In modern society, sugary foods have become an integral part of many people′s lives. However, excessive sugar consumption has adverse effects on both overall health and oral health, serving as a contributing factor to the global increasing incidence in oral diseases, cardiovascular diseases, cancers, obesity, and diabetes. In response to the health risks related to high-sugar diets, the World Health Organization (WHO) and World Dental Federation (FDI) have proposed initiatives and recommendations, with various governments implementing different policies and strategies to reduce sugar intake. Chinese government has also taken proactive measures. The "Healthy China Action (2019-2030)" initiative introduced by the State Council in 2019 established a crucial benchmark in limiting the average daily intake of added sugar to 25 g per person forward to 2030. Experts from Chinese Center for Disease Control and Prevention and the field of oral health have meticulously examined the impacts of sugar reduction on oral health, as well as strategies, methods, and practical considerations related to reducing sugar intake through several meeting and wrote the "Expert consensus: reducing free-sugar for caries prevention", which was subsequently reviewed and revised based on the feedback from multiple stakeholders. They have conducted thorough analyses of global trends in sugar reduction and best practices to provide valuable insights to China for crafting effective policies and strategies on sugar reduction. This consensus mainly includes the classification of free sugars, the latest scientific evidence on dental caries, recommendations from WHO on sugar-sweetened beverage taxes, nutrition labeling, advertising, food reform, adjusting supply systems, education, and promotion strategies, as well as sugar reduction actions taken by various governments around the world. Combining the actual situation in China, policy recommendations and authoritative popular science knowledge on sugar reduction for caries prevention to public are proposed to advocate for experts in multiple fields to focus on sugar reduction for caries prevention, promote the work process, and provide the scientific basis for oral health educators.

In modern society, sugary foods have become an integral part of many people′s lives. However, excessive sugar consumption has adverse effects on both overall health and oral health, serving as a contributing factor to the global increasing incidence in oral diseases, cardiovascular diseases, cancers, obesity, and diabetes. In response to the health risks related to high-sugar diets, the World Health Organization (WHO) and World Dental Federation (FDI) have proposed initiatives and recommendations, with various governments implementing different policies and strategies to reduce sugar intake. Chinese government has also taken proactive measures. The "Healthy China Action (2019-2030)" initiative introduced by the State Council in 2019 established a crucial benchmark in limiting the average daily intake of added sugar to 25 g per person forward to 2030. Experts from Chinese Center for Disease Control and Prevention and the field of oral health have meticulously examined the impacts of sugar reduction on oral health, as well as strategies, methods, and practical considerations related to reducing sugar intake through several meeting and wrote the "Expert consensus: reducing free-sugar for caries prevention", which was subsequently reviewed and revised based on the feedback from multiple stakeholders. They have conducted thorough analyses of global trends in sugar reduction and best practices to provide valuable insights to China for crafting effective policies and strategies on sugar reduction. This consensus mainly includes the classification of free sugars, the latest scientific evidence on dental caries, recommendations from WHO on sugar-sweetened beverage taxes, nutrition labeling, advertising, food reform, adjusting supply systems, education, and promotion strategies, as well as sugar reduction actions taken by various governments around the world. Combining the actual situation in China, policy recommendations and authoritative popular science knowledge on sugar reduction for caries prevention to public are proposed to advocate for experts in multiple fields to focus on sugar reduction for caries prevention, promote the work process, and provide the scientific basis for oral health educators.

