The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

As an important part of TCM diagnosis,eye diagnosis is of great significance and value in identifying the symptoms of diseases and predicting the regression of diseases.With the progress of science and technology,the research on"syndrome differentiation by observing the eyes"is gradually converging towards digitalization,standardization and objectification.Based on the theoretical foundation of"syndrome differentiation by observing the eyes",this article reviewed the modern clinical applications of objectifying eye diagnosis from aspects such as observing the scleral vessels,observing fundus signs,and observing eye movement information,and found that modern technological means such as eye diagnostic instrument,eye movement instrument and artificial intelligence algorithms have provided accurate and objective diagnostic bases for TCM syndrome differentiation by observing the eyes to identify the syndrome and have greatly promoted the development of the objectification of eye diagnosis.However,the objective application of eye diagnosis still faces challenges related to technology,data and standardization,calling for further in-depth research and the establishment of unified standards.Exploring the current research status and strategies can provide theoretical references for the objectification of TCM eye diagnosis and the improvement of clinical visual diagnosis accuracy.

Objective:To investigate the diagnostic efficacy of time-dependent diffusion MRI (t d-dMRI)-derived microstructural parameters for clinically significant prostate cancer (csPCa) and their associations with the pathological grade of prostate cancer(PCa) based on the International Society of Urological Pathology (ISUP) grades. Methods:This cross-sectional study prospectively enrolled 196 patients suspected of PCa from March 2023 to March 2024 at the First Affiliated Hospital, Sun Yat-Sen University. All patients underwent multiparametric MRI and t d-dMRI to obtain microstructural parameters, including cell diameter (d), intracellular volume fraction (f in), extracellular diffusion coefficient (D ex), cellularity, and apparent diffusion coefficient (ADC) value at oscillation frequencies of 33 Hz, 17 Hz, 0 Hz (ADC 33, ADC 17, and ADC 0). Pathologically, 95 cases were classified as csPCa (ISUP 2-5), and the rest 101 cases were classified as non-csPCa (benign or ISUP 1). Comparison of these microstructural metrics was made between csPCa and non-csPCa groups by independent t-tests or Mann-Whitney U tests, and multivariable logistic regression was used to identify independent predictors. A combined diagnostic model was then constructed based on the independent predictors. The receiver operating characteristic curve analysis was used to evaluate the diagnostic performance. Finally, in PCa, the correlation between microstructural parameters and ISUP grades was investigated by Spearman correlation. Results:The t d-dMRI measurements, including d, f in, cellularity, ADC 33,ADC 17 and ADC 0, were significantly different between csPCa and non-csPCa groups (All P<0.05). But D ex was not significantly different between the two groups ( Z=-1.27, P=0.204). The area under the receiver operating characteristic curve (AUC) for diagnosing csPCa were 0.701 (95% CI 0.628-0.775) for d, 0.869 (95% CI 0.819-0.920) for f in, 0.884 (95% CI 0.835-0.932) for cellularity, 0.777 (95% CI 0.712-0.842) for ADC 33, 0.852 (95% CI 0.799-0.905) for ADC 17, and 0.840 (95% CI 0.786-0.894) for ADC 0. Cellularity ( OR=6.142, 95% CI 2.920-12.929, P<0.001) and ADC 17 ( OR=0.108, 95% CI 0.027-0.429, P=0.002) were identified as the independent predictors, and their combined model achieved an AUC of 0.896 (95% CI 0.852-0.941). In PCa f in and cellularity were positively correlated with ISUP grades ( r=0.490 and 0.397, P<0.001), while ADC 33, ADC 17, and ADC 0 were negatively correlated with ISUP grades ( r=-0.198, -0.345, -0.360; P=0.041,<0.001,<0.001). d and D ex were not correlated with ISUP grades ( P>0.05). Conclusion:t d-dMRI based microstructural mapping correlates with ISUP grades of PCa and may be useful for the differential diagnosis of csPCa.

Objective To investige clinicopathological features and prognostic factors in patients with isocitrate dehydrogenase(IDH)wild-type glioblastoma(GBM).Methods A total of 137 patients with GBM diagnosed by surgical pathology at the General Hospital of Ningxia Medical University from January 2014 to July 2024 were retrospectively enrolled in this study.Clinical data,including age,gender,ethnicity,presence of epilepsy,neurological function status and Karnofsky Performance Status(KPS)score prior to radiotherapy,were collected.Tumor-related parameters,such as extent of resection,histological classification,tumor location,maximum tumor diameter,IDH mutation status,Ki-67 proliferation index,methylation status of the O6-methylguanine-DNA methyltransferase(MGMT)promoter and postoperative treatment regimens—including concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were also recorded.Multivariate Cox proportional hazards regression analysis was conducted to identify independent prognostic factors.Kaplan-Meier survival curves were used to evaluate overall survival according to clinical characteristics.Results The median overall survival(OS)of the 137 GBM patients was 20.9 months,and their 1-year,2-year and 3-year survival rates were 79.7%,36.9%and 16.4%,respectively.Pre-radiotherapy KPS score,MGMT promoter methylation status,receipt of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were significantly associated with median survival of GBM patients(P＜0.05).Multivariate Cox analysis revealed that absence of MGMT promoter methylation,lack of postoperative concurrent chemoradiotherapy after surgery and the number of adjuvant chemotherapy cycles＜6 were independent risk factors for reduced survival in patients with GBM(P＜0.05).Patients with a pre-radiotherapy KPS score＜80,MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles＜6 demonstrated significantly lower cumulative overall survival rates compared to those with these characteristics(P＜0.05).Conclusion MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and adjuvant chemotherapy cycles<6 are independent risk factors affecting overall survival in patients with IDH wild-type GBM.

