgery is influenced by surgical technique. The lowest incidence of MU was with a non-divided stomach, no vagotomy, transverse staple line, and circular stapled anastomosis. A retrocolic Roux limb was protective. There was no difference in the incidence of MU using laparoscopic versus open bypass if a similar technique was employed or using linear versus circular stapler for the gastrojejunostomy.

关键词： Gastric Bypass Marginal ulceration

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RADIOIMMUNOASSAY OF SERUM FERRITIN LEVEL IN PATIENTS WITH RECURRENT APHTHOUS ulceration

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Medical Bulletin of Shanghai Jiaotong University 1991年第2期14卷 70-74页

作者：程慧许国祺张庆华曹宏康史慧宝 Department of Oral Medicine School of Stomatology SSMU Shanghai

The purpose of this study was to assess the correlation between iron deficiency and recurrent aphthous ulceration (RAU). Radioimmunoassay was used to examine the serum ferritin level (SFL) in 52 patients with RAU and in 54 controls. Both were divided into 2 groups in accordance with sex. The 36 female patients were subdivided into 3 age-groups as follows: 8 aged 22-24, 10 aged 25-34, and 18 aged 35-50 while the male patients were gathered as one single group aged 26-57. The subdivision was adapted similarly for the normal age-grouts. Although no significant difference in SFL was found between the male control and the male patient groups, differences between the female control and female patient groups showed highly significant which levels, with the ascendance of age, were P<0.001, P<0.005 and P<0.001, respectively. Also the difference between male and female control groups were significant (P<0.05). However, no significant differences in SFL were discovered among the 3 patient groups. 10 female patients with SFL<12ng/ml were tested with ferrous sulfate for one month, then their SFL was reexamined one week after the treatment. A highly significant difference in SFL was noted between the pre-ad post-treatment (P<0.001). 9 of them showed that the interval of recurrences were prolonged, the number of ulcers reduced, the pain less intensive and its duration shorter than those before the treatment. This study demonstrated that a singificant decrease in iron-storage occurred in female RAU patients. The authors concluded that the decrease SFL was possibly related to menstruation and child bearing.

关键词： recurrent aphthous ulceration serum ferritin level

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Strictures, diaphragms, erosions or ulcerations of ischemic type in the colon should always prompt consideration of nonsteroidal anti-inflammatory drug-induced lesions

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World Journal of Gastroenterology 2005年第37期11卷 5828-5833页

作者： Manfred Stolte Diana Karimi Michael Vieth Hildegard Volkholz Klaus Dirschmid Sigrid Rappel Birgit Bethke Institute of Pathology Klinikum Bayreuth GmbH Bayreuth 95445 Germany

AIM： To investigate whether NSAIDs/ASA lesions in the colon can histologically be diagnosed on the basis of ischemic necrosis similar to biopsy-based diagnosis of NSAIDs/ASA- induced erosions and ulcers of the stomach. METHODS： In the period between 1997 and 2002, we investigated biopsy materials obtained from 611 patients （415 women, 196 men, average age 60.5 years） with endoscopic focal erosions, ulcerations, strictures or diaphragms in the colon. In the biopsies obtained from these lesions, we always established the suspected diagnosis of NSA/D-inducecl lesions whenever necroses of the ischemic type were found. Together with the histological report, we enclosed a questionnaire to investigate the use of medication. The data provided by the questionnaire were then correlated with the endoscopic findings, the location, number and nature of the lesions, and the histological findings. RESULTS： At the time of their colonoscopy, 86.1% of the patients had indeed been taking NSAID/ASA medication for years （43.9%） or months （29.5%）. The most common indication for the use of these drugs was pain （64.3%）, and the most common indication for colonoscopy was bleeding （55.5%）. Endoscopic inspection revealed multiple erosions and/or ulcers in 60.6%, strictures in 15.8%, and diaphragms in 3.0% of the patients. The lesions were located mainly in the right colon including the transverse colon （79.9%）. A separate analysis of age and sex distribution, endoscopic and histological findings for NSAIDs alone, ASA alone, combined NSAID/ASA, and for patients denying the use of such drugs, revealed no significant differences among the groups. CONCLUSION： This uncontrolled retrospective study based on the histological finding of an ischemic necrosis shows that the histologically suspected diagnosis of NSAID-induced lesions in the colon is often correct. The true diagnostic validity of this finding and the differentiation from ischemic colitis should, however, be investigated in a prospective