Objective To investigate the effects of dexmedetomidine(0.5,1.0,2.0 μg/kg)combined with ropivacaine ultrasound guided thoracic paravertebral nerve block(TPVB)in patients undergoing thoracoscopic surgery under general anesthesia on the vital signs,stress response and other indexes,and to provide reference for the optimization of anesthesia regimen in the clinic.Methods A total of 99 cases of patients undergoing thoracoscopic surgery under general anesthesia were selected,and the patients were divided into the low,medium,and high-dose groups of 33 cases each according to the method of randomized numerical table.At the end of anesthesia induction,dexmedetomidine 0.5,1.0,and 2.0 μg/kg compounded with 0.375%ropivacaine ultrasound-guided TPVB was administered to the low,medium,and high-dose groups,respectively,and all three groups were observed until 3 d postoperatively.Perioperative indicators,quality of awakening,degree of pain at 2,6,12,and 24 h postoperatively,vital signs before anesthesia(T1),at tracheal extubation(T2),and at 5 min of tracheal extu-bation(T3),and immune function,stress response,and adverse reactions during the observation time were com-pared between the groups.Results Compared with the low-dose group,remifentanil and propofol dosages were lower in the medium-and high-dose groups,and the number of postoperative self-controlled analgesia was lower(P＜0.05).Awakening,tracheal extubation,and recovery room stay were prolonged between the low,medium,and high dose groups(P＜0.05).Scores of visual analog scale(VAS)were progressively lower in the three groups at 2,6,12,and 24 h postoperatively(P＜0.05),and compared with the low-dose group,scores of VAS were lower in the medium and high-dose groups at 2,6,and 12 h postoperatively(P＜0.05).Compared with T1,heart rate(HR),mean arterial pressure(MAP)were higher in all three groups at T2,T3,and HR,MAP at T2,T3 were higher between the low,medium,and high dose groups(P＜0.05);compared with T2,HR,MAP were lower in all three groups at T3(P＜0.05).Compared with the preoperative period,levels of whole blood CD8+,serum cortisol(Cor),C-reactive protein(CRP),norepinephrine(NE),and epinephrine(E)were increased in the three groups at 3 d postoperatively,and the above indexes were elevated between the low,medium,and high dosage groups at 3 d postoperatively(P＜0.05);levels of whole blood CD3+,CD4+,CD4+/CD8+were decreased in the three groups at 3 d postoperatively,and the above indexes were elevated between the low,medium,and high dosage groups at 3 d postoperatively(P＜0.05).There was no statistically significant difference in the safety com-parison among the three groups(P＞0.05).Conclusions 1.0 μg/kg dexmedetomidine combined with ropivacaine ultrasound guided TPVB had certain advantages in reducing the degree of pain of general anesthesia thoracoscopic surgery patients,reducing the dosage of remifentanil and propofol and the number of postoperative self-controlled analgesia,while 0.5 μg/kg dexmedetomidine combined with ropivacaine ultrasound guided TPVB had certain advan-tages in improving patients'vital signs,reducing immunosuppression,stress reaction and promoting post-anesthesia awakening.Clinical anesthesia protocols could be rationally selected according to the actual situation of patients.

Objective To investigate the effects of dexmedetomidine(0.5,1.0,2.0 μg/kg)combined with ropivacaine ultrasound guided thoracic paravertebral nerve block(TPVB)in patients undergoing thoracoscopic surgery under general anesthesia on the vital signs,stress response and other indexes,and to provide reference for the optimization of anesthesia regimen in the clinic.Methods A total of 99 cases of patients undergoing thoracoscopic surgery under general anesthesia were selected,and the patients were divided into the low,medium,and high-dose groups of 33 cases each according to the method of randomized numerical table.At the end of anesthesia induction,dexmedetomidine 0.5,1.0,and 2.0 μg/kg compounded with 0.375%ropivacaine ultrasound-guided TPVB was administered to the low,medium,and high-dose groups,respectively,and all three groups were observed until 3 d postoperatively.Perioperative indicators,quality of awakening,degree of pain at 2,6,12,and 24 h postoperatively,vital signs before anesthesia(T1),at tracheal extubation(T2),and at 5 min of tracheal extu-bation(T3),and immune function,stress response,and adverse reactions during the observation time were com-pared between the groups.Results Compared with the low-dose group,remifentanil and propofol dosages were lower in the medium-and high-dose groups,and the number of postoperative self-controlled analgesia was