Objective To explore the efficiency improvement in segmenting neural network with the application of Transformer + U-Net artificial intelligence (AI) and modeling with the application of Python scripts in three-dimensional (3D) printing brachytherapy. Methods A Transformer + U-Net AI neural network model was constructed, and Adam optimizer was used to ensure rapid gradient descent. Computed tomography or magnetic resonance imaging data of patients were standardized and processed as self-made data sets. The training set was used to train AI and the optimal result weight parameters were saved. The test set was used to evaluate the AI ability. Python programming language was used to write an automated script to obtain the output segmentation image and convert it to the STL file for import. The source applicator and needle could be automatically modeled. The time of automatic segmentation and modeling and the time of manual segmentation and modeling were entered by two people, and the difference was verified by paired t-test. Results Dice similarity coefficient (DSC), mean intersection over union (MIOU), and Hausdorff distance (HD95) were used for evaluation. DSC was 0.9341, MIOU was 0.8762, and mean HD95 was 2.516. The mean time of manual segmentation was 1187 s, and the mean time of AI segmentation was 145 s (P < 0.01). The mean time of manual modeling was 321 s, and the mean time of modeling with Python automated scripts was 18 s (P < 0.01). Conclusion The application of Transformer + U-Net automatic segmentation and Python automated scripts can effectively improve work efficiency in the 3D printing brachytherapy for cervical cancer.

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans ; Consensus ; Orthodontic Appliance Design ; Orthodontic Appliances, Removable ; Tooth Movement Techniques/methods* ; Malocclusion/therapy* ; Orthodontics, Corrective/instrumentation*

Insufficient alveolar bone thickness increases the risk of periodontal dehiscence and fenestration, especially in orthodontic tooth movement. Abaloparatide (ABL), a synthetic analog of human PTHrP (1-34) and a clinical medication for treating osteoporosis, has recently demonstrated its potential in enhancing craniofacial bone formation. Herein, we show that intraoral submucosal injection of ABL, when combined with mechanical force, promotes in situ alveolar bone thickening. The newly formed bone is primarily located outside the original compact bone, implying its origin from the periosteum. RNA sequencing of the alveolar bone tissue revealed that the focal adhesion (FA) pathway potentially mediates this bioprocess. Local injection of ABL alone enhances cell proliferation, collagen synthesis, and phosphorylation of focal adhesion kinase (FAK) in the alveolar periosteum; when ABL is combined with mechanical force, the FAK expression is upregulated, in line with the accomplishment of the ossification. In vitro, ABL enhances proliferation, migration, and FAK phosphorylation in periosteal stem cells. Furthermore, the pro-osteogenic effects of ABL on alveolar bone are entirely blocked when FAK activity is inhibited by a specific inhibitor. In summary, abaloparatide combined with mechanical force promotes alveolar bone formation via FAK-mediated periosteal osteogenesis. Thus, we have introduced a promising therapeutic approach for drug-induced in situ alveolar bone augmentation, which may prevent or repair the detrimental periodontal dehiscence, holding significant potential in dentistry.
Osteogenesis/drug effects* ; Periosteum/cytology* ; Parathyroid Hormone-Related Protein/administration & dosage* ; Animals ; Focal Adhesion Protein-Tyrosine Kinases/metabolism* ; Alveolar Process/drug effects* ; Cell Proliferation/drug effects* ; Phosphorylation ; Rats ; Male ; Humans ; Focal Adhesion Kinase 1/metabolism* ; Cell Movement/drug effects*

OBJECTIVE To explore the mechanism of total flavonoids from stem and leaf of Scutellaria baicalensis in treating ulcerative colitis based on network pharmacology and animal experiments. METHODS The total flavonoids in stem and leaves of Scutellaria baicalensis were reviewed in literature, the corres ponding targets of total flavonoids in stem and leaves of Scutellaria baicalensis were retrieved by TCM systematic pharmacology database and analysis platform(TCMSP), and the related targets of ulcerative colitis were collected by GeneCards database. The corres ponding targets of total flavonoids from the stem and leaves of Scutellaria baicalensis and those related to ulcerative colitis were in put into Venny 2.1 mapping software to obtain the intersection targets, which were uploaded to STRING data platform for the construction of protein-protein interaction network. The gene ontology(GO) functions and the Kyoto encyclopedia of genes and genomes(KEGG) pathway enrichment were analyzed using the DAVID data platform jointly. The network pharmacological results were verified in a mouse model of ulcerative colitis induced by 3% DSS. RESULTS The results of network pharmacology showed that there were 69 related targets, 1383 related targets in ulcerative colitis and 24 overlapping targets in 7 components of total flavonoids from stem and leaves of Scutellaria baicalae. GO and KEGG pathway enrichment analysis were conducted to obtain the potential pathways of total flavonoids from stem and leaves of Scutellaria baicalensis in the treatment of ulcerative effects, including aryl hydrocarbon receptor(AhR), Th17 cell differentiation, T cell receptor, etc. The results of 3% DSS induced ulcerative colitis mouse model showed that compared with the model group, total flavonoids of scutellaria scutellaria stem and leaf significantly decreased the levels of MPO, TNF-α, IL-1β and IL-17 and increased levels of IL-10 and IL-22 with statistical difference, and restored the colon length of mice. Activated the AhR pathway and its CYP1A1 and CYP1B1 targets to promote the expression of anti-inflammatory factor IL-22, and repair the intestinal barrier by activating ZO-1 proteins. CONCLUSION Total flavonoids from stem and leaf of Scutellaria scutellaria can synergistically treat ulcerative colitis based on the characteristics of multi-component, multi-target and multi-pathway.