关键词： Erosion ulceration Stricture Diaphragm Ischemic necrose NSAIDs ASA

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Ozone Therapy in a Patient with Diabetic Foot ulcerations and a Decision for Amputation

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Case Reports in Clinical Medicine 2019年第2期8卷 35-41页

作者： Saltuk Aytacoglu Barlas Naim Aytacoglu Vocational School of Health Girne American University Girne TRNC Faculty of Medicine Girne American University Girne TRNC

Background: Diabetic foot together with open wounds in distal type peripheral arterial disease constitutes a challenge in therapeutic planning. Ozone therapy may unveil new horizons in management. Case Report: A 67-year-old woman with diabetes mellitus was applied with open wounds at the bottom of her foot with purulent discharge, with a decision for above ankle amputation. She had had numerous interventions for her wounds including metatarsal amputations due to osteomyelitis and had been on an intense treatment including antibiotics, insulin, antihypertensives and antiaggregants. Angiogram revealed diffuse peripheral arterial disease in lower extremities. All medication but antihypertensives was stopped. She received major medical ozone application as 2000 gamma/session i.v. for 2 weeks, external ozone sac application starting from 60 and dropping to 30 gamma/session for 3 weeks and ozone insuflation 40 gamma/session for 10 sessions. Her purulent discharge ceased after the third session and the atonic debris of the wounds exfoliated, the wounds healed from the base towards the surface of the skin. She was then put on cilostazol and clopidogrel therapy. Conclusion: By being one of the known strongest bactericide, virucide, and fungicide elements, medical ozone therapy stimulates and upregulates the antioxidant system of the body with its hormesis effects. After the cessation of all circulatory system supporting medication (as their interaction with ozone is not clear yet), appropriate ozone therapy may bring new horizons for patients when all classically known methods of treatment have been completed, before assigning the patients for amputation.

关键词： Diabetic Foot ulceration Medical Ozone Treatment Diabetes Mellitus Extremity Amputation

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Chronic Anogenital ulcerations and Polymicrobial Pelvic Infections: About a Case

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Open Journal of Obstetrics and Gynecology 2023年第1期13卷 82-87页

作者： Michèle Florence Mendoua Grâce Anita Nkoro Lucie Nguizaye Vanina Ngono Akam Esther Ngo Um Department of Gynaecology-Obstetrics Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Internal Medicine and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Department of Gynaecology-Obstetrics Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Genital ulceration is the loss of integrity of the mucous membranes (or genital skin) leaving the dermis uncovered and almost always accompanied by satellite lymphadenopathies. Beyond a month of evolution, it is said to be chronic. Sexually transmitted diseases are infections due to microbial agents among which parasites, bacteria, viruses and fungi that can be associated with each other to varying degrees. Sexually transmitted infections must be mentioned before any genital ulceration. Hence the interest of the case that we report of chronic anogenital ulcerations complicating a polymicrobial pelvic infection in a patient immunocompromised to HIV. The physical examination reveals a hypogastric sensitivity to deep palpation, the presence of a superinfected anogenital ulceration exposing the deep dermis covered with purulent serosities interesting the labia minora, the posterior vaginal fork, the anal region, the clitoris and an extension of the lesions to the gluteal fold is observed. We found a satellite lymphadenopathy in the right inguinal fold. The screening finds the HIV1 positive serology with a viral load of 28,000 copies, the herpes simplex 1&2 and Chlamydia trachomatis serologies were all positive. The genital samples are marked by the presence of bacterial vaginosis with Candida Albicans and Gardnerella Vaginalis, the presence of urogenital mycoplasmas of the Ureaplasma Urealyticum The pelvic ultrasound was in favor of a bilateral adnexitis. A protocol was put in place: the first step consisted of seat baths, antifungi and antibiotics administration: fluconazole 150 mg and tinidazole 2 g in single doses, then josamycin 1 g/24h in two doses per os for two weeks. The second stage consists of the administration of doxycycline 200 mg for 21 days, Aciclovir 500 mg for 10 days, and the administration of ARV (Tenofovir + Lamivudine + Dolutegravir) or one tablet daily. The evolution is marked by a progressive healing of the clitoris, the labia majora and labia min

