BACKGROUND:Dental pulp stem cells,which derived from the dental pulp tissue,are one type of dental-derived mesenchymal stem cells,possess significant properties of self-renewal and multi-lineage differentiation.In recent years,series of researches focus on dental pulp stem cells and their derivatives such as extracellular vesicles,conditioned medium,and decellularized extracellular matrix,those have positive effects on the repair and regeneration of pulp tissue injury,showing an attractive clinical application.OBJECTIVE:To systematically review the researches and applications of dental pulp stem cells and their derivatives in dental pulp tissue engineering.METHODS:Literature searches were conducted in PubMed,China Biology Medicine(CBM),and China National Knowledge Infrastructure(CNKI)databases for articles published from January 2005 to June 2023.The search terms included"dental pulp stem cells,extracellular vesicles,exosomes,apoptotic bodies,conditioned medium,decellularized matrix,regeneration"in Chinese and English.After screening the titles and abstracts,duplicate and irrelevant studies were excluded.Finally,103 studies closely related to dental pulp regeneration were included for review and analysis.RESULTS AND CONCLUSION:Dental pulp stem cells and their derivatives are rich in lots of bioactive factors that can effectively promote odontogenic,angiogenic,and neurogenic differentiation,exhibiting significant potential in the formation of the pulp-dentin complex.However,the clinical translation of dental pulp stem cells and their derivatives still faces several challenges.Future researches should focus on optimizing preparation protocols,elucidating the underlying mechanisms of action,and refining safety assessments to provide novel therapeutic strategies for the repair of dental pulp injury.

BACKGROUND:Dental pulp stem cells,which derived from the dental pulp tissue,are one type of dental-derived mesenchymal stem cells,possess significant properties of self-renewal and multi-lineage differentiation.In recent years,series of researches focus on dental pulp stem cells and their derivatives such as extracellular vesicles,conditioned medium,and decellularized extracellular matrix,those have positive effects on the repair and regeneration of pulp tissue injury,showing an attractive clinical application.OBJECTIVE:To systematically review the researches and applications of dental pulp stem cells and their derivatives in dental pulp tissue engineering.METHODS:Literature searches were conducted in PubMed,China Biology Medicine(CBM),and China National Knowledge Infrastructure(CNKI)databases for articles published from January 2005 to June 2023.The search terms included"dental pulp stem cells,extracellular vesicles,exosomes,apoptotic bodies,conditioned medium,decellularized matrix,regeneration"in Chinese and English.After screening the titles and abstracts,duplicate and irrelevant studies were excluded.Finally,103 studies closely related to dental pulp regeneration were included for review and analysis.RESULTS AND CONCLUSION:Dental pulp stem cells and their derivatives are rich in lots of bioactive factors that can effectively promote odontogenic,angiogenic,and neurogenic differentiation,exhibiting significant potential in the formation of the pulp-dentin complex.However,the clinical translation of dental pulp stem cells and their derivatives still faces several challenges.Future researches should focus on optimizing preparation protocols,elucidating the underlying mechanisms of action,and refining safety assessments to provide novel therapeutic strategies for the repair of dental pulp injury.

ObjectiveTo investigate the trends in the disease burden of falls among Chinese children and adolescents from 1990 to 2021, and to inform the development of targeted prevention and control strategies. MethodsData on age-standardized incidence rate, age-standardized mortality rate and age-standardized disability-adjusted life years (DALYs) rate for falls among Chinese children and adolescents under 20 years of age from 1990 to 2021 were systematically extracted from the Global Burden of Disease Study (GBD) 2021 database. The annual percent change (APC) and average annual percent change (AAPC) were calculated to evaluate temporal trends in fall-related disease burden across different age groups and sexes. ResultsFrom 1990 to 2021, the age-standardized incidence rate of falls among Chinese children and adolescents showed a non-linear fluctuation (AAPC=0.08%, P=0.040), while both the age-standardized mortality rate and age-standardized DALYs rate declined (AAPC=-3.66% and -3.09%, both P<0.001). The crude incidence rate decreased in the <5 years old and 5 ‒ <10 years old groups (AAPC=-1.38% and -0.29%, both P<0.001), but increased annually in the 10 ‒ <15 years old and 15 ‒ <20 years old groups (AAPC=0.27% and 0.81%, both P<0.001). The crude mortality rate and crude DALYs rate declined across all four age groups, with the most significant reduction observed in the <5 years old group (AAPC=-5.21%, 95%CI:-5.55%‒ -5.00%; AAPC=-4.98%, 95%CI: -5.20%‒ -4.79%, both P<0.001). For both males and females, the age-standardized incidence rate of falls showed a V-shaped trend (initial decline followed by a subsequent rise). In contrast, the age-standardized mortality rate and age-standardized DALY rate declined in both sexes, with an AAPC of -3.40% and -2.94% for males, and -4.50% and -3.49% for females, respectively (all P<0.001). ConclusionThe overall disease burden of falls among Chinese children and adolescents has been substantially improved; however, the incidence burden remains considerable. Future prevention efforts should be tailored to age- and sex-specific characteristics, with the family as the fundamental care unit in conjunction with high-quality nursing extension services, to establish a closed-loop management model encompassing “early identification, immediate intervention, and continuous follow-up.”

