Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.

Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.

Objective:To evaluate the efficacy and safety of mitoxantrone hydrochloride liposome injection in the treatment of peripheral T-cell lymphoma (PTCL) in a real-world setting.Methods:This was a real-world ambispective cohort study (MOMENT study) (Chinese clinical trial registry number: ChiCTR2200062067). Clinical data were collected from 198 patients who received mitoxantrone hydrochloride liposome injection as monotherapy or combination therapy at 37 hospitals from January 2022 to January 2023, including 166 patients in the retrospective cohort and 32 patients in the prospective cohort; 10 patients in the treatment-na?ve group and 188 patients in the relapsed/refractory group. Clinical characteristics, efficacy and adverse events were summarized, and the overall survival (OS) and progression-free survival (PFS) were analyzed.Results:All 198 patients were treated with mitoxantrone hydrochloride liposome injection for a median of 3 cycles (range 1-7 cycles); 28 cases were treated with mitoxantrone hydrochloride liposome injection as monotherapy, and 170 cases were treated with the combination regimen. Among 188 relapsed/refractory patients, 45 cases (23.9%) were in complete remission (CR), 82 cases (43.6%) were in partial remission (PR), and 28 cases (14.9%) were in disease stabilization (SD), and 33 cases (17.6%) were in disease progression (PD), with an objective remission rate (ORR) of 67.6% (127/188). Among 10 treatment-na?ve patients, 4 cases (40.0%) were in CR, 5 cases (50.0%) were in PR, and 1 case (10.0%) was in PD, with an ORR of 90.0% (9/10). The median follow-up time was 2.9 months (95% CI 2.4-3.7 months), and the median PFS and OS of patients in relapsed/refractory and treatment-na?ve groups were not reached. In relapsed/refractory patients, the difference in ORR between patients with different number of treatment lines of mitoxantrone hydrochloride liposome injection [ORR of the second-line, the third-line and ≥the forth-line treatment was 74.4% (67/90), 73.9% (34/46) and 50.0% (26/52)] was statistically significant ( P = 0.008). Of the 198 PTCL patients, 182 cases (91.9%) experienced at least 1 time of treatment-related adverse events, and the incidence rate of ≥grade 3 adverse events was 66.7% (132/198), which was mainly characterized by hematologic adverse events. The ≥ grade 3 hematologic adverse events mainly included decreased lymphocyte count, decreased neutrophil count, decreased white blood cell count, and anemia; non-hematologic adverse events were mostly grade 1-2, mainly including pigmentation disorders and upper respiratory tract infection. Conclusions:The use of mitoxantrone hydrochloride liposome injection-containing regimen in the treatment of PTCL has definite efficacy and is well tolerated, and it is a new therapeutic option for PTCL patients.

Objective: To investigate gender differences regarding changes of myopia rates among Han Chinese students aged 7-18 years in China, and to provide a scientific basis for precise myopia prevention and control. Methods: The visual acuity data of 871 112 students aged 7-18 years from four national student physical fitness and health surveys in 2005, 2010, 2014 and 2019 were selected to analyze gender differences in myopia rates and myopia rates among male and female students in each age group. Results: The overall myopia rate of students aged 7-18 years in China increased from 2005 to 2019( χ 2=7 265.06, P <0.01), and the myopia rate increased from 47.9%(2005) to 60.1% (2019). Gender differences in myopia rates among students trended to decrease( χ 2=72.24, P <0.01), and showed an inverted "U shaped" distribution from south to north, decreasing first and then increasing. Conclusion The problem of myopia in children and adolescents cannot be ignored, and the difference in myopia rates between male and female students should be taken into account, precise prevention and control of myopia accurately according to gender.

Objective To study the relationships between the standing balance and walking ability of hemiplegic stroke survivors.Methods Eighty-eight post-stroke hemiplegic patients who could walk independently for more than 10 metres were selected into a patient group,while 88 healthy counterparts were recruited into a control group.Descriptors of the gait and balance function of both groups were collected using a gait and balance training and evahuation apparatus (Model:AL-600).The gait parameters were step width,walking speed,step length asymmetry (SLA),swing time asymmetry (SWTA) and stand time asymmetry (STA).The balance parameters studied were total trajectory length of the center of plantar pressure (COPD),the average left and right deviation of the center of plantar pressure (COPD-X) and the average anterio-posterior deviation of the center of plantar pressure (COPD-Y).Differences in indexes of gait and balance function between the two groups were analyzed using t-tests,and the relationships between the gait and balance indicators were analyzed using Pearson correlation coefficients.Results The walking speed,step width,COPD,COPD-X,COPD-Y,SLA,SWTA and STA of the patient group [(37.64± 18.29)cm/s,(14.45±4.17)cm,(66.75±29.04)cm,(2.04±1.41)cm,(2.48±1.28)cm,(1.30±0.46),(1.65±0.67) and (1.18±0.16),respectively] all increased significantly more compared to the control group [(90.76±14.72)cm/s,(8.70±2.62) cm,(27.84±6.54) cm,(1.30±0.53) cm,(1.68±0.40) cm,(1.07±0.06),(1.07±0.08) and (1.05±0.06),respectively],though the walking speed was significantly slower than that in the control group (P＜0.05).The patient group's average COPD-X showed slightly and moderately negative correlation with their walking speed,step width,SLA and SWTA (P＜0.05).COPD-Y was weakly related with step width (P＜0.05).Conclusion The standing balance of hemiplegic patients after stroke is related to their walking speed,step width and gait asymmetry.Especially significant correlation is observed between standing balance parameters such as COPD-X and gait parameters.