Objective To investigate the prevalence and influencing factors of thyroid enlargement in school-age children in Tianjin. Methods School-age children were randomly selected in Tianjin to undergo thyroid ultrasound examination, and salt iodine, urine iodine, height, and weight tests. A questionnaire survey was conducted. Univariate and multivariate regression models were used to analyze the risk factors for thyroid enlargement. Results A total of 917 children aged 7-13 years in Tianjin were surveyed, with a thyroid enlargement rate of 4.03% and a median thyroid volume of 2.60 ml. There was a non-linear relationship between children's body mass index (BMI) and the incidence of thyroid enlargement in children (P=0.008), and a linear relationship between children's body surface area (BSA) and the incidence of thyroid enlargement in children (P<0.001). Being 9 years old (OR=3.728, 95%CI: 1.343-10.343, P=0.012), obesity (OR=3.886, 95%CI: 1.801-8.384, P=0.001), having lunch at school (OR=3.157, 95%CI: 1.497-6.658, P=0.003) and frequent consumption of preserved foods (OR=4.611, 95%CI: 1.643-12.945, P=0.004) were risk factors for goiter in children. Regular consumption of seaweed (OR=0.305, 95%CI: 0.100-0.927, P=0.036) was a protective factor for goiter in children. Conclusion The incidence of thyroid enlargement in children in Tianjin meets national standards. Obesity, eating lunch at school, frequently consuming pickled foods, and being 9 years old may be risk factors for thyroid enlargement in children. Eating seaweed or kelp regularly is a protective factor. At the same time, attention should be paid to the relationship between BMI, BSA, and thyroid enlargement rate in children..

Objective To explore the association between different levels of fluoride exposure and dyslipidemia in elderly people, and to analyze the influencing factors and their interactions. Methods A total of 1 143 elderly people over 60 years old were randomly selected from historical high water fluorosis areas and control areas in Tianjin. Logistic regression model and classification tree model were used to analyze the influencing factors of dyslipidemia, and to analyze the interaction between high fluoride exposure and relevant influencing factors on dyslipidemia. Results The prevalence of elevated low density lipoprotein cholesterol (LDL-C) was 5.69% (65/1 143). There was a significant difference in the prevalence of high LDL-C in different fluoride-exposed areas (2 = 0.092，P = 0.762). Multivariate logistic analysis showed that high fluoride exposure (OR=2.306，95%CI：1.185-4.491) and abdominal obesity (OR=2.274，95%CI：1.299-3.978) were risk factors for high LDL-C, while type B personality (OR=0.529，95%CI：0.308-0.908) was a protective factor for high LDL-C. The results of classification tree model showed that abdominal obesity contributed the most to the prevalence of high LDL-C in the elderly, followed by high fluoride exposure and hyperglycemia. There was a significant multiplicative interaction between high fluoride exposure and abdominal obesity on dyslipidemia (OR=5.191,95%CI：1.609-16.745，P=0.006). Conclusion High fluoride exposure may increase the risk of high LDL-C, and there is a multiplicative interaction between high fluoride exposure and abdominal obesity on dyslipidemia.

Objective　To analyze the monitoring data of SARS-CoV-2 variants from local cases in Hainan Province between January 2023 and March 2024, and to understand the predominant variants epidemic situation and population characteristics of SARS-CoV-2 in Hainan Province, providing scientific guidance for the prevention and control strategies formulation, early warning of the risk of SARS-CoV-2 infection. Methods　The variation surveillance data submitted by five sentinel monitoring hospitals in Hainan Province from January 2023 to March 2024 were collected, and general descriptive analysis was conducted on the dynamic epidemic trend of the dominant clade, population characteristics, and disease severity. Results　From January 2023 to March 2024, a total of 2 600 local cases clade information in Hainan Province were collected, all of which were Omicron variant strains involving 115 evolutionary branches. The three phases identified include: the co-dominance of BA.5.2.48 and BF.7 from the first week of 2023 to the 13th week of 2024; the prevalence of XBB and its subclades from the 16th to the 52nd week of 2023; and the predominance of BA.2.86 and its subclades from the first to the 13th week of 2024, with Omicron BA.2.75 causing small-scale sporadic outbreaks. Among all the age groups of branch infection cases, individuals aged >18~60 years constituted the largest group, while those under 4 years were the smallest, with no significant gender differences. The severity of the clinical disease was mainly asymptomatic and mild. Conclusions　Different dominant evolutionary clades of SARS-CoV-2 showed sequential replacement characteristics, and the clinical severity of illnesses has gradually decreased. In the future, the focus should be on individuals aged >60 years and above and those aged >18~60 years with underlying conditions, along with continuous enhancement of variant monitoring and analysis. This will ensure a timely understanding of the dynamic epidemic trend of dominant evolutionary clades in time, and focus on the immunogenicity of the new variant branch and changes in immunogenicity and vaccine protection of new variant clades, providing scientific guidance for the vaccine research, clinical treatment, and immunization strategy formulation.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Neck rejuvenation technique continue to expand and evolve, this article reviews the principle and effect of various non-operative treatment of neck wrinkles in recent years, which includes botulinum toxin injection, hyaluronic acid injection, radiofrequency technology, high-intensity focused ultrasound, laser and combined therapy. This article can provide more options for plastic surgeons.

