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

Objective To analyze the imaging features of pulmonary artery sarcoma(PAS)on CT and MRI.Methods The clini-cal features,CT and MRI findings of 21 patients with pathologically confirmed PAS were analyzed retrospectively.Results All PAS lesions involved the central pulmonary artery,of which 15 cases involved the main pulmonary artery and bilateral pulmonary artery trunks,4 cases involved the main pulmonary artery and right pulmonary artery trunk,1 case involved the main pulmonary artery and left pulmonary artery trunk,and 1 case involved the right pulmonary artery trunk.Five cases involved the pulmonary artery valve and right ventricular outflow tract as well.Nineteen cases of PAS showed complete filling defects in the central pulmonary artery,and the other 2 cases presented with nodular or lobulated filling defects attached to the pulmonary artery wall.The proximal margin of 19 PAS lesions was bulging or lobulated,and the distal pulmonary artery of 9 PAS lesions showed aneurysm-like dilatation.On MRI,all 13 cases of PAS were hyperintense on fat-suppressed T2WI,of which 11 cases were hyperintense on diffusion weighted imaging(DWI),and all lesions demonstrated significantly heterogeneous enhancement or delayed enhancement.Conclusion On computed tomography pul-monary angiography(CTPA),filling defects which grow expansively in the central pulmonary artery,and which have proximal bul-ging shape or distal aneurysm-like dilatation are highly suggestive of PAS.On contrast-enhanced MRI,the significantly heterogene-ous enhancement mass in the central pulmonary artery should be highly suspected of PAS.

Objective: To investigate the effects of RNA m6A demethylase ALKBH5 gene deficiency on cerebellar morphology and function in the aged mice, and to explore the role of ALKBH5 in cerebellar degeneration. Methods: Western blot was performed to detect the protein level of ALKBH5 in the cerebellum of wild-type mice of various ages. The expression of NeuN, Calbindin-D28K, MAP2, GFAP and other proteins in the cerebella of middle-aged (12-month-old) and aged (18-month-old) wild-type mice and ALKBH5^-/- mice was examined using immunohistochemistry. The balance beam test and gait analysis were performed to test the balance ability and motor coordination of the mice. Results: With aging of the mice, the expression of ALKBH5 in the cerebellum increased gradually in an age-dependent manner. In the aged mice, but not middle-aged mice, the body weight, whole brain weight and cerebellum weight of ALKBH5^-/- mice decreased by 15%, 10% and 21%, respectively (P<0.05). The expression of ALKBH5 in the Purkinje cells was much higher than that in other types of neural cells. Correspondingly, ALKBH5-deficiency caused 40% reduction in the number of Purkinje cells, as well as the length and density of neuronal dendrites in the aged mice (P<0.01). In addition, the time for the aged ALKBH5^-/- mice to pass the balance beam was 70% longer than that of the wild type mice of the same age, with unstable gaits (P<0.01). Conclusions: Gene deficiency of RNA m6A demethylase ALKBH5 causes cerebellar atrophy, Purkinje neuron loss and damage in the aged mice. These changes eventually affect mice's motor coordination and balance ability. These results suggest that imbalanced RNA m6A methylation may lead to neurodegenerative lesions in the cerebellum of mice.
Animals ; Mice ; AlkB Homolog 5, RNA Demethylase/metabolism* ; Cerebellum/metabolism* ; Methylation ; RNA/metabolism*

Humans ; AIDS Dementia Complex/pathology* ; HIV Infections

Antibodies, Monoclonal, Humanized/adverse effects* ; Humans ; Immune Checkpoint Inhibitors/adverse effects* ; Myocarditis/drug therapy*

