Molar-incisor hypomineralization (MIH) is a developmental defect of enamel that is characterized primarily by abnormal enamel mineralization affecting the first permanent molars and permanent incisors. Due to insufficient mineralization, teeth affected by MIH are prone to post-eruptive breakdown and caries, potentially leading to sequelae such as tooth sensitivity and occlusal problems. The diagnosis of MIH is primarily based on relevant perinatal and infantile medical history, the characteristic distribution of affected teeth, and the morphological features of the enamel defects. Based on the extent and severity of the enamel defect, MIH is classified as mild or severe. Diagnosis and treatment strategies emphasize early screening, diagnosis, and intervention, prioritizing prevention, providing symptomatic care, and implementing regular recall assessments. Mild MIH predominantly manifests as demineralized enamel opacities or discoloration, typically without significant enamel breakdown. Treatment focuses on caries prevention and aesthetic restoration, employing techniques such as remineralization, micro-abrasion, resin infiltration, bleaching, fluoride application, and fissure sealants. Severe MIH typically presents with extensive enamel opacities accompanied by substantial enamel breakdown and may be complicated by caries and tooth sensitivity. Management primarily involves restoring the structural defects or, for teeth that cannot be preserved, extraction followed by orthodontic treatment. Comprehensive management often requires a multimodal approach integrating various therapeutic modalities to restore both the function and aesthetics of the affected teeth and overall dentition. This article provides a review of advancements in diagnosis and the treatment strategies for MIH, offering a reference for clinical practice.

Objective To explore the adverse event signals of children using macrolide drugs （azithromycin, clarithromycin, and erythromycin）, and provide reference for rational medicine use in clinical practice. Methods Data from children under 12 years old were extracted from the US FAERS database spanning from the first quarter of 2004 to the second quarter of 2023. The adverse drug reaction （ADR） signal mining for three macrolide antibiotics was conducted using the Reporting Odds Ratio （ROR） and Bayesian Confidence Propagation Neural Network （BCPNN） methods. Special emphasis was placed on analyzing and contrasting the differences in adverse events among the three drugs. Results A total of 1 615 reports for children under 12 years old were retrieved from the FAERS database, including 1 024 reports of azithromycin, 460 reports of clarithromycin, and 131 reports of erythromycin. Among azithromycin and erythromycin, there were more reports from boys than girls, while for clarithromycin, there were more reports from girls than boys. Oral administration was the most common route of administration for all three drugs. Regarding the outcome of adverse events reported, azithromycin and clarithromycin were primarily associated with other serious adverse events, whereas erythromycin was mainly associated with hospitalization and other serious adverse events. The number of adverse events reported decreased with increasing age, with a higher number of reports in the 0-3 age group. Using the ROR and BCPNN methods for signal detection, 86 signals were identified for azithromycin, 91 for clarithromycin, and 34 for erythromycin. These signals involved 22 System Organ Classes （SOCs）, with azithromycin mainly concentrated in skin and subcutaneous tissue disorders （n=21）, clarithromycin in gastrointestinal disorders （n=15）, and erythromycin in gastrointestinal disorders （n=8）. Twenty-four signals of moderate to high risk were detected, with 13 for azithromycin, 9 for clarithromycin, and 2 for erythromycin. Conclusion The adverse events induced by the three drugs with different risks in different systems. When clinically treating Mycoplasma pneumoniae pneumonia in children, the risk profiles of drugs in different systems should be considered, and personalized dosing should be implemented.

Objective To establish a three-dimensional(3-D)structural mode-based nursing quality evaluation index system for the bleeding risk care in patients with deep venous thrombosis(DVT)of lower extremity receiving catheter-directed thrombolysis(CDT),so as to provide a reference for the normalization and standardization of bleeding risk care.Methods Based on the 3-D structural mode,through literature review,clinical practice research and group discussion,the first draft of nursing quality evaluation index system for CDT bleeding risk care was formulated.Using Delphi method,two rounds of letter inquiry were conducted,and the index content and index weighting were determined.Results The nursing quality evaluation index system included 3 level-Ⅰ indicators,11 level-Ⅱ indicators and 58 level-Ⅲ indicators.Two rounds of expert consultation were conducted,with 30 questionnaires for each round.The valid recovery rate of the questionnaire was 100.00％,indicating that expert's enthusiasm was higher.In the first round of letter inquiry,28 experts(93.3％)submitted suggestions for modification,and in the second round of letter inquiry,15 experts(50.0％)submitted suggestions for draft modification.The level of expert authority was as follows:the basis coefficient of expert judgment(Ca)was 0.93,the coefficient of expert familiarity with items(Cs)was 0.90,and the authority coefficient was 0.92.The degree of expert opinion coordination assessed by Kendall's harmony coefficient(Kendall's W)was 0.18-0.26(P＜0.05),and the coefficient of variation of each dimension was less than 0.15.Conclusion The nursing quality evaluation index system established in this study is scientific,reliable and practical.It can provide certain useful reference for the evaluation of CDT bleeding risk care quality.

