Early caries confined to the enamel layer represent a critical window for achieving noninvasive intervention in caries management. Caries management has shifted from the traditional “drill-and-fill” model toward a modern paradigm centered on caries risk and lesion management. Based on contemporary concepts, this review systematically summarizes recent advances in early caries management, including caries risk assessment, early diagnosis, treatment strategy selection, and follow-up monitoring, while highlighting the major challenges currently being faced, and further reviewing and discussing the application of artificial intelligence (AI) in early caries management. In terms of risk management, conventional systems including the American Dental Association, Caries Management by Risk Assessment, Cariogram, and the Caries-Risk Assessment Tool remain mainstays in clinical practice. However, AI offers predictive capability through higher-dimensional data processing and the integration of numerous influencing factors, with the potential to improve the accuracy of risk stratification. For diagnosis, visual inspection, tactile examination, and bitewing radiography remain fundamental methods, yet their sensitivity for early caries—particularly proximal lesions—is limited. The application of optical technologies, including quantitative light-induced fluorescence, optical coherence tomography, near-infrared light transillumination, fiber-optic transillumination, and laser-induced fluorescence, enables digital characterization of caries lesions, providing a data foundation for demineralization assessment, lesion activity evaluation, and AI model development. The management of early caries primarily relies on noninvasive and minimally invasive approaches. Remineralization therapy is suitable for superficial lesions, resin infiltration offers the dual advantages of inhibiting lesion progression and improving aesthetics, and microabrasion and bleaching may serve as adjunctive aesthetic treatments. Emerging modalities such as laser, ozone, and photodynamic therapy have also demonstrated potential. Treatment decision-making should comprehensively consider lesion activity, patient caries risk status, demineralization depth, patient compliance, and treatment preferences. However, precise quantification of demineralization depth remains challenging, and standardized decision-making criteria are still lacking. Follow-up management should be individualized based on risk stratification, with attention to lesion changes, patient compliance, and the risk of recurrence. In summary, intelligent and precision-based approaches are expected to define the future of early caries management, and the application of AI in risk prediction, image analysis, and clinical decision support is anticipated to further enhance the efficiency and effectiveness of early caries diagnosis and treatment.

[Objective]To explore the mechanism of Dihuang Yinzi Decoction on kidney essence deficiency syndrome of Alzheimer's disease(AD)based on vitamin D axis(VD axis)-Ca2+-Calpain-cyclin-dependent kinase 5(CDK5)signaling pathway.[Methods]Thirty-six SD rats were randomly divided into control group,model group,Dihuang Yinzi Decoction low-dose group(5.36 g/kg),medium-dose group(10.72 g/kg),high-dose group(21.45 g/kg)and donepezil group(0.25 mg/kg).First,model of kidney essence deficiency syndrome was established in rats through intraperitoneal injection of D-galactose.Subsequently,an AD model with kidney essence deficiency syndrome was developed by injecting Aβ25-35 bilaterally into the CA1 region of the hippocampus.Morris water maze experiment was used to observe the behavioral changes of each group of mice.The concentrations of 25-hydroxyvitamin D3[25(OH)D3],1,25-dihydroxyvitamin D3[1,25-(OH)2D3]and Ca2+in serum were detected by enzyme-linked immunosorbent assay(ELISA).The ultrastructure of neurons in hippocampus was observed by transmission electron microscope.The expression levels of Calpain 1,CDK5,p35,p25,tau,phospho-tau Thr205(pT205)and phospho-tau Ser396(pS396)in hippocampus were detected by Western blot.[Results]Compared with model group,behavioral experiment showed Dihuang Yinzi Decoction can relieve the cognitive impairment and anxiety-like behaviors of AD kidney essence deficiency syndrome model rats(P<0.01).ELISA results showed that after Dihuangyinzi Decoction treatment,the concentrations of 25(OH)D3 and 1,25-(OH)2D3 in the rat serum increased(P<0.05,P<0.01),while the Ca2+concentration decreased(P<0.05,P<0.01).Transmission electron microscopy showed that Dihuang Yinzi Decoction improved the structural morphology of hippocampal neurons and alleviated mitochondrial swelling.Western blot showed that Dihuang Yinzi Decoction decreased the protein expressions of Calpain 1,CDK5,p25,tau,pT205 and pS396(P<0.01,P<0.05),and increased the protein expression of p35(P<0.05).[Conclusion]Dihuang Yinzi Decoction can regulate the cognitive ability of rats with AD kidney essence deficiency syndrome by regulating the VD axis-Ca2+-Calpain-CDK5 signaling pathway,and protect hippocampal nerve cells.