Objective: Severe radiation-induced late rectal injury (sRLRI) directly affects the quality of life of patients with rectal cancer. Effective prediction of sRLRI before surgery may provide important information for the selection of surgical strategies and perioperative managements. The purpose of this study is to evaluate the feasibility of predicting sRLRI based on magnetic resonance imaging (MRI) features before and after radiotherapy for rectal cancer. Methods: This was a diagnostic study. Clinical and imaging data of 90 patients with rectal cancer receiving long-term radiotherapy from June 2013 to July 2018 in the Sixth Affiliated Hospital of Sun Yat-sen University were collected retrospectively. Case inclusion criteria: (1) rectal cancer was diagnosed by pathology and age of ≥ 18 years old; (2) patients received neoadjuvant chemoradiotherapy and anterior rectal resection; (3) follow up time ≥ 3 years; (4) patients had no history of other neoplasm. Exclusion criteria: (1) patients did not receive MRI examination in our hospital within 2 weeks before and/or 8 weeks after radiotherapy; (2) images were not good enough for evaluation; (3) medical records were incomplete; (4) patients had severe gastrointestinal diseases. According to the RTOG/EORTC classification criteria for radiation reactions, severe complications of grade 3-4 requiring surgical management were defined as sRLRI. T2WI and DWI images before and after radiotherapy were evaluated. The rectal wall thickness, bladder wall thickness, rectal sacral spacing and apparent diffusion coefficient (ADC) were measured. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the above indicators for sRLRI. Results: Among the 90 patients with rectal cancer, 34 (37.8%) developed sRLRI. Before radiotherapy, the median rectal wall thickness of sRLRI and non-sRLRI patients was 4.530 mm and 4.355 mm, respectively; the median bladder wall thickness was 3.962 mm and 3.868 mm, respectively; the median rectal sacral spacing was 15.557 mm and 12.433 mm, respectively; the median ADC value of rectal wall was 1.620 ×10(-3) mm(2)/s and 1.653 ×10(-3) mm(2)/s, respectively. There were no significant differences in above indicators between sRLRI and non-sRLRI patients (all P>0.05). After radiotherapy, compared with non-sRLRI patients, sRLRI patients had increased rectal wall thickness (median: 8.239 mm vs. 6.223 mm, Z=-3.512, P=0.001), rectal sacral spacing (median: 17.728 mm vs. 13.885 mm, Z=-2.247, P=0.025), and change of rectal wall thickness after radiotherapy (median: 98.106% vs. 49.584%, Z=-4.169, P<0.001). After radiotherapy, there were no significant differences in the bladder wall thickness and its change value, the ADC value of rectal wall and its change rate before and after radiotherapy between the two groups (all P>0.05). The area under the curve (AUC) of the change rates of rectal wall thickness after radiotherapy, rectal wall thickness and rectal sacral spacing after radiotherapy for predicting sRLRI was 0.763, 0.722 and 0.642, respectively, while the sensitivity was 85.3%, 70.6% and 76.5%, respectively, and the specificity was 64.3%, 71.4% and 57.1%, respectively. Conclusion: Based on MRI examinations, assessments of rectal wall thickness after radiotherapy, the change rate of rectal wall thickness after radiotherapy, and rectal sacral spacing after radiotherapy are helpful for evaluating the risk of sRLRI after radiotherapy for patients with rectal cancer.
Adolescent ; Chemoradiotherapy ; Diffusion Magnetic Resonance Imaging ; Humans ; Magnetic Resonance Imaging ; Neoadjuvant Therapy ; Quality of Life ; Rectal Neoplasms/radiotherapy* ; Retrospective Studies ; Treatment Outcome

Objective: To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention. Methods: A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively. Results: Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P<0.05). Before intervention, the scores of Barthel index, upper limb motor function, lower limb motor function were (33.15±7.08), (22.88±4.42), (15.31±3.38) in the observation group, and (33.40±3.78), (22.26±5.03), (16.04±3.30) in the control group, however, those index mentioned above were (47.96±8.45). There was no significant difference in Barthel index, motor function scores between two groups pre-intervention (P>0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05). Conclusion Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention.

· AIM:To investigate the correlation between retinal thickness (CSRT) in the macular region and glycosylated hemoglobin (HbA1c) of patients with type 2 diabetes mellitus.· METHODS:Totally 39 cases of patients with diabetes (77 eyes) who screened from May 2016 to March 2017 were selected,and were divided into two groups according to the levels of HbA1c,which the 24 cases (47 eyes) in the low HbA1c group (HbA1c＜8％) and 15 cases (30 eyes) in high HbA1c group (HbA1c≥8％).Other 22 cases of normal people (normal control group) and who for healthy physical examination were selected in the same period.Then,the correlation between HbA1c level and CSRT were analyzed by the Spearman correlation analysis.· RESULTS:In the high HbA1c group,HbA1c was (10.45±1.30)％,FBG was 10.67±1.64mmol/L and 2hPG was 15.98± 1.38mmol/L,which was higher than that in the low HbA1c group,and there was significant difference between the two groups (P＜ 0.05).The CSRT in the normal group was lower than the low HbA1c group and the high HbA1c group,and there was significant difference between the groups (P＜ 0.05).According to the analysis of the Spearman method,there was positive correlation between HbA1c and CSRT,macular volume,average macular thickness,FBG and those parameters,2hPG and them (P＜0.01).· CONCLUSION:The HbA1c level is associated with retinal thickening in the macular region of patients with diabetes,which could predict the severity of diabetic retinopathy and provide important guidance for prevention and treatment.