Objective To establish the drug use evaluation(DUE)criteria of recombinant human prourokinase(rhPro-UK),and to provide reference for the rational clinical application of rhPro-UK.Methods Based on the drug instructions of rhPro-UK,DUE standard rules were established by referring to relevant guidelines,expert consensus,authoritative literature and expert consultation.The medical records of hospitalized patients treated with rhPro-UK from January 2019 to May 2022 in Xilin Gol League Central Hospital were evaluated by retrospective investigation.The effectiveness of rhPro-UK was evaluated based on clinical outcome,and its safety was evaluated based on the incidence and severity of adverse reactions.Results A total of 230 cases were included,and 4 cases fully met the evaluation criteria(medication indication,medication process,medication results),accounting for 1.74％.There were 226 patients(98.26％)with irrational drug use,mainly manifested in two aspects of drug indication and drug process(administration mode and dosage).Treatment was effective in 221 patients,with an overall effective rate of 96.09％;139 patients experienced adverse reactions,with an incidence rate of 60.43％.Conclusion The clinical use of rhPro-UK in our hospital is irrational in the indication of medication and the process of medication,and the establishment of the DUE standard rules of rhPro-UK can provide a reference to standardize the clinical application of rhPro-UK and promote its rational use.

The biomolecular mechanisms that regulate tooth root development and odontoblast differentiation are poorly understood. We found that Atp6i deficient mice (Atp6i^-/-) arrested tooth root formation, indicated by truncated Hertwig's epithelial root sheath (HERS) progression. Furthermore, Atp6i deficiency significantly reduced the proliferation and differentiation of radicular odontogenic cells responsible for root formation. Atp6i^-/- mice had largely decreased expression of odontoblast differentiation marker gene expression profiles (Col1a1, Nfic, Dspp, and Osx) in the alveolar bone. Atp6i^-/- mice sample RNA-seq analysis results showed decreased expression levels of odontoblast markers. Additionally, there was a significant reduction in Smad2/3 activation, inhibiting transforming growth factor-β (TGF-β) signaling in Atp6i^-/- odontoblasts. Through treating pulp precursor cells with Atp6i^-/- or wild-type OC bone resorption-conditioned medium, we found the latter medium to promote odontoblast differentiation, as shown by increased odontoblast differentiation marker genes expression (Nfic, Dspp, Osx, and Runx2). This increased expression was significantly blocked by anti-TGF-β1 antibody neutralization, whereas odontoblast differentiation and Smad2/3 activation were significantly attenuated by Atp6i^-/- OC conditioned medium. Importantly, ectopic TGF-β1 partially rescued root development and root dentin deposition of Atp6i^-/- mice tooth germs were transplanted under mouse kidney capsules. Collectively, our novel data shows that the prevention of TGF-β1 release from the alveolar bone matrix due to OC dysfunction may lead to osteopetrosis-associated root formation via impaired radicular odontoblast differentiation. As such, this study uncovers TGF-β1 /Smad2/3 as a key signaling pathway regulating odontoblast differentiation and tooth root formation and may contribute to future therapeutic approaches to tooth root regeneration.
Female ; Animals ; Mice ; Transforming Growth Factor beta1 ; Odontoblasts ; Culture Media, Conditioned ; Cell Differentiation ; Signal Transduction ; Disease Models, Animal ; Tooth Root

Objective: To investigate the mediating role of psychological resilience in the relationship between family intimacy and adaptability and experiential avoidance among undergraduate nursing students (hereafter referred as nursing undergraduates). Methods: A total of 725 nursing undergraduates from six colleges in Guangdong Province were selected as the research subjects using convenience sampling method. The Acceptance Action Questionnaire-2nd Edition, Conner-Davidson Resilience Scale and Family Intimacy and Adaptability Scale were used to evaluate the experiential avoidance, psychological resilience, and family intimacy and adaptability, respectively. Results: The mean scores of experiential avoidance, psychological resilience and family intimacy and adaptability among nursing undergraduates were (23.4±7.7), (58.8±8.9) and (99.7±20.3), respectively. The results of the mediation analysis indicated that the total effect of family intimacy and adaptability on experiential avoidance was -0.16 (P<0.01), with a direct effect of -0.05 (P>0.05). Psychological resilience played a significant mediating role in the relationship between family intimacy and adaptability and experiential avoidance among nursing undergraduates (P<0.01). The standardized mediation effect was -0.11, accounting for 68.8% of the total effect. Conclusion: Resilience plays a mediating role between family intimacy and adaptability and experiential avoidance among nursing undergraduates.

