Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Objective To investigate the prevalence of Echinococcus infections in small rodents around human residential areas in Yushu City, Qinghai Province in 2023, so as to provide insights into precision echinococcosis control. Methods One or two quadrats, each measuring 50 m × 50 m, were randomly assigned in Shanglaxiu Township and Longbao Township, Yushu City, Qinghai Province on June 2023, respectively, and 300 plate-type mouse traps, each measuring 12.0 cm × 6.5 cm, were assigned in each quadrat. Small rodents were captured during the period between 10 : 00 and 18 : 00 each day for 4 days. Then, all captured small rodents were identified and dissected, and liver specimens with suspected Echinococcus infections were subjected to pathological examinations. The Echinococcus cytochrome c oxidase 1 (cox1) gene was amplified using PCR assay, and the sequence of the amplified product was aligned to that was recorded in the GenBank to characterize the parasite species. In addition, a phylogenetic tree of Echinococcus was generated based on the cox1 gene sequence using the neighbor-joining method. Results A total of 236 small rodents were captured in Shanglaxiu and Longbao townships, Yushu City, including 65 Qinghai voles and 51 plateau pikas in Shanglaxiu Township, and 62 Qinghai voles and 58 plateau pikas in Longbao Township, and there was no significant difference in the constituent ratio of small rodents between the two townships (χ² = 0.294, P > 0.05). Seven plateau pikas and 12 Qinghai voles were suspected to be infected with Echinococcus by dissection, and pathological examinations showed unclear structure of hepatic lobules and disordered hepatocyte arrangement in livers of small rodents suspected of Echinococcus infections. PCR assay identified E. shiquicus DNA in 7 Qinghai voles, which were all captured from Shanglaxiu Township. Phylogenetic analysis showed that the cox1 gene sequence of Echinococcus in small rodents was highly homologous to the E. shiquicus cox1 gene sequence reported previously. Conclusion Plateau pika and Qinghai vole were predominant small rodents around human residential areas in Yushu City, Qinghai Province in 2023, and E. shiquicus infection was detected in Qinghai voles.

Objective To explore the expression and clinical value of serum calprotectin and toll like receptor 2(TLR2)with type 2 diabetic kidney disease(DKD).Method According to the levels of UACR,90 T2DM patients treated in our hospital from January 2019 to January 2022 were divided into normal albuminuria group(Con,UACR<30 mg/g),microalbuminuria group(Micro,UACR 30～300 mg/g),and macroalbuminuria group(Macro,UACR>300 mg/g),30 cases per group.Result The levels of BMI,HbAlc,calprotectin,TLR2,and NLRP3 increased sequentially from Con,Micro to Macro groups(P<0.05),while eGFR in the Macro group was lower than that in the Con or Micro groups(P<0.05).Pearson correlation analysis showed that serum calprotectin was positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr,UACR(P<0.05 or P<0.01),and negatively correlated with eGFR(P<0.01);NLRP3 is positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr,SUA,and UACR(P<0.01),and negatively correlated with eGFR(P<0.01);TLR2 was positively correlated with BMI,WC,SBP,FPG,HbAlc,TC,TG,Scr and UACR(P<0.05 or P<0.01),and negatively correlated with eGFR(P<0.01).Multiple linear regression analysis showed that FPG,HbAlc,TC,Scr,calprotectin,and TLR2 were the influencing factors of UACR.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve for diagnosing DKD with serum calprotectin and TLR2 was 0.883 and 0.961,with sensitivities of 73.33%and 96.67%,and specificity of 100.00%and 83.33%.Conclusion Serum calprotectin and TLR2 are closely related to the occurrence and development of DKD.The diagnostic value of TLR2 for DKD is superior to serum calprotectin.

