Cuproptosis and ferroptosis， two recently identified metal ion-dependent forms of cell death， are triggered by homeostasis dysregulation of intracellular copper and iron， as well as oxidative stress. They demonstrate considerable potential in anti-tumor therapy. Cuproptosis arises from mitochondrial dysfunction and proteotoxic stress caused by copper overload， while ferroptosis is driven by iron-dependent lipid peroxidation. Although traditional Chinese medicine （TCM） exhibits regulatory effects on cuproptosis and ferroptosis， its clinical application is hindered by poor solubility and low bioavailability. Through physical nanonization or carrier-based delivery technologies adopted by nano-TCM， the targeting specificity， stability， and bioavailability of drugs are significantly improved. By integrating sustained-release and controlled-release properties， metal ion homeostasis and redox balance in the tumor microenvironment （TME） can be precisely modulated. Research demonstrates that nano-TCM， such as celastrol-copper nanocomplexes （Cel-Cu NPs）， induces cuproptosis by augmenting intracellular copper accumulation and suppressing glutathione （GSH） levels. Nano-systems encapsulating camptothecin or artemisinin trigger ferroptosis via Fenton reaction and GSH depletion. Synergistic strategies of nano-materials， including ferrum-based metal-organic frameworks （Fe-MOFs） combined with piperlongumine， further amplify antitumor efficacy. Despite advancements in targeting cuproptosis and ferroptosis， challenges persist in nano-TCM development， including complex fabrication processes， suboptimal dosage optimization， and insufficient integration with the holistic principles of TCM. Future research should focus on exploring the interaction between cuproptosis and ferroptosis， developing multi-targeted nanodelivery systems， and fostering deeper integration of TCM theory with nanomedicine to advance novel therapeutic strategies for oncology.

Cuproptosis and ferroptosis， two recently identified metal ion-dependent forms of cell death， are triggered by homeostasis dysregulation of intracellular copper and iron， as well as oxidative stress. They demonstrate considerable potential in anti-tumor therapy. Cuproptosis arises from mitochondrial dysfunction and proteotoxic stress caused by copper overload， while ferroptosis is driven by iron-dependent lipid peroxidation. Although traditional Chinese medicine （TCM） exhibits regulatory effects on cuproptosis and ferroptosis， its clinical application is hindered by poor solubility and low bioavailability. Through physical nanonization or carrier-based delivery technologies adopted by nano-TCM， the targeting specificity， stability， and bioavailability of drugs are significantly improved. By integrating sustained-release and controlled-release properties， metal ion homeostasis and redox balance in the tumor microenvironment （TME） can be precisely modulated. Research demonstrates that nano-TCM， such as celastrol-copper nanocomplexes （Cel-Cu NPs）， induces cuproptosis by augmenting intracellular copper accumulation and suppressing glutathione （GSH） levels. Nano-systems encapsulating camptothecin or artemisinin trigger ferroptosis via Fenton reaction and GSH depletion. Synergistic strategies of nano-materials， including ferrum-based metal-organic frameworks （Fe-MOFs） combined with piperlongumine， further amplify antitumor efficacy. Despite advancements in targeting cuproptosis and ferroptosis， challenges persist in nano-TCM development， including complex fabrication processes， suboptimal dosage optimization， and insufficient integration with the holistic principles of TCM. Future research should focus on exploring the interaction between cuproptosis and ferroptosis， developing multi-targeted nanodelivery systems， and fostering deeper integration of TCM theory with nanomedicine to advance novel therapeutic strategies for oncology.

OBJECTIVE To provide a reference for optimizing the market access process for over-the-counter drugs （OTC） in China. METHODS Based on literature review， questionnaire survey was designed and distributed via the Wenjuanxing platform to respondents from pharmaceutical enterprises， drug regulatory agencies， industry associations， medical institutions and universities. The collected survey data were then subjected to statistical analysis. RESULTS A total of 154 questionnaires were collected， all of which were valid. Among the respondents， 58.5% were from pharmaceutical enterprises， 18.8% were from the field of drug regulation， and the remaining 22.7% were from universities and medical institutions. More than half of the respondents had been working for 10 years or more. A total of 89.6% of the respondents called for the establishment of an independent review system for OTC. Additionally， 88.3% believed it was necessary to establish an OTC monograph system based on China’s national conditions. Meanwhile， 73.4% of respondents believed it was necessary to standardize the monograph inclusion procedures and processes， while 77.3% thought the specific process for switching prescription drugs to OTC status should be improved. Furthermore， 91.0% of the respondents considered that real-world data/evidence could contribute to simplifying the OTC market approval pathway， although challenges related to data quality and data accessibility were acknowledged. CONCLUSIONS The review cycle for China’s OTC market access mechanism is relatively long. A localized adaptation and optimization path of “institutional reconstruction-technological innovation-regulatory innovation” in a trinity is proposed to provide a decision-making basis for establishing a scientific and efficient OTC regulatory system with international experience serving as a reference.