Objective To explore the influencing factors of health-related quality of life in patients after ileal ureteral replacement,and to provide a reference for formulating effective management plans.Methods Based on the conceptual model of health-related quality of life,16 patients who underwent ileal ureteral replacement in the Department of Urology of a tertiary A hospital in Beijing were selected for semi-structured interviews using descriptive research methods and purposive sampling method.The data were analyzed using directed content analysis.Results There are 6 themes and 10 sub-themes:symptom factors(distress of tube-related symptoms,distress of gastrointestinal symptoms);individual characteristics factors(obvious negative emotions,health behavior development);environmental factors(support from relatives and colleagues,lack of primary medical services);functional status factors(physical function rehabilitation,social function recovery);physiological function factors(test abnormal test index,risk of primary disease recurrence);general health perception factors.Conclusion The health-related quality of life of patients undergoing ileal ureteral replacement surgery was affected by symptoms,negative emotions,health behaviors,social support,functional status et al.In view of the above factors,medical staff should carry out effective evaluation and intervention in time,so as to improve the quality of life of patients.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

This study identified the types and pathogen carrying status of fleas on the surface of sheep in some areas of southern Xinjiang,and analyzed the genetic evolution differences with respect to related pathogens.The aim was to provide a reference for the local prevention and control of fleas and insect borne infectious diseases.A total of 1 586 fleas were collected from agricultural and pas-toral areas of Tumushuke City and Hotan Prefecture.Flea species were identified on the basis of morphology and the Pulex irritans mi-tochondrial COII gene.Flea DNA was extracted,and PCR was conducted to amplify the Bartonella gltA gene;Arsenophonus,Ana-plasma,Ehrlichia,and Wolbachia 16S rRNA genes;RickettsiaOmpA,17kDa,16S rRNA genes,and Yersinia pestis 16S rDNA gene.The amplified products were sequenced,and the homology of the genes of the three detected pathogens(gltA gene of Bartonella,16S rRNA gene of Wolbachia,and Anaplasma phagocytophilum)with respect to known corresponding genes of the same pathogen in Gen-Bank was analyzed.Phylogenetic trees were constructed with the adjacency method in MEGA 11.0.According to morphological and mo-lecular biology identification results,all fleas collected in this study were Pulex irritans.PCR indicated that the target gene fragments had been added to the mitochondrial COII,BartonellagltA,Wolbachia,and autophagosomal 16S rRNA genes of human fleas,all of which were consistent with the expected fragment sizes.Target bands were not amplified from Ehrlichia,Arsenophonus,spotted fever group Rickettsia,and Yersinia pestis.According to homology and genetic evolution analysis of human flea mitochondrial COII and the corresponding genes of the above-described pathogens,the COX2 gene(ON455234.1)of human fleas in Tumushuke city and Iran ob-tained in this study showed the highest homology(99.84%).The COII gene(NC_063709.1)of human fleas in Hetan City and Hunan region showed the highest homology(100%).Our findings further confirmed that the flea species was Pulex irritans.The PCR amplifi-cation results indicated that the collected Pulex irritans carried multiple pathogens,among which Bartonella and Wolbachia had the highest infection rates,and the infection rate with Anaplasma phagocytophilum was relatively low.This study is the first to discover flea species on the surface of sheep in some areas of southern Xinjiang.Our findings preliminarily confirmed that Bartonella,Wolba-chia,and Anaplasma phagocytophilum are the main Pulex irritans pathogens.

Objective To investige clinicopathological features and prognostic factors in patients with isocitrate dehydrogenase(IDH)wild-type glioblastoma(GBM).Methods A total of 137 patients with GBM diagnosed by surgical pathology at the General Hospital of Ningxia Medical University from January 2014 to July 2024 were retrospectively enrolled in this study.Clinical data,including age,gender,ethnicity,presence of epilepsy,neurological function status and Karnofsky Performance Status(KPS)score prior to radiotherapy,were collected.Tumor-related parameters,such as extent of resection,histological classification,tumor location,maximum tumor diameter,IDH mutation status,Ki-67 proliferation index,methylation status of the O6-methylguanine-DNA methyltransferase(MGMT)promoter and postoperative treatment regimens—including concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were also recorded.Multivariate Cox proportional hazards regression analysis was conducted to identify independent prognostic factors.Kaplan-Meier survival curves were used to evaluate overall survival according to clinical characteristics.Results The median overall survival(OS)of the 137 GBM patients was 20.9 months,and their 1-year,2-year and 3-year survival rates were 79.7%,36.9%and 16.4%,respectively.Pre-radiotherapy KPS score,MGMT promoter methylation status,receipt of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles were significantly associated with median survival of GBM patients(P＜0.05).Multivariate Cox analysis revealed that absence of MGMT promoter methylation,lack of postoperative concurrent chemoradiotherapy after surgery and the number of adjuvant chemotherapy cycles＜6 were independent risk factors for reduced survival in patients with GBM(P＜0.05).Patients with a pre-radiotherapy KPS score＜80,MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and the number of adjuvant chemotherapy cycles＜6 demonstrated significantly lower cumulative overall survival rates compared to those with these characteristics(P＜0.05).Conclusion MGMT promoter unmethylation,lack of postoperative concurrent chemoradiotherapy and adjuvant chemotherapy cycles<6 are independent risk factors affecting overall survival in patients with IDH wild-type GBM.