Objective To evaluate the nutritional status of elderly inpatients by using the nutritional risk screening table 2002(NRS2002)and the short-form mini-nutritional assessment(MNA-SF),and to eval-uate the applicability of the two tools.Methods The general data were collected from the inpatients aged ≥80 years old by the random sampling method.They were divided into the two age groups:≥90 years old and＜90 years old,and their nutritional status was assessed by using the two nutritional screening tools.Meanwhile,the fasting venous blood nutritional related indicators including albumin(Alb),hemoglobin(Hb),C-reactive protein(CRP),transferrin(TRF),prealbumin(PA)and retinol-binding protein(RBP)levels were detected.Furthermore the results conducted the correlation analysis.Results There were 404 cases(48.56％)of nutri-tional risk in the NRS2002 evaluation.The occurrence rate of nutritional risk in the ≥90 years old group was higher than that in the＜90 years old group(P＜0.01).There were 616 cases(74.04％)of malnutrition/risk of malnutrition in the MNA-SF evaluation.The incidence rate of malnutrition risk in the≥90 years old group was higher than that in the＜90 years old group(P＜0.01).With the serum ALB＜30 g/L as the ref-erence standard,the applicabilities were compared between the two kinds of nutritional screening tools,the re-sults found that the two kinds of nutritional screening tools all were suitable for the nutritional status screen-ing of elderly inpatients.The area under the receiver operating characteristic(ROC)curve(AUC)of the MNA-SF for evaluating the nutritional status in the elderly inpatients was 0.814,the sensitivity and specificity were 75.7％and 87.7％respectively.AUC of ROC in NRS2002 for evaluating the nutritional status in the elderly inpatients was 0.805,the sensitivity and specificity were 88.6％and 62.2％respectively.The correla-tion analysis results of Hb,CRP,PA,RBP and TRF biochemical indexes with MNA-SF score and NRS2002 score showed that NRS2002 score and MNA-SF score were correlated with PA,RBP and TRF.Conclusion The incidence rate of nutritional risk in elderly inpatients is high.Both NRS2002 and MNF-SF nutritional screening tools are suitable for elderly inpatients and have high accuracy.Meanwhile,combining nutrition-related indicators to evaluate the nutritional status of elderly patients can improve the accuracy of nutritional assessment.

Objective To analyze the very high frequency(VHF)ultrasound features of mixed tumor of the skin(MTS),and to explore the diagnostic value of VHF ultrasound features for MTS.Methods A total of 63 cases of MTS confirmed by surgery and pathology in the Department of Dermatology of Hangzhou Third People's Hospital from January 2019 to March 2024 were selected as observation group,and 63 other benign skin tumors in the same period were used as control group.The VHF ultrasound features of MTS were retrospectively analyzed and summarized,and the diagnostic efficiency of VHF ultrasound features for MTS was evaluated.Results Compared with other benign skin tumors,there were no significant differences in the length diameter,transverse diameter,aspect ratio,presence or absence of calcification,cystic disease,blood flow grade and resistance index between two groups(P＞0.05).However,MTS had a more obvious pseudo-capsule,and most of the internal echoes were not uniform,and the posterior side was accompanied by a enhancing effect,and the blood flow was dominated by marginal blood flow,and the difference between two groups was obvious(P＜0.05).The receiver operating characteristic curve showed that the combination of pseudo capsule,internal echo,marginal flow and peripheral enhancement had the highest diagnostic efficacy,with an area under the curve of 0.772,a sensitivity of 77.8％ ,and a specificity of 71.4％ .Conclusion MTS have specific VHF ultrasound features,which can provide more assistance in the clinical diagnosis of MTS.

Chang-Kang-Fang (CKF) formula, a Traditional Chinese Medicine (TCM) prescription, has been widely used for the treatment of irritable bowel syndrome (IBS). However, its potential material basis and underlying mechanism remain elusive. Therefore, this study employed an integrated approach that combined ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS) with network pharmacology to systematically characterize the phytochemical components and metabolites of CKF, as well as elucidating its underlying mechanism. Through this comprehensive analysis, a total of 150 components were identified or tentatively characterized within the CKF formula. Notably, six N-acetyldopamine oligomers from CicadaePeriostracum and eight resin glycosides from Cuscutae Semen were characterized in this formula for the first time. Meanwhile, 149 xenobiotics (58 prototypes and 91 metabolites) were detected in plasma, urine, feces, brain, and intestinal contents, and the in vivo metabolic pathways of resin glycosides were elaborated for the first time. Furthermore, network pharmacology and molecular docking analyses revealed that alkaloids, flavonoids, chromones, monoterpenes, N-acetyldopamine dimers, p-hydroxycinnamic acid, and Cus-3/isomer might be responsible for the beneficial effects of CKF in treating IBS, and CASP8, MARK14, PIK3C, PIK3R1, TLR4, and TNF may be its potential targets. These discoveries offer a comprehensive understanding of the potential material basis and clarify the underlying mechanism of the CKF formula in treating IBS, facilitating the broader application of CKF in the field of medicine.
Humans ; Tandem Mass Spectrometry/methods* ; Irritable Bowel Syndrome/drug therapy* ; Molecular Docking Simulation ; Drugs, Chinese Herbal/chemistry* ; Glycosides ; Chromatography, High Pressure Liquid/methods*