BACKGROUND:Gingival thickness is an important indicator to determine gingival phenotype.The correct evaluation of gingival phenotype is helpful for the smooth going of periodontal surgery,implant implantation and orthodontic treatment.The search for a comfortable,accurate and convenient method of measuring gingival thickness has always been a research hotspot in this field. OBJECTIVE:To analyze the gingival thickness in different dental positions and to study the consistency of cone-beam computed tomography(CBCT)image and digital intraoral scanners and cone-beam computed tomography(DIS-CBCT)superimposition image for measuring gingival thickness and determining whether the gingiva is thick or thin. METHODS:Twenty volunteers(10 males and 10 females)with complete maxillary dentition were recruited.The thickness of the gingiva 2 mm below the buccal gingival margin of 160 teeth was measured by CBCT image and DIS-CBCT digital superimposition image.Gingival thickness was used to determine whether the gingiva was thick or thin.Paired t-test was used to analyze the differences in gingival thickness measured by the two methods.Pearson correlation analysis was used to evaluate the correlation between the gingival thickness results of the two methods.The intraclass correlation coefficient(ICC)and Bland-AItman chart were used to analyze the repeatability and consistency in measuring gingival thickness using the two methods.Kappa value was used to analyze the consistency in determining whether the gingiva was thick or thin using the two methods. RESULTS AND CONCLUSION:The gingival thickness measured by CBCT image and DIS-CBCT digital superimposition image was(1.47±0.39)and(1.42±0.36)mm,respectively(t=5.673,P＜0.05).Pearson correlation analysis showed that the gingival thickness measured by the two methods was positively correlated(r=0.968,P＜0.001).In the CBCT group,the values of intraobserver and interobserver ICC were 0.980-0.982 and 0.984,respectively;in the DIS-CBCT group,the values of intraobserver and interobserver ICC were 0.941-0.984 and 0.964,respectively(P＜0.001).The intergroup ICC value of gingival thickness measured by the two methods was 0.967(P＜0.001).Bland-AItman analysis showed that 4.37%(7/160)of the points measured by both methods for gingival thickness was outside the 95%limits of agreement.There were 71 cases of thick-gingiva and 89 cases of thin-gingiva measured by CBCT imaging,and 59 cases of thick-gingiva and 101 cases of thin-gingiva measured by DIS-CBCT digital superimposition image.The Kappa value of the two groups was 0.845(P＜0.001).These findings indicate that there is a significant difference in the thickness measurement of the gingiva 2 mm below the gingival margin between the CBCT group and the DIS-CBCT group,but the correlation is very strong.The repeatability and consistency of gingival thickness measurement are both high,and there is a good consistency between the two methods when used to determine whether the gingiva is thick or thin.

Background In recent years, radiation diagnosis and treatment technology has been increasingly applied and popularized in the medical field, and the status of radiation health protection has attracted widespread attention. Objective To understand the knowledge, attitude, and behavior of radiological health protection in radiation workers in Jiading District of Shanghai. Methods Convenience sampling method was used to select 441 radiation workers from 33 medical institutions in Jiading District, Shanghai to conduct a questionnaire survey from May to August 2023. Basic information and radiation protection associated knowledge, attitude, and behavior were collected from the study participants, and the scores of knowledge, attitude, and behavior were calculated. Factors affecting the behavior were evaluated by multiple linear regression. Results A total of 441 subjects were included in this study, with an age range of 22-71 years, 53.06% male and 46.94% female. In terms of knowledge, the correct response rate of the study subjects to the seven questions on the basics of radiation protection ranged from 44.22%-96.60%, with the lowest rate of 44.22% for the question on "radiation stochastic effect diseases". The subjects acquired knowledge about radiation hygiene mainly through vocational training (98.41%), and wanted to acquire knowledge mainly about the basics of nuclear and radiation (76.42%). In terms of attitude, the recognition level (strongly agree/agree) of the study subjects on the six attitude questions ranged from 73.47% to 96.37%, in which only 56.92% of the radiological staff at tertiary hospitals believed that the radiation dose they were exposed to at work would be hazardous to their health, and 73.85% believed that it was necessary to participate in training on knowledge of radiological protection, both lower than those in other levels of hospitals. In terms of behavior, the implementation rate (always/often) of the five behavioral questions by the study participants ranged from 75.28% to 91.84%, and there was a statistically significant difference in the total behavioral scores of the study participants by levels of hospitals (P=0.015). The results of multiple linear regression showed that gender, age, and radiation work permit associated with the behavioral scores of the study subjects. Conclusion In Jiading District, Shanghai, the coginitive rate of radiation workers' basic knowledge of theoretical protection still needs to be improved, and occupational training should be carried out in a targeted manner; the attitude of radiation workers varies by levels of hospitals, and the publicity and education of workers at tertiary hospitals in particular should be strengthened; and the supervision and management of male, senior, and non-certified radiation workers in hospitals of different levels should be enhanced.