[Objective]To explore the mechanism of Dihuang Yinzi Decoction on kidney essence deficiency syndrome of Alzheimer's disease(AD)based on vitamin D axis(VD axis)-Ca2+-Calpain-cyclin-dependent kinase 5(CDK5)signaling pathway.[Methods]Thirty-six SD rats were randomly divided into control group,model group,Dihuang Yinzi Decoction low-dose group(5.36 g/kg),medium-dose group(10.72 g/kg),high-dose group(21.45 g/kg)and donepezil group(0.25 mg/kg).First,model of kidney essence deficiency syndrome was established in rats through intraperitoneal injection of D-galactose.Subsequently,an AD model with kidney essence deficiency syndrome was developed by injecting Aβ25-35 bilaterally into the CA1 region of the hippocampus.Morris water maze experiment was used to observe the behavioral changes of each group of mice.The concentrations of 25-hydroxyvitamin D3[25(OH)D3],1,25-dihydroxyvitamin D3[1,25-(OH)2D3]and Ca2+in serum were detected by enzyme-linked immunosorbent assay(ELISA).The ultrastructure of neurons in hippocampus was observed by transmission electron microscope.The expression levels of Calpain 1,CDK5,p35,p25,tau,phospho-tau Thr205(pT205)and phospho-tau Ser396(pS396)in hippocampus were detected by Western blot.[Results]Compared with model group,behavioral experiment showed Dihuang Yinzi Decoction can relieve the cognitive impairment and anxiety-like behaviors of AD kidney essence deficiency syndrome model rats(P<0.01).ELISA results showed that after Dihuangyinzi Decoction treatment,the concentrations of 25(OH)D3 and 1,25-(OH)2D3 in the rat serum increased(P<0.05,P<0.01),while the Ca2+concentration decreased(P<0.05,P<0.01).Transmission electron microscopy showed that Dihuang Yinzi Decoction improved the structural morphology of hippocampal neurons and alleviated mitochondrial swelling.Western blot showed that Dihuang Yinzi Decoction decreased the protein expressions of Calpain 1,CDK5,p25,tau,pT205 and pS396(P<0.01,P<0.05),and increased the protein expression of p35(P<0.05).[Conclusion]Dihuang Yinzi Decoction can regulate the cognitive ability of rats with AD kidney essence deficiency syndrome by regulating the VD axis-Ca2+-Calpain-CDK5 signaling pathway,and protect hippocampal nerve cells.

Objective:To investigate the molecular mechanisms by which SARS-CoV-2 accessory protein ORF7a mediating NF-κB activation and thus inducing inflammatory cytokines production.Methods:Effects of ORF7a on NF-κB promoter activity was analyzed by luciferase reporter assay.qRT-PCR was used to analyze expressions of inflammatory cytokines.Effects of ORF7a on phos-phorylation and nuclear-translocation of p65 were determined by Western blot and immunofluorescence.Co-immunoprecipitation and immunofluorescence assay were performed to investigate potential target s of ORF7a.Results:Luciferase reporter assay showed that ORF7a activated NF-κB promoter activity in a dose-dependent manner(P<0.001),while has no effect on activation of AP-1 reporter gene.ORF7a significantly upregulates expressions of TNF-α,IL-1β and IL-8 mRNA levels(P<0.05).Western blot showed that ORF7a markedly increased phosphorylation of p65 protein(P<0.05)and p65 nuclear localization(P<0.01).The interaction between ORF7a and IKKβ protein of NF-κB signaling pathway was found by immunoprecipitation assay,and the co-localization of ORF7a and IKKβ was also confirmed by immunofluorescence assay.Conclusion:SARS-CoV-2 ORF7a targets IKKβ to promote active NF-κB pathway to the release of inflammatory cytokines.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective To investigate the insecticide resistance levels of adult Culex pipiens quinquefasciatus to four common insecticides in Guiyang City.Methods Larvae of Culex pipiens quinquefasciatus were collected from 8 areas of Guiyang City by larval scoop method from August to September 2015,and raised in the laboratory to adult Culex pipiens quinquefasciatus.Contact tube method was used to determine the insecticide resistance levels of adult Culex pipiens quinquefasciatus to four common insecticides,and knockdown rate of 1 h and mortality rate of 24 h recovery were calculated.The resistance level was judged according to the mortality rate:＜ 90％ was in the resistant group (R);90％-＜ 98％ was in the potential resistant group (M);and ≥98％ was in the sensitive group (S).Results The adult Culex pipiens quinquefasciatus were exposed to 7.70 g/L dichlorvos,3.30 g/L propoxur,0.25 g/L beta-cypermethrin and 0.20 g/L dehamethrin,knockdown rates of 1 h were 57.78％ (52/90)-91.11％ (82/90),86.67％ (78/90)-100.00％ (90/90),23.33％ (21/90)-77.78％ (70/90) and 27.78％ (25/90)-88.89％ (80/90),respectively;and mortality rates of 24 h recovery were 61.11％ (55/90)-94.44％ (85/90),90.00％ (81/90)-97.78％ (88/90),23.33％ (21/90)-73.33％ (66/90) and 21.11％ (19/90)-72.22％ (65/90),respectively.Conclusion Adult Culex pipiens quinquefasciatus in Guiyang City have developed some resistance to four common insecticides,in which the mosquito has a higher resistance to pyrethroid insecticides such as beta-cypermethrin and deltamethrin.