Objective:To explore the path of standardized training and quality supervision for geriatric nursing assistants basing on the three-way linkage of "hospital, government and market".Methods:From January 2019 to December 2020, we conducted standardized training and management for geriatric nursing assistants in 24 nursing institutions for the aged in Mianyang, Sichuan Province in batches. Through the three-way linkage of "hospital, government and market", the whole-process management mode of "standardized training of geriatric nursing assistants, one-to-many tracking service for three months after the training, and service quality supervision of nursing institutions for the aged" has been established. The theoretical and operational achievements of nursing staff before and after training, the service quality of nursing home and the incidence of adverse events before and after the implementation of the project were observed and compared.Results:From 2019 to 2020, a total of 224 geriatric nursing assistants were trained in five sessions. There were statistical differences in the theoretical and operational scores before and after the training ( t=-72.494, -26.150; P<0.01) . 13 nursing institutions participating in the training in 2019 were selected to compare the service quality before and after the project implementation, the difference was statistically significant ( t=-14.575, P<0.01) , and the incidence of nursing adverse events decreased (χ 2=-7.913, P<0.01) . Conclusions:The mode of geriatric nursing assistants training and quality supervision based on the three-way linkage of "hospital, government, market" is conducive to giving full play to the administrative function of the government and the professional function of the hospital, effectively integrating resources and improving the quality of geriatric nursing service in the region.

Objective To explore the establishment of a two-way referral system for the treatment of cervical diseases within a medical alliance. The two-way referral system was introduced to reduce the morbidity and mortality of cervical cancer through better management of patients'who have tested positive for cervical disease, screening effectively for early diagnosis and treatment of cervical precancerous lesions, and providing early interventions for cervical cancer patients. Methods The control group consisted of 2, 515 patients who had screened positive for cervical disease between January 2018 and December 2018 at one of four community health service centers that were not within the medical alliance. The experimental group consisted of 2, 384 patients who had screened positive for cervical disease at one of four community health service centers in the medical alliance. The control group was treated using the original management mode;the experimental group's treatment was managed within the two-way referral system, which included standardized screening, referral, follow-up, health education, and professional training. The hospital visit rates, time intervals from diagnosis to the start of interventions, detection rates, and treatment rates were observed for both groups of women. Results The hospital visit rates, detection rates, and treatment rates were higher for those in the experimental group than the control group. The time interval from receiving a diagnosis to the first hospital visit was (16.9±11.5) days for patients in the experimental group and (25.7±20.9)days for those in the control group. The difference was a statistically significant (-0.05). Conclusion The management of cases in a two-way referral system within a medical alliance facilitates patients receiving earlier diagnosis and treatment for cervical pre-cancerous lesions and malignant tumors. Such efficiency improvements may reduce morbidity and mortality as well as help control medical costs, all of which have long-term economic and social significance.