ObjectiveBased on the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway， the effects of Huanglian Zhimutang on glucose and lipid metabolism disorders and hepatic insulin resistance （IR） with type 2 diabetes mellitus （T2DM） were investigated. MethodsGoto-Kakizaki （GK） rats were fed a high-fat diet to induce a T2DM rat model and then randomly divided into four groups： normal control group， model control group， metformin group （0.10 g·kg^-1）， and Huanglian Zhimutang group （3.60 g·kg^-1）， with eight rats in each group. Drug intervention was administered continuously for 8 weeks. Serum and liver tissues were collected from each group. Fasting insulin （FINS） levels were measured using enzyme-linked immunosorbent assay （ELISA）， and the homeostasis model assessment of insulin resistance （HOMA-IR） index was calculated. Total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） levels were measured using an automatic biochemical analyzer. Liver tissue pathology was observed via hematoxylin-eosin （HE） staining. Serum interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） levels were detected using ELISA. Network pharmacology and transcriptomics sequencing were combined to analyze differentially expressed genes （DEGs） in liver tissue from the normal control group， model control group， and Huanglian Zhimutang group. Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis was performed to identify pathways affected by Huanglian Zhimutang intervention in T2DM. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to assess the mRNA expression of insulin receptor substrate-1 （IRS-1）， PI3K， Akt， and peroxisome proliferator-activated receptor gamma （PPARγ） in liver tissue， while Western blot was used to evaluate corresponding protein expression levels. ResultsAfter 8 weeks of Huanglian Zhimutang intervention， typical symptoms of T2DM rats such as polydipsia， polyphagia， and polyuria were significantly alleviated， along with reductions in fasting blood glucose levels and insulin resistance（P<0.01）. Histopathological results revealed that Huanglian Zhimutang effectively improved hepatic steatosis and inflammatory edema and reduced lipid vacuole formation. Biochemical tests demonstrated that Huanglian Zhimutang significantly reduced serum levels of TC， TG， and LDL-C（P<0.01）. ELISA results showed that Huanglian Zhimutang effectively decreased serum concentrations of IL-6 and TNF-α（P<0.05，P<0.01）. Combined network pharmacology predictions with KEGG pathway analysis of transcriptomics showed that DEGs between the Huanglian Zhimutang and model control groups were significantly enriched in the PI3K/Akt signaling pathway. Real-time PCR and Western blot results confirmed that Huanglian Zhimutang upregulated the expression of PI3K/Akt signaling pathway-related mRNAs and proteins in liver tissue（P<0.05，P<0.01）， thereby reducing inflammation， alleviating hepatic lipid accumulation， and enhancing insulin sensitivity. ConclusionHuanglian Zhimutang effectively ameliorates glucose and lipid metabolism disorders in T2DM rats. Its mechanism may be related to the regulation of the PI3K/Akt pathway， which reduces inflammation and hepatic lipid deposition and relieves hepatic insulin resistance.