Functional orthodontics is one of the most important methods in the treatment of skeletal class II malocclusion in adolescents. A deep understanding of the many factors affecting the effect of functional orthopedics can improve the efficiency of correction and achieve good results. In this paper, from the two aspects of patients and appliances, we analyzed the factors that affect the curative effect of class II malocclusion functional orthopedics and deeply analyzed the therapeutic mechanism of functional appliances to guide clinical treatment. The results of the literature review show that the peak period of growth and development is the best period for the treatment of skeletal Class II malocclusion. For patients with a vertical growth type, it is recommended to use a high head cap traction appliance to prevent the lower jaw from rotating backward and downward, and functional appliances such as titanium plates or implant nail-assisted anchorage can effectively reduce the lip inclination of the lower anterior teeth. In addition, compared with the traditional functional appliance, digital and personalized transparent braces are not only more aesthetically pleasing, comfortable and beneficial to periodontal health but also have many orthopedic appliances advantages, such as two-stage fusion, better incisor torque and vertical control of the posterior teeth, and can solve the problems of anterior interference and lateral deficiency while leading. With the development of digital orthodontics, transparent appliances have become an important developmental direction for functional appliances, but there are few related studies, and more clinical studies are needed to confirm their efficacy.

Objective: To explore the prenatal dietary and environmental risk factors in children aged 6-16 years with asthma (CWA) comorbid neuropsychiatric disorders. Methods: This cross-sectional study was conducted from March 2016 to March 2017.CWA aged 6 to 16 years were recruited as the study participants at the Outpatient Asthma Unit of Guizhou Provincial People′s Hospital, China.Informed consent was obtained from their parents, and their parents were invited to participate in the Mini International Neuropsychiatric Interview of children and adolescents (MINI Kid) to assess the current neuropsychiatric disorders.Meanwhile, the questionnaires information about prenatal diet and environment were collected from their mothers as well.Patients were divided into 2 groups, one group with asthma comorbid neuropsychiatric disorders and the other with asthma only.Single factor analysis and multivariate non-conditional Logistic regression analysis were used to determine the risk factors associated with neuropsychiatric comorbidity. Results: The study consisted of 261 patients (male: 163 cases, female: 98 cases) with asthma, with the age of (11.25±3.12) years, the rate of asthma comorbid neuropsychiatric disorders was 26.4% (69/261 cases). Single factor analysis showed that prenatal tobacco smoke exposure, winter coal combustion, food additives had statistically significant differences between the 2 group (χ²=7.385, 3.993, 4.529, all P<0.05), the other factors were not significantly different between two groups (all P>0.05); multivariate analysis indicated that prenatal tobacco smoke exposure was the independent risk factor for neuropsychiatric comorbidity in CWA (OR=5.098, 95%CI: 1.089-23.871, P=0.039). Conclusions The result revealed that the prenatal tobacco smoke exposure is the independent risk factor for neuropsychiatric comorbidity in CWA, need to enhance the propaganda and education of negative effects for parents should be enhanced during pregnancy to diminish the prevalence.

OBJECTIVE: This study was performed to validate the autonomous maximal smile (AMS) as a new reference for evaluating dental and gingival exposure. METHODS: Digital video clips of 100 volunteers showing posed smiles and AMS at different verbal directives were recorded for evaluation a total of three times at 1-week intervals. Lip-teeth relationship width (LTRW) and buccal corridor width (BCW) were measured. LTRW represented the vertical distance between the inferior border of the upper vermilion and the edge of the maxillary central incisors. Intraclass correlation coefficients (ICCs) for reproducibility, and the m-value (minimum number of repeated measurements required for an ICC level over 0.75), were calculated. RESULTS: LTRW and BCW of the AMS were 1.41 and 2.04 mm, respectively, greater than those of the posed smile (p < 0.05), indicating significantly larger dental and gingival exposure in the AMS. The reproducibility of the AMS (0.74 to 0.77) was excellent, and higher than that of the posed smile (0.62 to 0.65), which had fair-to-good reproducibility. Moreover, the m-value of the AMS (0.88 to 1.05) was lower than that of the posed smile (1.59 to 1.85). CONCLUSIONS: Compared to the posed smile, the AMS shows significantly larger LTRW and BCW, with significantly higher reproducibility. The AMS might serve as an adjunctive reference, in addition to the posed smile, in orthodontic and other dentomaxillofacial treatments.
Incisor ; Volunteers