Abstract The prevention and control of myopia in children and adolescents has become a national health strategy in China, and its prevention and management are transitioning from experience driven approaches to precise and intelligent strategies. Understanding the role of artificial intelligence (AI) in myopia prevention and control can provide a foundation for a comprehensive myopia prevention and control system. AI, with its powerful capabilities in data analysis and pattern recognition, shows significant potential in myopia risk prediction, screening and diagnosis, intervention support and behavior monitoring in children and adolescents. The article systematically summarizes the scientific evidence and consensus on the application of AI for myopia prevention and control in children and adolescents. From the perspective of public health practice, it proposes hierarchical expert recommendations for multiple scenarios including schools, families, communities and medical institutions, as well as policy and research with development. Furthermore, it discusses current challenges and future directions, aiming to provide a reference for building an intelligent, precise and fully covered comprehensive myopia prevention and control system in children and adolescents.

Objective: To analyze the trend in disease burden attributable to insufficient physical activity among residents in Zhejiang Province from 1990 to 2021, so as to provide evidence for developing targeted prevention and control strategies. Methods: Data on years of life lost due to premature mortality (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) due to insufficient physical activity among residents of Zhejiang Province were collected from the Global Burden of Disease (GBD) 2021 database. The average annual percentage change was used to analyze the trends in YLL, YLD, and DALY rates from 1990 to 2021. Results: YLL, YLD, and DALY rates attributable to insufficient physical activity among residents of Zhejiang Province increased from 42.65/105, 11.12/105, and 53.77/105 in 1990 to 85.67/105, 31.56/105, and 117.23/105 in 2021, respectively, showing an upward trend (AAPC=2.267%, 3.428%, and 2.517%, all P<0.05). From 1990 to 2021, the YLL, YLD, and DALY rates attributable to insufficient physical activity were consistently higher in females than in males. Both males and females demonstrated upward trends in YLL (AAPC=2.631%, 2.031%), YLD (AAPC=3.711%, 3.268%), and DALY (AAPC=2.840%, 2.303%) rates (all P<0.05). From 1990 to 2021, the YLL, YLD, and DALY rates were highest in the ≥70 years age group. From 1990 to 2021, 15-<50 and ≥70 years age groups showed upward trends in YLL (AAPC=0.439%, 0.818%), YLD (AAPC=3.102%, 1.351%), and DALY (AAPC=1.749%, 0.932%) rates (all P<0.05). The 50-<70 years age group exhibited an increasing trend in YLD rate (AAPC=1.222%), while declining trends in YLL (AAPC=-1.400%) and DALY (AAPC=-0.663%) (all P<0.05). In both 1990 and 2021, the top five diseases attributable to insufficient physical activity in Zhejiang Province were stroke, diabetes, colorectal cancer, ischemic heart disease, and chronic kidney disease. Compared to 1990, the DALY rates for these five diseases increased in 2021, with change rates of 89.20%, 164.84%, 110.67%, 223.40%, and 80.95%, respectively. Conclusions From 1990 to 2021, the overall disease burden attributable to insufficient physical activity in Zhejiang Province showed an upward trend. The disease burden was relatively high among females, the elderly, and for chronic diseases such as stroke, while premature mortality burden declined among residents aged 50-<70 years.

Objectives:To investigate association of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) with the stroke severity and short-term outcome in patients with acute ischemic stroke (AIS), and to evaluate the predictive value of NHHR for outcome.Methods:Patients with the first-ever AIS admitted to the Affiliated Hospital of Qingdao University from June 2018 to June 2024 whose etiological types were large artery atherosclerosis (LAA), small vessel occlusion (SVO) and cardiac embolism (CE) were included retrospectively. According to the National Institutes of Health Stroke Scale (NIHSS) score at admission, the patients were divided into mild stroke group (≤8) and moderate to severe stroke group (>8). According to the modified Rankin Scale score at discharge, they were divided into good outcome group (≤2) and poor outcome group (>2). Multivariate logistic regression analysis was use to determine the independent correlation between NHHR and stroke severity and short-term outcome in patients with AIS. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of NHHR for short-term poor outcome in overall patients with AIS and different etiological subtypes. Results:A total of 2 865 patients with AIS were enrolled, including 1 925 males (67.2%), aged (61.00 ± 10.17) years. 2 483 patients (86.67%) had mild stroke and 382 (13.33%) had moderate to severe stroke; 2 161 (75.43%) had good short-term outcome, while 704 (24.57%) had poor short-term outcome. Multivariate logistic regression analysis showed that NHHR was significantly and independently associated with moderate to severe stroke (odds ratio [ OR] 2.251, 95% confidence interval [ CI] 1.895-2.675; P<0.001) and poor short-term outcome ( OR 3.454, 95% CI 2.936-4.063; P<0.001). ROC curve analysis showed that NHHR had a high predictive value for short-term poor outcome in patients with AIS (the area under the curve [AUC] 0.764, 95% CI 0.745-0.784), and it also demonstrated high predictive value in patients with various etiological types such as LAA (AUC=0.755, 95% CI 0.730-0.781), SVO (AUC=0.801, 95% CI 0.777-0.824) and CE (AUC=0.797, 95% CI 0.774-0.820). Conclusion:NHHR is significantly correlated with the severity of stroke and poor short-term outcome in patients with AIS, and has a high predictive value for poor short-term outcome.