lower(P＜0.05).Awakening,tracheal extubation,and recovery room stay were prolonged between the low,medium,and high dose groups(P＜0.05).Scores of visual analog scale(VAS)were progressively lower in the three groups at 2,6,12,and 24 h postoperatively(P＜0.05),and compared with the low-dose group,scores of VAS were lower in the medium and high-dose groups at 2,6,and 12 h postoperatively(P＜0.05).Compared with T1,heart rate(HR),mean arterial pressure(MAP)were higher in all three groups at T2,T3,and HR,MAP at T2,T3 were higher between the low,medium,and high dose groups(P＜0.05);compared with T2,HR,MAP were lower in all three groups at T3(P＜0.05).Compared with the preoperative period,levels of whole blood CD8+,serum cortisol(Cor),C-reactive protein(CRP),norepinephrine(NE),and epinephrine(E)were increased in the three groups at 3 d postoperatively,and the above indexes were elevated between the low,medium,and high dosage groups at 3 d postoperatively(P＜0.05);levels of whole blood CD3+,CD4+,CD4+/CD8+were decreased in the three groups at 3 d postoperatively,and the above indexes were elevated between the low,medium,and high dosage groups at 3 d postoperatively(P＜0.05).There was no statistically significant difference in the safety com-parison among the three groups(P＞0.05).Conclusions 1.0 μg/kg dexmedetomidine combined with ropivacaine ultrasound guided TPVB had certain advantages in reducing the degree of pain of general anesthesia thoracoscopic surgery patients,reducing the dosage of remifentanil and propofol and the number of postoperative self-controlled analgesia,while 0.5 μg/kg dexmedetomidine combined with ropivacaine ultrasound guided TPVB had certain advan-tages in improving patients'vital signs,reducing immunosuppression,stress reaction and promoting post-anesthesia awakening.Clinical anesthesia protocols could be rationally selected according to the actual situation of patients.

Objective:To investigate the risk factors for organoid culture failure in colorectal cancer.Methods:This was a retrospective observational study. Tumor specimens were obtained from 1130 patients with colorectal cancer who had undergone surgery or biopsy and had no other concurrent malignancies at Nanfang Hospital of Southern Medical University from December 2021 to November 2022. Organoid culture was performed on 1231 tumor tissue samples. Univariate analysis and multivariate logistic regression were used to analyze the factors that might have influenced the rate of successful organoid culture of colorectal cancer tissue samples.Results:The median (range) duration of organoid culture was 7 (3–12) days. The overall rate of successful culture was 76.3% (939/1231). The rate of successful organoid cultures varied according to the sampling site, malignant ascites having the highest success rate (96.4%, 27/28), followed by liver metastases (83.1%, 54/65), lung metastases (8/10), primary tumors (76.0%, 816/1074), omental metastases (10/14), peritoneal metastases (61.5%, 16/26), ovarian metastases (3/5), and lymph node metastases (5/9). The difference in rates of successful organoid culture between primary tumors and malignant ascites was statistically significant ( P=0.012), whereas none of the other rates of successful organoid culture success differed significantly (all P>0.05). The rate of successful organoid culture was 96.4% (27/28) for malignant ascites obtained by abdominal puncture, 76.5% (864/1130) for surgical specimens, and 65.8% (48/73) for endoscopic biopsies; these differences are statistically significant (χ 2=10.773, P=0.005). The rate of successful organoid culture was 62.5% (40/64) in the neoadjuvant chemoradiotherapy group, which is significantly lower than in the non-adjuvant (76.9%, 787/1023) and chemotherapy groups (77.8%, 112/144) (χ 2=7.134, P=0.028). Multivariate logistic regression analysis revealed that endoscopic biopsy (OR=0.557, 95%CI: 0.335–0.924, P=0.024) and neoadjuvant chemoradiotherapy (OR=0.483, 95%CI: 0.285–0.820, P=0.007) were independent risk factors for failure of organoid culture of colorectal cancer samples. Malignant ascites (OR=8.537, 95%CI:1.154–63.131, P=0.036) and abdominal puncture (OR=8.294, 95% CI: 1.112–61.882, P=0.039) were identified as independent protective factors. Conclusions:The rate of successful organoid culture was influenced by the sampling site, sampling method, and chemoradiotherapy. The rate of successful organoid culture was lower for endoscopic biopsies and in patients receiving preoperative neoadjuvant chemoradiotherapy, and higher for malignant ascites. We consider that culture of malignant ascites is preferable when peritoneal metastases are suspected.