ObjectiveBased on the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway， the effects of Huanglian Zhimutang on glucose and lipid metabolism disorders and hepatic insulin resistance （IR） with type 2 diabetes mellitus （T2DM） were investigated. MethodsGoto-Kakizaki （GK） rats were fed a high-fat diet to induce a T2DM rat model and then randomly divided into four groups： normal control group， model control group， metformin group （0.10 g·kg^-1）， and Huanglian Zhimutang group （3.60 g·kg^-1）， with eight rats in each group. Drug intervention was administered continuously for 8 weeks. Serum and liver tissues were collected from each group. Fasting insulin （FINS） levels were measured using enzyme-linked immunosorbent assay （ELISA）， and the homeostasis model assessment of insulin resistance （HOMA-IR） index was calculated. Total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） levels were measured using an automatic biochemical analyzer. Liver tissue pathology was observed via hematoxylin-eosin （HE） staining. Serum interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） levels were detected using ELISA. Network pharmacology and transcriptomics sequencing were combined to analyze differentially expressed genes （DEGs） in liver tissue from the normal control group， model control group， and Huanglian Zhimutang group. Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis was performed to identify pathways affected by Huanglian Zhimutang intervention in T2DM. Real-time quantitative polymerase chain reaction （Real-time PCR） was used to assess the mRNA expression of insulin receptor substrate-1 （IRS-1）， PI3K， Akt， and peroxisome proliferator-activated receptor gamma （PPARγ） in liver tissue， while Western blot was used to evaluate corresponding protein expression levels. ResultsAfter 8 weeks of Huanglian Zhimutang intervention， typical symptoms of T2DM rats such as polydipsia， polyphagia， and polyuria were significantly alleviated， along with reductions in fasting blood glucose levels and insulin resistance（P<0.01）. Histopathological results revealed that Huanglian Zhimutang effectively improved hepatic steatosis and inflammatory edema and reduced lipid vacuole formation. Biochemical tests demonstrated that Huanglian Zhimutang significantly reduced serum levels of TC， TG， and LDL-C（P<0.01）. ELISA results showed that Huanglian Zhimutang effectively decreased serum concentrations of IL-6 and TNF-α（P<0.05，P<0.01）. Combined network pharmacology predictions with KEGG pathway analysis of transcriptomics showed that DEGs between the Huanglian Zhimutang and model control groups were significantly enriched in the PI3K/Akt signaling pathway. Real-time PCR and Western blot results confirmed that Huanglian Zhimutang upregulated the expression of PI3K/Akt signaling pathway-related mRNAs and proteins in liver tissue（P<0.05，P<0.01）， thereby reducing inflammation， alleviating hepatic lipid accumulation， and enhancing insulin sensitivity. ConclusionHuanglian Zhimutang effectively ameliorates glucose and lipid metabolism disorders in T2DM rats. Its mechanism may be related to the regulation of the PI3K/Akt pathway， which reduces inflammation and hepatic lipid deposition and relieves hepatic insulin resistance.

Objective To evaluate the selected dosimetric performance of four types of thermoluminescent extremity dosimeters, and to provide a reference for selecting devices for extremity and skin dose monitoring. Methods In accordance with the IEC 62387-2020 standard, photon and β-ray irradiation tests were conducted on four types of thermoluminescent extremity dosimeters (A, B, C, D), which were composed of different dose holders and detector configurations. Linear regression analysis was performed. Technical indicators including nonlinear response, coefficient of variation, and energy response were calculated. Results Dosimeters A, B, C, and D all exhibited excellent linearity with R² > 0.999. The nonlinear response ranges were 0.93-1.03, 0.99-1.06, 0.92-1.04, and 0.95-1.02 for dosimeters A, B, C, and D, respectively. The coefficients of variation were all below the standard limits. The energy response ranges were 0.79-1.27, 0.83-1.24, 0.76-1.21, and 0.15-0.36 for dosimeters A, B, C, and D, respectively. Conclusion Dosimeters A, B, and C meet the technical requirements of IEC 62387-2020 for extremity dosimeters used in photon monitoring in terms of nonlinear response, coefficient of variation, and energy response. They are suitable for extremity and skin dose monitoring in photon-dominated scenarios, such as radiological diagnosis/therapy and industrial radiation. Dosimeter D satisfies the technical requirements in the standard for extremity dosimeters used in β-ray monitoring in terms of nonlinear response and coefficient of variation, but exhibits a defect in β-ray energy dependence. It is recommended to optimize the dosimeter window and detector sensitive layer or introduce an energy compensation algorithm to enhance its adaptability to a broad energy spectrum. This study provides experimental support for the quality control and technical improvement of extremity dose monitoring equipment.