关键词： Anogenital ulceration Polymicrobial Infection

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Acupuncture therapy for experimental stomach ulcer and c-Fos expression in rats

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World Journal of Gastroenterology 2005年第35期11卷 5517-5520页

作者： Hong Wang Chun-Yang Wang Jin-Shan Zhang Lan Sun Jing-Ping Sun Qing-Hua Tian Xiang-Lan Jin Ling Yin Neuroinformatics Center Chinese PLA General HospitalBeijing 100853 China Department of Urology Chinese PLA GeneralHospital Beijing 100853 China Department of Embryology andHistology the Fourth Military Medical University Xi'an 710032Shaanxi Province China

AIM: To determine the role of acupuncture therapy in treating experimental gastric ulcer in ***: Twenty-eight adult male Sprague-Dawley rats were randomly divided into four groups (pre-acupuncture group; acupuncture group; paradistance-acupuncture group;and control group), and pre-acupuncture, paradistanceacupuncture, and control groups received 5 μL acetic acid (200 mL/L HAc) injection after a same course of electroacupuncture (EA) treatment (4 Hz, 0.6 mA, 0.45 ms,45 min for 4 d). The rats in these three groups recovered within 4 d. The acupuncture group received EA therapy for 4 d, after HAc injection. The stomach was dissected to compare the pathological structures of ulcer. Also c-Fos activation in the nuclei of solitary tract (NTS) was observed under microscope after regular immunohistochemistry staining of brain stem ***: The number of ulcers was different among the four groups, especially between control group and paradistance-acupuncture group or pre-acupuncture group. In the latter group, the number of ulcers was much less. The gastric ulcer area was consistent with the histopathological results, indicating that pre-acupuncture had an obvious therapeutic effect on gastric *** had a very modest effect and paradistanceacupuncture had no effect on gastric ulcers. No therapeutic effect was found in the control group. Fos-Li neurons in NTS induced by noxious gastric ulcer showed a significant difference between pre-acupuncture and control ***: Acupuncture before ulceration can obviously alleviate ulcer. The production of c-Fos proves that the vagus nerve mediates the induction of c-Fos in nuclei of solitary tract following experimental ulceration,suggesting that parasympathetic afferents promote the process of noxious visceral stimulation.

关键词： Zusanli acupuncture ulceration c-Fos Nucleusof solitary tract

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Adamantiades-Behcet's disease-complicated gastroenteropathy

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World Journal of Gastroenterology 2012年第7期18卷 609-615页

作者： Qing-Jun Wu Feng-Chun Zhang Xuan Zhang Feng-Chun Zhang Xuan ZhangDepartmentof RheumatologyPeking Union Medical College HospitalPe-king Union Medical CollegeChinese Academy of Medical Sci-encesBeijing 100730China

Adamantiades-Behcet's disease (ABD) is a chronic,relapsing,systemic vasculitis of unknown *** is more prevalent in populations along the ancient Silk Road from Eastern Asia to the Mediterranean Basin,and most frequently affects young adults between the second and fourth decades of ***-complicated gastroenteropathy is a significant cause of morbidity and mortality,with abdominal pain as the most common *** ileocecal region is affected predominantly,with ulcerations that may lead to penetration and/or perforation,whereas other parts of the gastrointestinal system including the esophagus and stomach can also be *** is useful to locate the site and extent of the lesions,and tissue biopsy is often warranted to examine the histopathology that is often suggestive of underlying vasculitis of small veins/venules or,alternatively in some cases,nonspecific *** wall thickening is the most common finding on computed tomography *** is largely empirical since well-controlled studies are difficult to conduct due to the heterogeneity of the disease,and the unpredictable course with exacerbation and *** with or without other immunosuppressive drugs,such as cyclophosphamide,azathioprine,sulfasalazine,tumor necrosis factor α antagonist or thalidomide should be applied before surgery,except in emergency.

关键词： Adamantiades-Behcet's disease Gastro-enteropathy ulceration Vasculitis

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