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Objective:To investigate the association between body mass index (BMI) and the risk of chronic obstructive pulmonary disease (COPD).Methods:This study employed a single-center, cross-sectional design combined with online Mendelian randomization (MR) analysis. A total of 16 187 pieces of lung function data for COPD screening from the “Happy Breathing” project in the Jingzhou area between September 2021 and October 2023 were initially collected. Cases with missing questionnaire information, failed quality control, or isolated restrictive or small airway dysfunction were excluded, resulting in a final dataset of 3 999 cases, comprising 2 330 non-COPD and 1 669 COPD cases. Binary COPD status was set as the outcome variable, with BMI as the exposure variable. A smooth curve plot was used to depict the relationship between BMI and COPD prevalence; if non-linearity was observed, a two-piece linear regression model was employed to calculate threshold effects, adjusting for potential confounders such as age, sex, smoking history, biomass fuel exposure, and COPD awareness. Subsequently, online genome-wide association study (GWAS) data were utilized for MR analysis to explore any potential causal link between high BMI and COPD development.Results:Analysis of the “Happy Breathing” COPD screening data from the Jingzhou area revealed a nonlinear relationship between BMI and COPD risk. For BMI values <23.7 kg/m2, each 1 kg/m2 increase in BMI was associated with an 18% decrease in COPD risk ( OR=0.82, 95% CI: 0.79-0.85). However, for BMI >23.7 kg/m2, no significant association was found between increasing BMI and COPD risk ( OR=1.00, 95% CI: 0.96-1.05). MR analysis using online GWAS data suggested no potential causal relationship between high BMI and COPD occurrence, with both heterogeneity and pleiotropy tests yielding P>0.05. Conclusion:There may be a nonlinear relationship between BMI and the risk of COPD, with no apparent association between BMI and COPD risk for values above 23.7 kg/m2.

Objective:To investigate the feasibility of classifying imaging patterns of dermatomyositis/polymyositis-related interstitial lung disease (DM/PM-ILD) into subtypes based on chest CT radiomics features and a model was constructed by machine learning algorithms.Methods:From November 2011 to November 2020, 107 patients diagnosed with PM/DM-ILD at the First Affiliated Hospital of Xi′an Jiaotong University were retrospectively analyzed. A total of 315 cases with chest CT were collected. Doctors pre-classified image patterns, including 105 cases with non-specific interstitial pneumonia (NSIP), 90 cases with organizing pneumonia (OP), and 66 cases with non-specific interstitial pneumonia combined with organizing pneumonia (NSIP+OP), 35 cases with common interstitial pneumonia (UIP), and 19 cases with diffuse alveolar damage (DAD), ANOVA was used to test the difference of baseline clinical information among the imaging classification groups. All images were divided into the training set and the est set by stratified random sampling at a ratio of 4∶1. In each CT scan, 3D slicer was used to segment each lung lobe, and then reconstructed into 3 mm 3 of voxels, and Pyradiomics library was used to extract the radiomic features of the whole lung and each lobe. The multi-classification goal was achieved by constructing random forest base classifiers for each of the five groups and then voting as the final model. In the process of constructing the base classifier, firstly, the balance between sample groups was achieved by SMOTETomek comprehensive sampling, and the optimal feature set was selected by independent sample t test and L1 regularized least absolute shrinkage and selection operator (LASSO) regression. In this study, the Radiomics model was constructed based on chest CT radiomics features, and the Radiomics + model was constructed by introducing gender and age information. The base classifier and the integration model use the mean accuracy and the area under the receiver operator characteristics analysis curve (AUC) to evaluate the performance, respectively. Results:There was a statistically significant difference ( P<0.05) between the ages of the NSIP, OP, NSIP+OP, UIP, and DAD groups [(57±13),(53±8),(54±10),(44±11), and (46±8)years old, respectively], F=11.82, P<0.001. In the Radiomics model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.87, 0.91, 0.91, 0.96, and 0.99, respectively, and the AUC of the test set were 0.81, 0.82, 0.79, 0.93, 0.89. In the final Radiomics + model, for each group of NSIP, OP, NSIP+OP, UIP, and DAD, the AUCs of the training set were 0.89, 0.91, 0.92, 0.97, and 0.99, respectively, and the AUCs of the test set were 0.84, 0.82, 0.78, 0.94, 0.90. Conclusion:Based on chest CT radiomics features and key clinical features (sex, age), the Radiomics + model constructed by machine learning has good classification performance for the imaging patterns of PM/DM-LD.