Objective:To investigate the clinical effect of cervical cerclage at different gestational weeks in twin pregnancy with cervical length (CL)≤15 mm.Methods:This was a retrospective cohort study. Eighty-three twin pregnant women with CL≤15 mm detected by transvaginal ultrasound at 16-27 +6 weeks of gestation in Fujian Maternity and Child Health Hospital from January 2017 to December 2023 were enrolled. According to different treatment methods, they were divided into cervical cerclage group (47 cases) and conservative treatment group (36 cases), and stratified according to the gestational age of CL≤15 mm diagnosis (<26 weeks, ≥26 weeks). The differences in pregnancy outcomes between the two groups were compared. Multivariate logistic regression was used to analyze the effect of cervical cerclage on preterm birth in twin pregnant women with different CL≤15 mm diagnosis weeks. Results:(1) The gestational age at delivery and prolonged gestational age in the cervical cerclage group were longer than those in the conservative treatment group (median gestational age at delivery: 35.3 vs 33.0 weeks; median prolonged gestational age: 10.4 vs 7.2 weeks), and preterm birth rates before 34, 32 and 28 weeks were lower than those in the conservative treatment group [34 weeks: 23% (11/47) vs 53% (19/36); 32 weeks: 15% (7/47) vs 39% (14/36); 28 weeks: 4% (2/47) vs 25% (9/36)], the differences were statistically significant (all P<0.05). There were no significant differences in the rates of preterm birth before 37 weeks of gestation and preterm premature rupture of membranes between the two groups (all P>0.05). (2) When gestational age at CL≤15 mm diagnosis was <26 weeks, pregnancy outcomes in the cervical cerclage group were better than those in the conservative treatment group, including gestational age at delivery (median: 35.4 vs 31.3 weeks) and prolonged gestational age (median: 11.1 vs 5.6 weeks), neonatal birth weight [(2 246±519) vs (1 594±691) g], incidence of adverse neonatal outcomes [19% (13/68) vs 56% (19/34)], and proportion of live births [100% (68/68) vs 82% (28/34)], respectively; the differences were statistically significant (all P<0.05). When the gestational age of CL≤15 mm diagnosis was ≥26 weeks, there were no statistically significant difference in pregnancy outcomes between the two groups (all P>0.05). (3) Multivariate logistic regression analysis showed that when the gestational age of CL≤15 mm diagnosis was <26 weeks, cervical cerclage reduced the risk of preterm birth before 34 weeks (a OR=0.10, 95% CI: 0.02-0.51; P<0.05), 32 weeks (a OR=0.11, 95% CI: 0.02-0.58; P<0.05) and 28 weeks (a OR=0.04, 95% CI: 0.01-0.65; P<0.05). When the gestational age of CL≤15 mm diagnosis was ≥26 weeks, cervical cerclage did not reduce the risk of preterm birth before 34, 32 and 28 weeks of gestation (all P>0.05). Conclusions:Cervical cerclage might reduce the risk of preterm birth and improve neonatal outcomes in twin pregnancies with CL≤15 mm before 26 weeks. However, cerclage showed no advantage over conservative treatment in twin pregnancies with CL≤15 mm over 26 weeks.

Objective:To investigate the clinical effect of cervical cerclage at different gestational weeks in twin pregnancy with cervical length (CL)≤15 mm.Methods:This was a retrospective cohort study. Eighty-three twin pregnant women with CL≤15 mm detected by transvaginal ultrasound at 16-27 +6 weeks of gestation in Fujian Maternity and Child Health Hospital from January 2017 to December 2023 were enrolled. According to different treatment methods, they were divided into cervical cerclage group (47 cases) and conservative treatment group (36 cases), and stratified according to the gestational age of CL≤15 mm diagnosis (<26 weeks, ≥26 weeks). The differences in pregnancy outcomes between the two groups were compared. Multivariate logistic regression was used to analyze the effect of cervical cerclage on preterm birth in twin pregnant women with different CL≤15 mm diagnosis weeks. Results:(1) The gestational age at delivery and prolonged gestational age in the cervical cerclage group were longer than those in the conservative treatment group (median gestational age at delivery: 35.3 vs 33.0 weeks; median prolonged gestational age: 10.4 vs 7.2 weeks), and preterm birth rates before 34, 32 and 28 weeks were lower than those in the conservative treatment group [34 weeks: 23% (11/47) vs 53% (19/36); 32 weeks: 15% (7/47) vs 39% (14/36); 28 weeks: 4% (2/47) vs 25% (9/36)], the differences were statistically significant (all P<0.05). There were no significant differences in the rates of preterm birth before 37 weeks of gestation and preterm premature rupture of membranes between the two groups (all P>0.05). (2) When gestational age at CL≤15 mm diagnosis was <26 weeks, pregnancy outcomes in the cervical cerclage group were better than those in the conservative treatment group, including gestational age at delivery (median: 35.4 vs 31.3 weeks) and prolonged gestational age (median: 11.1 vs 5.6 weeks), neonatal birth weight [(2 246±519) vs (1 594±691) g], incidence of adverse neonatal outcomes [19% (13/68) vs 56% (19/34)], and proportion of live births [100% (68/68) vs 82% (28/34)], respectively; the differences were statistically significant (all P<0.05). When the gestational age of CL≤15 mm diagnosis was ≥26 weeks, there were no statistically significant difference in pregnancy outcomes between the two groups (all P>0.05). (3) Multivariate logistic regression analysis showed that when the gestational age of CL≤15 mm diagnosis was <26 weeks, cervical cerclage reduced the risk of preterm birth before 34 weeks (a OR=0.10, 95% CI: 0.02-0.51; P<0.05), 32 weeks (a OR=0.11, 95% CI: 0.02-0.58; P<0.05) and 28 weeks (a OR=0.04, 95% CI: 0.01-0.65; P<0.05). When the gestational age of CL≤15 mm diagnosis was ≥26 weeks, cervical cerclage did not reduce the risk of preterm birth before 34, 32 and 28 weeks of gestation (all P>0.05). Conclusions:Cervical cerclage might reduce the risk of preterm birth and improve neonatal outcomes in twin pregnancies with CL≤15 mm before 26 weeks. However, cerclage showed no advantage over conservative treatment in twin pregnancies with CL≤15 mm over 26 weeks.