Objective:To study the alveolar bone remodeling of maxillary anterior teeth after extraction treatment and 2-year recovery period in adolescent patients with maxillary anterior arch protrusion.Methods:15 adolescent patients with maxillary anterior arch protru-sion were included,2 maxillary first premolars were extracted and implant anchorage combined with sliding method were used to close the extraction gap.CBCT images were taken before treatment(T0),after treatment(T1)and 2 years of recorvery period(T2),respectively.After multi-plane reconstruction with Dophin Imaging,the alveolar bone area(ABA)changes of maxillary central incisor,lateral incisor and canine at cementoenamel junction(CEJ-3 mm),root neck,central part,and root tip were measured and recorded as TAC,TA1,TA2 and TA3 respectively.The labial palatal alveolar crest to CEJ bone height(BH)of each tooth was recorded as BCL,BCP respectively.The data were analyzed by IBM SPSS statistics 25.0.Results:In T0-T2 phase,TA1 of each tooth was reduced.In T0-T1 phase,the horizontal adsorption of teeth was significantly correlated with ΔBCP,followed by ΔTA3.In T0-T2 phase,ΔBCP,ΔTA2,ΔTA3 and the horizontal adsorption of teeth showed low negative correlation.In T0-T1 phase,the vertical reduction of teeth was significantly positively correlated with ΔTAC,followed by low correlation with ΔTA3 and ΔTA1.Conclusion:In the treatment of anterior arch protrusion after extraction correction in adolescent patients the more the vertical reduction and horizontal adsorption of teeth in the treatment phase,the more the alveolar bone thickness and height around the tooth root in the maintenance phase,which were significantly positively correlated.Reasonable control of the vertical move-ment of teeth in the alveolar bone can improve the periodontal condition around the teeth to a certain extent.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To assess the mediating effects of obesity and metabolic factors in the relationship between hyperuricemia (HUA) and prehypertension.Methods:A total of 9 399 individuals were selected using a multistage stratified whole-group random sampling method from 90 villages (neighborhood committees) in 30 towns (streets) of 5 districts (counties) in Fuzhou. A total of 4 754 study subjects were included. A linear regression model was used to analyze the association of HUA with obesity and metabolic factors. Single-factor and multi-factor logistic regression models were used to analyze the association of HUA, obesity, and metabolic factors with prehypertension. Mediating effects models were used to analyze the mediating effects of obesity and metabolic factors on the association between HUA and prehypertension.Results:After adjusting for confounders, the association between HUA and cholesterol, triglycerides, HDL-C, LDL-C, BMI, waist circumference, creatinine, and urea nitrogen were significantly correlated ( P<0.001). HUA, waist circumference, BMI, and triglycerides were significantly associated with prehypertension ( P<0.001). Waist circumference, BMI, and triglycerides mediated the relationship between HUA and prehypertension, with OR (95% CI) of 1.018 (1.007-1.027), 1.010 (1.002-1.018), and 1.010 (1.003-1.017) ( P<0.001), with mediating proportions of 7.76%, 4.31%, and 4.31% respectively. No mediating effect of cholesterol, HDL-C, LDL-C, creatinine, and urea nitrogen was found on the relationship ( P>0.05). Conclusions:Waist circumference, BMI, and triglycerides all had mediating effects in the association between HUA and prehypertension. For the general population, weight control, waist circumference, and a high-fat diet should be used to reduce the occurrence of prehypertension.

Proteins in the human body are usually made of 20 natural amino acids.Through different amino acid combinations and isomerization, proteins of diverse functions are built.An emerging genetic code expansion technology can introduce unnatural amino acids into specific sites of target protein, endowing the protein with new biological characteristics including covalently binding with proximal proteins, carrying fluorescence, and mimicking specific protein post-translational modifications.In this paper, based on the structure and function of unnatural amino acids, the applications of different types of unnatural amino acids in regulating protein''s stability, studying protein''s conformation, expression level, and localization, and uncovering heretofore unknown protein-protein interactions were reviewed.Besides, genetic code expansion of unnatural amino acids is anticipated to find broad utilities in biomedicine by bringing new ideas and methods to the design and optimization of biologics.

Objective:To explore the necessity and feasibility of introducing the courses of dental practice management in the undergraduate education of stomatology under the background of the undergraduate entrepreneurship education reform.Methods:In the School of Stomatology of Zhejiang Chinese Medical University, the entrepreneurial course dental practice management was set-up for the junior undergraduate students. CBL, PBL, teacher's lecture, student's lecture on the stage and PPT demonstration, role-play, and team cooperation were taken in the course. And the questionnaires were used to investigate the course setting, necessity, teaching forms and satisfaction from multiple groups. SPSS was performed for data analysis, and the teaching effect was evaluated through the data results.Results:The scores of 108 students in the study [(75.99±5.76) points] were roughly distributed as normal functions. The results of the survey showed that the number of students who planned to have their own private clinics after the course increased by 41 (37.96%) compared with that before the course. All instructors and 33 (78.57%) active dentists thought that the course was reasonable in the undergraduate courses.Conclusion:It is necessary and feasible to introduce the dental practice management course in undergraduate education of stomatology, which will have a certain guiding effect on the long-term development of dentists, and is also beneficial to the reform of innovation and entrepreneurship courses in medical universities.