Blepharophimosis ; diagnosis ; genetics ; Humans ; Male ; Middle Aged ; Pedigree ; Phenotype ; Skin Abnormalities ; diagnosis ; genetics ; Urogenital Abnormalities

Objective To study the role of atrial natriuretic peptide (ANP) and renin-angiotensin-aldosterone system (RAAS) in the pathogenesis of salt-sensitive (SS) hypertension and mechanism of the hypotensive effect of benazepril and ANP in patients with SS essential hypertension. Methods Sixty-four patients with essential hypertension were divided into SS (n=30) and non-salt-sensitive (NSS, n=34) groups by modified Sulliran's method. Plasma ANP, angiotensin Ⅱ (AⅡ) and aldosterone (ALD) were determined before and during the period of salt loading test. Thirty healthy subjects as controls were also enrolled. A self-comparative study of benazepril with the placebo was performed in SS group. Before and after the placebo and benazepril therapy, blood pressure (BP) and plasma ANP were determined. Results (1)Basal plasma ANP level in the SS group was significantly lower than that in the NSS group. Basal plasma ANP level in the NSS group was also significantly lower than that in the control group [(110.28±15.40) pmol/L vs NSS (145.52±26.53) pmol/L and control (197.74±26.20) pmol/L]. Plasma ANP in both SS and NSS groups [(133.56±34.03) pmol/L and (169.20±35.91) pmol/L respectively, both P<0.05 vs control]. Percentage of increase of plasma ANP in SS and NSS groups was of no difference (P>0.05) . (2) No significant difference of basal plasma AⅡ and ALD levels were found between SS and NSS groups (P>0.05). There were no significant changes of plasma AⅡ and ALD during salt loading in both SS and NSS groups ( both P>0.05). (3) After the benazepril treatment, plasma ANP was increased significantly [(146.74±31.86) pmol/L , P<0.01]; both systolic and diastolic BP were reduced significantly in SS group. (4) Basal plasma ANP level was negatively correlated with the magnitude of increase of mean arterial pressure (MAP) by salt loading (b=-0.06, P<0.05). Conclusion Deficiency of circulating endogenous ANP may play an important role in the pathogenesis of SS hypertension. Benazepril could reduce BP and increase plasma ANP significantly in patients with SS hypertension.

The relationship between hyperhomocysteinemia and coronary artery disease (CAD) was investigated and the influence of environmental factors (Folate, VitB12) and genetic factors ［N5,N10-methylenetetrahydrofolate reductase gene (MTHFR) or MTHFR gene mutation］ on plasma homocysteine (Hcy) levels and the risk of CAD observed. Fifty-one CAD patients and 30 CAD-free subjects were recruited in the study. The polymorphisms of MTHFR gene were analyzed by PCR-RFLP and plasma total Hcy levels were measured by high performance liquid chromatography with fluorescence detection. Plasma folate and vitamin B12 concentrations were measured by an automated chemiluminescence method. It was found that mean total plasma Hcy concentrations were significantly higher in CAD patients than in CAD-free subjects (P<0.01). The differences were also apparent among the three genotypes of MTHFR gene in CAD group (P<0.05). There was no significant difference in the genotype distributions and allele frequencies between the two groups. A strong inverse correlation was found between folate or vitamin B12 and plasma Hcy levels according to MTHFR genotype (P<0.01). It was concluded that hyperhomocysteinemia is a new independent risk factor for CAD. However, MTHFR gene mutation alone does not relate significantly to the morbidity of CAD since hyperhomocysteinemia and its influence on the risk of CAD are decided by both environmental and genetic factors. Supplementary treatment with vitamins B can effectively lower the plasma levels of Hcy, thus maybe reduceing the risk of CAD.

The relationship between hyperhomocysteinemia and coronary artery disease (CAD) was investigated and the influence of environmental factors (Folate, VitB12) and genetic factors ［N5,N10-methylenetetrahydrofolate reductase gene (MTHFR) or MTHFR gene mutation］ on plasma homocysteine (Hcy) levels and the risk of CAD observed. Fifty-one CAD patients and 30 CAD-free subjects were recruited in the study. The polymorphisms of MTHFR gene were analyzed by PCR-RFLP and plasma total Hcy levels were measured by high performance liquid chromatography with fluorescence detection. Plasma folate and vitamin B12 concentrations were measured by an automated chemiluminescence method. It was found that mean total plasma Hcy concentrations were significantly higher in CAD patients than in CAD-free subjects (P<0.01). The differences were also apparent among the three genotypes of MTHFR gene in CAD group (P<0.05). There was no significant difference in the genotype distributions and allele frequencies between the two groups. A strong inverse correlation was found between folate or vitamin B12 and plasma Hcy levels according to MTHFR genotype (P<0.01). It was concluded that hyperhomocysteinemia is a new independent risk factor for CAD. However, MTHFR gene mutation alone does not relate significantly to the morbidity of CAD since hyperhomocysteinemia and its influence on the risk of CAD are decided by both environmental and genetic factors. Supplementary treatment with vitamins B can effectively lower the plasma levels of Hcy, thus maybe reduceing the risk of CAD.