Objective:To explore the predictive value of prognostic nutritional index (PNI) combined with serum peroxiredoxin 3 (PRX3) level for the prognosis of patients with advanced high-grade serous ovarian cancer (HGSOC) .Methods:A total of 103 patients with advanced HGSOC admitted to Affiliated Hospital of Jining Medical University from Jan. 2020 to Dec. 2022 were retrospectively selected and included in the study. Serum albumin (Alb), PRX3 levels and peripheral blood lymphocyte count (LY) levels were measured. The patients were followed up for 2 years, and they were divided into good prognosis group (70 cases) and poor prognosis group (33 cases). Multivariate stepwise Logistic regression analysis was used to analyze the prognostic factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of PNI combined with PRX3 on prognosis.Results:The age, proportion of postoperative residual lesions, proportion of lymph node metastasis, proportion of stage Ⅲ, and PRX3 level in the poor prognosis group were higher than those in the good prognosis group, and the PNI level was lower than that in the good prognosis group ( P<0.05). Multivariate Logistic regression analysis showed that postoperative residual lesions ( OR=2.731, 95% CI: 1.562-4.774), clinical stage ( OR=3.526, 95% CI: 1.503-8.271), PNI level ( OR=0.148, 95% CI: 1.503-8.271) 0.057-0.387) and PRX3 level ( OR=4.011, 95% CI: 1.972-8.154) were independent influencing factors for the prognosis of patients ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) of PNI, PRX3 and their combination for predicting the prognosis of advanced HGSOC patients were 0.807, 0.781 and 0.874, respectively ( P<0.05). The survival curve of patients with high PNI and PRX3 levels was different from that of patients with low PNI and PRX3 levels ( P<0.05) . Conclusion:PNI and PRX3 are independent prognostic factors for advanced HGSOC patients, and the combination of PNI and PRX3 has a better prognostic value in patients with advanced HGSOC.

OBJECTIVE To prepare vancomycin hydrochloride(VH)-loaded polydopamine(PDA)nanoparticles(VH@PDA nanoparticles),and study their antimicrobial effect in combination with photothermal therapy.METHODS Using PDA as the carrier,VH was loaded to prepare VH@PDA nanoparticles(PDA nanoparticles were prepared using the same method).The nanoparticles were characterized with laser particle size analyzer,transmission electron microscope,and UV visible absorption spectrometer;the drug loading capacity and encapsulation efficiency of the nanoparticles were determined.The near-infrared laser irradiation was adopted to determine their photothermal ability.Taking Staphylococcus aureus as the research object,the bactericidal properties of the nanoparticles in combination with photothermal therapy in vitro were clarified through plate colony coating method,live/dead staining analysis,crystal violet staining.Using L929 cells as the research object,the effects of VH@PDA nanoparticles at different mass concentrations(0,3.125,6.25,12.5,25,50 and 100 μg/mL)on cell viability were investigated to assess their biocompatibility.RESULTS VH@PDA nanoparticles were successfully loaded with VH,exhibiting uniform particle size(approximately 300 nm),distinct pore size,and a spherical structure.The drug loading capacity was 11.34%,the encapsulation efficiency was 32.00%,the photothermal conversion efficiency reached 23.55%,and they demonstrated stable photothermal performance.The antibacterial effect results of the combined photothermal therapy demonstrated that without near-infrared laser irradiation,the antibacterial effects of VH,PDA nanoparticles,and VH@PDA nanoparticles were not significant.However,when subjected to near-infrared laser irradiation,VH@PDA nanoparticles exhibited a pronounced antibacterial effect.The results of the cell experiments revealed that after treatment with VH@PDA nanoparticles at various mass concentrations,the cell viability rates remained above 80%.CONCLUSIONS VH@PDA nanoparticles are successfully prepared,which exhibit stable photothermal properties,significant antibacterial effects when combined with photothermal therapy,and good biocompatibility.