Objective:To explore the spectrum of genetic variants and phenotypes of Phenylalanine hydroxylase deficiency (PAHD) in Lianyungang area and the correlation between genotype and phenotypes among the patients.Methods:Eighty children with Hyperphenylalaninemia (HPA) diagnosed at the Lianyungang Branch of Jiangsu Provincial Newborn Screening Center between January 2015 and December 2022 were enrolled. Peripheral blood samples were collected for genetic analysis using next generation sequencing (NGS), Sanger sequencing, and multiplex ligation-dependent probe amplification (MLPA) to identify the variants of PAH gene. Clinical and phenotypic data were concurrently analyzed to investigate the correlation between the types of PAH gene variant and phenotypes. This study was approved by the Medical Ethics Committee of Lianyungang Maternal and Child Health Care Hospital (Ethics No.: XM2022041). Results:① PAH variants were identified in 93.75% (75/80) of the children, classified as PAHD cases, while 6.25% (5/80) harbored PTS variants. ② Of the 150 PAH alleles from 75 PAHD children, a total of 152 variants (55 distinct types) were detected, with a detection rate of 100%. 80.26% (122/152) were located in exons, with the main types of variants were missense variants (67.11%, 102/152). 53.29% (81/152) of coding sequence variants occurred in the PAH gene catalytic center region of PAH protein, while 19.74% (30/152) of variants involved non-coding sequences. ③The phenotypes of the 75 PAHD children were evenly distributed. The rescreening Phe concentrations and Phe/Tyr ratios of classic-phenylketonuria (CPKU) and mild-phenylketonuria (MPKU) patients were markedly higher than initial screening values ( P<0.001, P<0.001; P=0.004, P=0.016). The genotypes of the PAHD patients mostly occurred as compound heterozygotes, and different mutation positions and variant types significantly affect the phenotype ( P=0.042, P=0.045). ④APV/GPV genotype-phenotype analysis of 61 patients showed high consistency between predicted and actual phenotypes ( κ=0.755, P<0.001). Conclusion:PAH variants were detected in the most of HPA children in Lianyungang area. The location and type of PAH variants were related to the severity of the phenotype, and the non-coding sequence variants and non-missense variants may aggravate the phenotype, and the APV/GPV model predicted the phenotype was highly consistent with the actual phenotype.

Objective:To investigate the main influencing factors of mild cognitive impairment(MCI)in the elderly and explore the interaction between high fluoride exposure and related co-factors on MCI.Methods:A cross-sectional study was conducted from May to December 2024 in four towns in the rural areas of Tianjin(two historically high-fluoride towns and two non-high-fluoride towns). A total of 125 elderly people aged 60 years and above were randomly selected from each township.MCI was diagnosed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment-Basic(MoCA-B)according to the diagnostic criteria for MCI.Binary logistic regression was used to analyze the influencing factors of MCI, and conditional logistic regression was employed to assess multiplicative and additive interaction effects.Results:A total of 481 participants were included, with 354 in the normal group and 127 in the MCI group, and the incidence of MCI was 26.40%.Univariate analysis showed that MCI was associated with age, annual household income per capita, high fluoride exposure, life stress, depression, and abnormal urinalysis( χ2=4.241, 4.017, 4.552, 7.143, 4.151, 5.113, all P<0.05). Multivariate logistic regression revealed that after adjusting for other confounders, high fluoride exposure( OR=1.816, 95% CI: 1.177-2.802), age ≥70 years( OR=1.584, 95% CI: 1.034-2.428), depression( OR=2.106, 95% CI: 1.042-4.254), and abnormal urinalysis( OR=1.595, 95% CI: 1.041-2.444)increased the risk of MCI.Compared with severe life stress, moderate stress( OR=0.254, 95% CI: 0.082-0.790)reduced the risk of MCI.No multiplicative or additive interaction was found between high fluoride exposure and depression, life stress, or abnormal urinalysis. Conclusions:High fluoride exposure, age ≥70 years, depression, abnormal urinalysis, and severe life stress may increase the risk of MCI in the elderly, but there is no interaction among them.