Objective:To investigate the risk factors for organoid culture failure in colorectal cancer.Methods:This was a retrospective observational study. Tumor specimens were obtained from 1130 patients with colorectal cancer who had undergone surgery or biopsy and had no other concurrent malignancies at Nanfang Hospital of Southern Medical University from December 2021 to November 2022. Organoid culture was performed on 1231 tumor tissue samples. Univariate analysis and multivariate logistic regression were used to analyze the factors that might have influenced the rate of successful organoid culture of colorectal cancer tissue samples.Results:The median (range) duration of organoid culture was 7 (3–12) days. The overall rate of successful culture was 76.3% (939/1231). The rate of successful organoid cultures varied according to the sampling site, malignant ascites having the highest success rate (96.4%, 27/28), followed by liver metastases (83.1%, 54/65), lung metastases (8/10), primary tumors (76.0%, 816/1074), omental metastases (10/14), peritoneal metastases (61.5%, 16/26), ovarian metastases (3/5), and lymph node metastases (5/9). The difference in rates of successful organoid culture between primary tumors and malignant ascites was statistically significant ( P=0.012), whereas none of the other rates of successful organoid culture success differed significantly (all P>0.05). The rate of successful organoid culture was 96.4% (27/28) for malignant ascites obtained by abdominal puncture, 76.5% (864/1130) for surgical specimens, and 65.8% (48/73) for endoscopic biopsies; these differences are statistically significant (χ 2=10.773, P=0.005). The rate of successful organoid culture was 62.5% (40/64) in the neoadjuvant chemoradiotherapy group, which is significantly lower than in the non-adjuvant (76.9%, 787/1023) and chemotherapy groups (77.8%, 112/144) (χ 2=7.134, P=0.028). Multivariate logistic regression analysis revealed that endoscopic biopsy (OR=0.557, 95%CI: 0.335–0.924, P=0.024) and neoadjuvant chemoradiotherapy (OR=0.483, 95%CI: 0.285–0.820, P=0.007) were independent risk factors for failure of organoid culture of colorectal cancer samples. Malignant ascites (OR=8.537, 95%CI:1.154–63.131, P=0.036) and abdominal puncture (OR=8.294, 95% CI: 1.112–61.882, P=0.039) were identified as independent protective factors. Conclusions:The rate of successful organoid culture was influenced by the sampling site, sampling method, and chemoradiotherapy. The rate of successful organoid culture was lower for endoscopic biopsies and in patients receiving preoperative neoadjuvant chemoradiotherapy, and higher for malignant ascites. We consider that culture of malignant ascites is preferable when peritoneal metastases are suspected.