Objective    To systematically review the efficacy and safety of single-port video-assisted thoracoscopic surgery (VATS) vs. multiple-port VATS in lobectomy for non-small cell lung cancer (NSCLC). Methods    The PubMed, EMbase, the Cochrane Library, CBM, CNKI, Wanfang, VIP and Web of Science were searched to collect clinical studies about single- vs. multiple-port VATS for patients with NSCLC from inception to August 2018. The literatures were screened, data were extracted and the risk of bias of included studies was assessed independently by two reviewers. The meta-analysis with the collected data was performed by using RevMan 5.3 software. Results    Eleven studies (4 randomized controlled trials, 1 prospective cohort study and 6 retrospective cohort studies), including 1 574 patients. Among them, 779 patients were in the single-port group, and 795 in the multiple-port group. The results of meta-analysis showed that there was no significant difference between the two groups in the operation time (MD=3.60, 95%CI –8.59 to 15.79, P=0.56), the conversion rate (OR=1.06, 95%CI 0.54 to 2.06, P=0.87), the incidence of postoperative complications (OR=0.76, 95%CI 0.53 to 1.10, P=0.15), postoperative hospitalization time (MD=0.74, 95%CI –1.60 to 0.12, P=0.09), chest tube placement time (MD=0.63, 95%CI –1.28 to 0.02, P=0.06) or harvested lymph nodes (MD=–0.11, 95%CI –0.46 to 0.24, P=0.54). The intraoperative blood loss (MD=–17.12, 95%CI –31.16 to –3.08, P=0.02) was less in the single-port group than that in the multiple-port group. The visual analogue score (VAS) on postoperative first day (MD=–1.30, 95%CI –1.85 to –0.75, P<0.000 01) and on postoperative third day (MD=–0.82, 95%CI –1.00 to –0.65, P<0.000 01) were lower in the single-port group than those in the multiple-port group. Conclusion    The meta-analysis indicates that the efficacy of single-port VATS for NSCLC is equivalent to multiple-port VATS. However the intraoperative blood loss, the VAS scores on postoperative first and third days in the single-port group are better.

OBJECTIVE： To prepare puerarin microemulsion with phase Ⅰ metabolic regulation （R-PR-ME） and to study pharmacokinetic characteristics of rats in vivo. METHODS： R-PR-ME and Puerarin microemulsion without metabolic regulation （NR-PR-ME） were prepared by Shah method. Pseudo-ternary phase diagram was used to optimize microemulsion formula using drug loading amount as index. The particle size and PDI of microemulsion were characterized by using a laser particle size analyzer. Rats were used as animal models， and HPLC method was used to determine the blood concentration of puerarin before and 5， 10， 15， 20， 30， 45， 60， 90， 120， 180， 240， 360， 480， 600 min after intragastric administration of R-PR-ME， NR-PR-ME and puerarin suspension （PR-SP） at puerarin dosage of 120 mg/kg. The pharmacokinetic parameters were calculated by using DAS 2.0 software. SPSS 19.0 software was used for statistical analysis. The relative bioavailability of R-PR-ME was calculated with NR-PR-ME as reference preparation. RESULTS： The formula of R-PR-ME included that oleoyl polyoxyl-6 glyserides （oil phase）-polysorbate 20 （emulsifier）-glycerides （co-emulsifier） mass ratio of 2 ∶ 4 ∶ 4； drug-loading amount of 67.50 mg/g， particle size was （22.59±0.53） nm （n＝3） and PDI was 0.182±0.017 （n＝3）. The formula of NR-PR-ME included that soybean oil （oil phase）-polysorbate 80 （emulsifier）- glycerol （co-emulsifier） mass ratio of 1 ∶ 4.5 ∶ 4.5， drug-loading amount of 61.32 mg/g， particle size of （15.45±1.06） nm（n＝3） and PDI of 0.156±0.012 （n＝3）. Pharmacokinetic parameters of R-PR-ME， NR-PR-ME and PR-SP included that AUC0-600 min were （134.187±37.152）， （65.145±18.762） and （49.623±12.143） μg·min/mL； cmax were （1.316±0.306）， （1.082±0.294） and （0.425±0.106） μg/mL； MRT were （155.068±33.204）， （100.264±27.683）， （60.524±14.086） min； t1/2β were （365.880±101.250）， （283.280±80.940）， （80.063±21.189） min （n＝6）， respectively. Compared with PR-SP， AUC0-600 min， cmax， MRT and t1/2β of R-PR-ME and NR-PR-ME were increased significantly （P＜0.05 or P＜0.01）. Compared with NR-PR-ME， AUC0-600 min， MRT and  t1/2β of R-PR-ME were more higher （P＜0.05）. The relative bioavailability of of R-PR-ME was 205.98％. CONCLUSIONS： R-PR-ME is prepared successfully with high drug-loading amount， and can significantly increase the bioavailability of puerarin in rats， compared with PR-SP and NR-PR-ME.