Objective:To establish the HPLC fingerprints and multi-component content determination method of Yinchen Wuling Powder; To evaluate the quality of Yinchen Wuling Powder combined with chemical pattern recognition technology.Methods:A wavelength-switching HPLC method was used to establish the fingerprint profiles of different batches of Yinchen Wuling Powder and determine the contents of seven components of neochlorogenic acid, chlorogenic acid, isochlorogenic acid B, isochlorogenic acid A, isochlorogenic acid C, cinnamic acid, cinnamaldehyde. Principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA) were applied to evaluate the quality. Quality difference biomarkers were screened.Results:The fingerprint profiles of 24 batches of Yinchen Wuling Powder were identified with 20 common peaks, and 7 components were recognized. The similarity between the 24 batches of samples and the control profile was 0.966-0.994, and the attribution analysis showed that peaks 1, 2, 3 were common to Artemisia Scoparia and Alismatis Rhizoma. Chromatographic peaks 4 (neochlorogenic acid), 5, 6, 7 (chlorogenic acid), 8, 9, 10, 11, 12, 13, 14 (isochlorogenic acid B), 15 (isochlorogenic acid A), 16 (isochlorogenic acid C), and 19 were from Artemisia Scoparia, and peaks 17, 18 and 20 were from Cinnamomi Ramulus. Principal component analysis classified the 24 batches of samples into 4 categories, and partial least squares discriminant analysis was used to determine 11 quality difference biomarkers, including isochlorogenic acid B and neochlorogenic acid.Conclusions:The established method of determining fingerprint and multi-component content is accurate and with good repeatability. The results can provide a certain basis for the quality evaluation of Yinchen Wuling Powder.

OBJECTIVES: In recent years, the incidence and detection rate of pancreatic cystic lesions (PCLs) have increased significantly. Endoscopic ultrasound (EUS) plays an indispensable role in the diagnosis and differential diagnosis of PCLs. However, evidence comparing the diagnostic performance of EUS-guided fine-needle aspiration (EUS-FNA) and fine-needle biopsy (FNB) remains limited. This study aims to compare the diagnostic yield, adequacy of tissue acquisition, and safety between EUS-FNA and EUS-FNB in evaluating PCLs to inform clinical practice. METHODS: A retrospective review was conducted on patients with PCLs who underwent either EUS-FNA or EUS-FNB between January 2014 and August 2021. The diagnostic yield, tissue acquisition adequacy, and incidence of adverse events were compared between the 2 groups. RESULTS: A total of 90 patients with PCLs were included (52 in the FNA group and 38 in the FNB group). The diagnostic yield was similar between the FNA and FNB groups (94.2% vs 94.7%, P>0.05). The adequacy of tissue acquisition was 71.2% in the FNA group and 81.6% in the FNB group (P>0.05). No statistically significant difference was observed in the incidence of adverse events between the 2 groups (P>0.05). CONCLUSIONS Both EUS-FNA and EUS-FNB demonstrate equally high diagnostic yields and tissue adequacy in PCLs, with excellent safety profiles. Both methods are safe and effective diagnostic tools for evaluating PCLs.
Humans ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/adverse effects* ; Retrospective Studies ; Female ; Male ; Pancreatic Cyst/diagnostic imaging* ; Middle Aged ; Biopsy, Fine-Needle/adverse effects* ; Aged ; Pancreatic Neoplasms/diagnosis* ; Adult ; Endosonography/methods* ; Pancreas/pathology* ; Diagnosis, Differential

Osteoarthritis (OA), the most prevalent joint disease of late life, is closely linked to cellular senescence. Previously, we found that the senescence of fibroblast-like synoviocytes (FLS) played an essential role in the degradation of cartilage. In this work, single-cell sequencing data further demonstrated that cartilage acidic protein 1 (CRTAC1) is a critical secreted factor of senescent FLS, which suppresses mitophagy and induces mitochondrial dysfunction by regulating SIRT3 expression. In vivo, deletion of SIRT3 in chondrocytes accelerated cartilage degradation and aggravated the progression of OA. Oppositely, intra-articular injection of adeno-associated virus expressing SIRT3 effectively alleviated OA progression in mice. Mechanistically, we demonstrated that elevated CRTAC1 could bind with NRF2 in chondrocytes, which subsequently suppresses the transcription of SIRT3 in vitro. In addition, SIRT3 reduction could promote the acetylation of FOXO3a and result in mitochondrial dysfunction, which finally contributes to the degradation of chondrocytes. To conclude, this work revealed the critical role and underlying mechanism of senescent FLSs-derived CRTAC1 in OA progression, which provided a potential strategy for the OA therapy.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*