OBJECTIVE: To detect variants of IVD gene among 4 neonates with suspected isovalerate acidemia in order to provide a guidance for clinical treatment. METHODS: 111 986 newborns and 7461 hospitalized children with suspected metabolic disorders were screened for acyl carnitine by tandem mass spectrometry. Those showing a significant increase in serum isovaleryl carnitine (C5) were analyzed for urinary organic acid and variants of the IVD gene. RESULTS: Four cases of isovalerate acidemia were detected, which included 2 asymptomatic newborns (0.018‰, 2/111 986) and 2 children suspected for metabolic genetic diseases (0.268‰, 2/7461). The formers had no obvious clinical symptoms. Analysis of acyl carnitine has suggested a significant increase in C5, and urinary organic acid analysis has shown an increase in isovaleryl glycine and 3-hydroxyisovalerate. Laboratory tests of the two hospitalized children revealed high blood ammonia, hyperglycemia, decreased red blood cells, white blood cells, platelets and metabolic acidosis. The main clinical manifestations have included sweaty foot-like odor, feeding difficulty, confusion, drowsiness, and coma. Eight variants (5 types) were detected, which included c.158G>A (p.Arg53His), c.214G>A (p.Asp72Asn), c.548C>T (p.Ala183Val), c.757A>G (p.Thr253Ala) and 1208A>G (p.Tyr403Cys). Among these, c.548C>T and c.757A>G were unreported previously. None of the variants was detected by next generation sequencing of 2095 healthy newborns, and all variants were predicted to be likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics. CONCLUSION The incidence of isovalerate acidemia in Liuzhou area is quite high. Screening of metabolic genetic diseases is therefore recommended for newborns with abnormal metabolism. The discovery of novel variants has enriched the mutational spectrum of the IVD gene.
Infant, Newborn ; Child ; Humans ; Acidosis ; Carnitine ; Erythrocytes ; High-Throughput Nucleotide Sequencing

Objecfive:To investigate the clinical characteristics and surgical management of tumor invasion on recurrent laryngeal nerve at the entrance of larynx in thyroid cancer.Methods:The clinical data of 30 patients with recurrent laryngeal nerve invasion by thyroid cancer from Aug 2012 to Aug 2018 in Cangzhou Central Hospital were analyzed retrospectively. Patients were divided into groups A (14 cases ,nerve was invaded at the larynx) and group B (16 cases,nerve was involved in other parts).Results:Between the two groups, operation time, intraoperative blood loss, number of tumor focus, adhesion and infiltration were not statistically different ( P>0.05). The tumor size in group A was smaller ( t=-3.614, P=0.001), the lymph node metastasis rate was lower ( χ2=5.593, P=0.018), and the microcancer rate was higher ( χ2=4.051, P=0.044).Follow up data up to 24 months showed there were no significant difference in postoperative hoarseness , laryngoscope abnormality and recurrence rate between the two groups (all P>0.05). Conclusion:Patients of thyroid cancer with recurrent laryngeal nerve invasion at the larynx had relatively small tumor size, higher proportion of microcancer, lower rate of lymph node metastasiss.

Objective:This study aims to examine the incidence and risk factors of violent behaviors in community-dwelling unmedicated patients with severe mental disorders in Shenzhen.Methods:The baseline and follow-up data of unmedicated patients with severe mental disorders were collected from the Information Management System of Mental Health Prevention and Control in Shenzhen. The incidence of violent behaviors in unmedicated patients was described. The influencing factors of violent behaviors were analyzed using logistic regression model.Results:A total of 3 163 patients were included. The incidence of violent behaviors was 9.1% (288/3 163) in 2019. Multivariate logistic regression analysis showed that having an acute illness onset ( OR=1.589, 95 %CI 1.181-2.139) was the risk factor of violent behaviors, while having cohabitants ( OR=0.596, 95 %CI 0.410-0.867), being diagnosed as mental retardation comorbid with psychotic disorders ( OR=0.432, 95 %CI 0.199-0.938), having application for carers allowances ( OR=0.440, 95 %CI 0.319-0.606), and participating in family doctor services ( OR=0.642, 95 %CI 0.492-0.838) and community face-to-face interviews during 2019 ( OR (1-2 times vs. 0 times)=0.633, 95 %CI 0.466-0.861; OR (3-4 times vs. 0 times)=0.546, 95 %CI 0.368-0.811) were the protective factors. Conclusions:The incidence of violent behaviors is high in unmedicated patients with severe mental disorders with acute illness onset. The improvement of comprehensive level of community mental health services and the development of targeted intervention measures would help to reduce the occurrence of violent behaviors among unmedicated patients with severe mental disorders in the community.