Objective:To observe the effects of palmitic acid(PA)and static pressure on the expression of receptor activator of NF-κB ligand(RANKL)and osteoprotegerin(OPG)in human periodontal ligament cells(HPDLCs)cultured from the subjects of differ-ent ages.Methods:The effects of PA with the dose(μmol/L)of 10,100,200,250,300,400 and 500 respectively on the prolif-erative activity of HPDLCs cultured in vitro from the subjects aged 12-45 years were determined by CCK-8 method.200 μmol/L PA was selected to treat HPDLCs,and the static pressure of 200 Pa was applied in the in vitro culture.Under different conditions(PA group,static pressure group,PA+static pressure group and blank control group),The expression of RANKL and OPG in HPDLCs was determined by ELISA before and after the treatment at 3,6,12,24,36,48 and 72 h respectively,and the OPG/RANKL ratio was calculated.Results:PA inhibited the proliferation of HPDLCs of all ages(P＜0.05),and the proliferation activity of HPDLCs decreased gradually with the increase of PA concentration,patient age and treatment time.Under static pressure,PA up-regulated the expression of RANKL protein,down-regulated the expression of OPG protein and the ratio of OPG/RANKL(P＜0.05),but RANKL protein expression decreased and OPG protein expression and the ratio of OPG/RANKL increased with age.Conclusion:Combined treatment of PA and static pressure can synergistically promote remodeling of periodontal bone.The expressions of RANKL and OPG is closely related to age of the subjects.

Peri-implantitis is a pathologic condition associated with dental plaque that occurs in the implant tissue and is characterized by inflammation of the mucous membrane surrounding the implant, followed by the progressive loss of supporting bone. In this study, a case of guided bone regeneration therapy based on plaque control of peri-implant inflammation was reported. Four years after surgery for the left second premolar implant, the patient presented with "left lower posterior tooth swelling and discomfort for more than 2 years". The X-ray periapical film showed a decrease in distal bone mineral density of implant, and the clinical diagnosis was peri-implantitis of the left second premolar. Implants underwent guided bone regeneration and regular periodontal maintenance treatment. Re-examination at 3.5 months, 11 months, 18 months, and 7 years showed that the alveolar bone height and bone mineral density were stable, and the periodontal depth became shallow. However, the gingival recession was mild. In the present case, follow-up at 7 years demonstrated that the clinical periodontal indexes could be remarkably improved after complete periodontal treatment for peri-implantitis, and the alveolar bone could be well restored and regenerated.
Humans ; Peri-Implantitis/etiology* ; Follow-Up Studies ; Bone Regeneration ; Guided Tissue Regeneration, Periodontal/methods* ; Dental Plaque/prevention & control* ; Male ; Female ; Dental Implants/adverse effects*

Objective: To understand the dose response relationship between urinary fluoride and dental fluorosis among children from drinking water borne endemic fluorosis areas in Tianjin, so as to provide a scientific basis for assessing fluoride exposure risk among children from endemic areas and establishing reference values for urinary fluoride. Methods: From January to December 2024, 83 endemic villages were selected in Tianjin. A total of 2 382 children aged 8-12 years from these villages underwent dental fluorosis examination, along with water fluoride and urinary fluoride testing. Additionally, data from areas where the drinking water fluorosis control target was achieved for more than 12 years (10 villages, 50 people per village) were included as controls. A restricted cubic spline model was used to analyze the relationship between urinary fluoride levels and dental fluorosis prevalence, and benchmark dose (BMD) and benchmark dose lower bound (BMDL), as well as reference dose (RfD), were calculated using the benchmark dose method. Results: The prevalence rates of dental fluorosis among children in drinking water borne endemic fluorosis areas and areas of normal fluoride content in water in Tianjin were 10.58%, 7.60%, with a geometric mean urinary fluoride level of 0.72 and 0.60 mg/L,respectively. There were statistically significant differences in both dental fluorosis prevalence and geometric mean urinary fluoride levels between the drinking water borne endemic fluorosis areas group and the areas of normal fluoride content in water ( χ 2/Z = 4.05 , -7.31, both P <0.05). Across different periods of water source improvement, there were statistically significant differences in overall population, male, and female dental fluorosis prevalence rates and geometric mean urinary fluoride levels ( χ 2/H =44.95, 23.96, 21.05; 168.39, 63.93, 107.50, all P <0.01). Significant differences were also observed across age groups among children from drinking water borne endemic fluorosis areas in terms of dental fluorosis prevalence and geometric mean urinary fluoride levels ( χ 2/H =32.14, 79.73, both P <0.01). The results of the restricted cubic spline model showed that the risk of dental fluorosis in different sex, age and overall children in the drinking water borne endemic fluorosis areas increased significantly with rising urinary fluoride concentration(all P-general trend <0.05). The BMD value for the drinking water borne endemic fluorosis areas was 1.72 mg/L, the BMDL was 1.31 mg/L, and the RfD was 1.31 mg/L. Conclusions The prevalence of dental fluorosis among children in the drinking water borne endemic fluorosis areas in Tianjin has been effectively controlled, but it is still higher than that in the areas of normal fluoride content in water. Moreover, urinary fluoride levels and dental fluorosis prevalence among children from drinking water borne endemic fluorosis areas show a clear dose response relationship.