Objective To analyze the status of quality indicators(QI) on specimen acceptability and establish preliminary qual ity specification.Methods Web based External Quality Assessment system was used to collect data of laboratories partici pated in "Medical quality control indicators in clinical laboratory" from 2015 to 2017,including once in 2015 and 2017 and twice in 2016.Rate and sigma scales were used to evaluate incorrect sample type,incorrect sample container,incorrect fill level and anticoagulant sample clotted.The 25th percentile (P25) and 75th percentile (P75) of the distribution of each QI were employed to establish the high,medium and low specification.Results 5 346,7 593,5 950 and 6 874 laboratories sub mitted the survey results respectively.The P50 of biochemistry (except incorrect fill level),immunology and microbiology reach to 6σ.The P50 of clinical laboratory is 4 to 6σ except for incorrect sample container.There is no significant change of the continuous survey results.Based on results in 2017 to establish the quality specification,the P25 and P75 of the four QIs is 0 and 0.084 4 ％,0 and 0.047 6 ％,0 and 0.114 2 ％,0 and 0.078 4 ％,respectively.Conclusion According to the results of the survey,most laboratories had a faire performance in biochemistry,immunology and microbiology,and clinical laboratory needs to be strengthened.Laboratories should strengthen the laboratory information system construction to ensure the actual and reliable data collection,and make a long time monitoring to achieve a better quality.

Objective To evaluate the dynamic changes of left ventricular mechanical synchrony in the early period after acute myocardial infarction (AMI) by two-dimensional speckle tracking imaging (2D-STI) and real time three-dimensional echocardiography (RT-3DE),and analyze the correlation with phase analysis of single photo emission computed tomography gated myocardial perfusion imaging (SPECT GMPI) in porcine models,and further to investigate the clinical significance of left ventricular mechanical dyssynchrony in patients with AMI.Methods Bama minipigs(n =11) were subjected to left anterior descending (LAD) occlusion by balloon to introduce AMI porcine models.All animals underwent 2D-STI and RT-3DE at the baseline (before AMI),1 day,1 week and 4 weeks after LAD occlusion,respectively.In addition,SPECT GMPI was measured at baseline and 1 day after AMI.Data was analyzed and compared the dynamic changes of left ventricular mechanical synchrony before and after AMI.Then the correlation between echocardiography and SPECT GMPI in evaluating left ventricular mechanical synchrony before and after AMI were calculated.Results Eight pigs were successfully established as AMI models and complete the study.SPECT GMPI,2D-STI and RT-3DE showed that the left ventricular mechanical synchrony indexes were significantly higher at 1 day after AMI than those before AMI,which means the appearance of left ventricular mechanical dyssynchrony.Compared with those 1 day after AMI,GLS,Time SD,Tmsv16-SD％ and Tmsv16-Dif％ did not change significantly at 1 week after AMI,but they significantly increased at4 weeks after AMI (all P ＜0.05).At baseline and 1 day after AMI,the GLS measured by 2D-STI and the SPECT GMPI parameter phase bandwidth (BW) showed good correlation(r =0.708-0.719,P ＜0.05),Time SD was significantly correlated with the SPECT GMPI parameter phase standard deviation (SD)(r =0.717-0.830,P ＜0.05),while Tmsv16-Dif％ derived from RT-3DE had a better positive correlation with BW (r =0.713-0.857,P ＜0.05),as similar as Tmsv16-SD％ with SD(r =0.803-0.957,P ＜0.05).Conclusions Left ventricular mechanical dyssynchrony is present 1 day after AMI.Compared with that 1 day after AMI,left ventricular mechanical dyssynchrony doesn't change significantly at 1week after AMI,but further aggravates at 4 weeks after AMI.The parameters of 2D-STI and RT-3DE have good correlation with the mechanical synchrony parameters measured by SPECT GMPI.2D-STI and RT-3DE can be used as reliable methods to evaluate left ventricle mechanical dyssynchrony early after AMI.