Isochrysis galbana is considered an ideal bait for functional foods and nutraceuticals of humans because of its high fucoxanthin(Fx)content.However,multi-omics analysis of the regula-tory networks for Fx biosynthesis in I.galbana has not been reported.In this study,we report a high-quality genome assembly of I.galbana LG007,which has a genome size of 92.73 Mb,with a contig N50 of 6.99 Mb and 14,900 protein-coding genes.Phylogenetic analysis confirmed the monophyly of Haptophyta,with I.galbana sister to Emiliania huxleyi and Chrysochromulina tobinii.Evolutionary analysis revealed an estimated divergence time between I.galbana and E.huxleyi of～133 million years ago.Gene family analysis indicated that lipid metabolism-related genes exhibited significant expansion,including IgPLMT,IgOAR1,and IgDEGS1.Metabolome analysis showed that the content of carotenoids in I.galbana cultured under green light for 7 days was higher than that under white light,and β-carotene was the main carotenoid,accounting for 79.09％of the total carotenoids.Comprehensive multi-omics analysis revealed that the content of β-carotene,antheraxanthin,zeaxanthin,and Fx was increased by green light induction,which was significantly correlated with the expression of IgMYB98,IgZDS,IgPDS,IgLHCX2,IgZEP,IgLCYb,and IgNSY.These findings contribute to the understanding of Fx biosynthesis and its regulation,pro-viding a valuable reference for food and pharmaceutical applications.

OBJECTIVE： To systematically evaluate the efficacy and safety of Tapentadol immediate-release preparation （Tap IR） for relieving severe acute pain after brachiocephalic arteritis， and to provide evidence-based reference for rational drug use. METHODS： Retrieved from PubMed， Medline， Cochrane library， CNKI， VIP， Wanfang database and American clinical trial database， randomized controlled trials （RCTs） about Tap IR （trial group） versus Oxycodone immediate-release preparation or placebo for relieving severe acute pain after brachiocephalic arteritis were collected. After literature screening， data extraction and literature quality evaluation with modified Jadad scale， Meta-analysis was conducted by using RevMan 5.3 software. RESULTS： A total of 6 RCTs were included， involving 2 378 patients. Results of Meta-analysis showed that 48 h total pain relief value （TOTPAR48） of trial group was significantly higher than control group [MD＝35.60，95％CI（27.31， 43.88）， P＜0.000 01]. Results of sub-group analysis showed that TOTPAR48 of trial group using Tap IR 50 mg [MD＝28.68， 95％CI （18.18， 39.17），P＜0.00 001]， 75 mg [MD＝39.97， 95％CI （34.21， 45.73）， P＜0.000 01] and 100 mg[MD＝38.50， 95％CI（1.46， 75.54），P＝0.04] were significantly higher than control group； TOTPAR48 of patients who received Tap IR 75 mg were significantly higher than patients who received Tap IR 50 mg [MD＝9.04，95％ CI（4.31， 13.77），P＝0.000 2]. There was no statistical significance in the utilization rate of rescue medicine （URM） between 2 groups [RR＝1.23，95％ CI（0.84， 1.80），P＝0.29]. Subgroup analysis showed that URM in patients who received Tap IR 75 mg was significantly lower than those receiving Tap IR 50 mg [RR＝0.62，95％CI（0.41， 0.94），P＝0.02]. The total difference of 48 h pain intensity （SPID48） in trial group was significantly lower than control group [MD＝－18.96，95％CI（－37.28，－0.64），P＝0.04]. Subgroup analysis showed that SPID48 in patients who received Tap IR 75 mg was significantly higher than those receiving Tap IR 50 mg [MD＝21.66，95％CI（8.93， 34.39），P＝0.000 9]. There was no statistical significance in the total change of pain impression （PGIC） between 2 groups [RR＝0.95，95％CI（0.88， 1.03），P＝0.23]. Subgroup analysis showed that PGIC in patients who received Tap IR 75 mg was significantly higher than those receiving Tap IR 50 mg [RR＝1.07，95％CI（1.01， 1.13），P＝0.02] but significantly lower than those receiving Tap IR 100 mg [RR＝0.86，95％CI（0.77， 0.97），P＝0.01]. The incidence of nausea， vomiting， constipation， dizziness and headache in trial group were significantly lower than control group （P＜0.05）. CONCLUSIONS： Tap IR shows good therapeutic efficacy and safety for severe acute pain after brachiocephalic arteritis， and the efficacy of Tap IR might be better when the dose of Tap IR is 75 mg.