Objective:To study the effects of chlorhexidine (CHX) and ethylene diamine tetraacetic acid (EDTA) on adhesive properties of moderate fluorosis dentin.Methods:From August to September 2024, a total of 30 freshly extracted, non-carious and non-defective mandibular molars with moderate dental fluorosis, extracted for impaction or orthodontic reasons, were collected from the patients at the Department of Oral and Maxillofacial Surgery at Guiyang Stomatological Hospital and randomly divided into three groups (Groups A, B, and C, n = 10) using a simple randomization method, and pretreated for 60 s with normal saline (Group A), 17%EDTA gel (Group B), and 2%CHX solution (Group C), respectively. Subsequently, microtensile bonding strength testing and microleakage evaluation were performed. Results:The immediate bonding strengths of Groups A, B, and C were (14.23 ± 4.75), (20.94 ± 7.46), and (28.76 ± 14.61) MPa, respectively, and the bonding strengths after aging were (9.89 ± 3.81), (19.05 ± 7.85), and (22.15 ± 8.67) MPa, respectively. There were statistically significant differences in both immediate and aged bonding strengths among the three groups ( F = 6.08, 8.07, P = 0.010, 0.002). The immediate bonding strength of Group C was significantly higher than that of Group A ( P < 0.05), and the post aging bonding strength of both Group B and Group C was significantly higher than that of Group A ( P < 0.05). The proportion of silver staining area with microleakage in Groups A, B, and C were 21.87% (14.65%, 40.15%), 2.34% (1.87%, 5.29%), and 17.54% (4.59%, 20.47%), respectively, with statistically significant differences among the three groups ( H = 27.36, P = 0.001). The proportion of silver stained area with microleakage in Group B was significantly lower than that in Group A and Group C, and the difference was statistically significant ( P < 0.05). Conclusions:Pretreatment of moderate fluorosis dentin with 2%CHX or 17%EDTA can improve resin bongding performance, with EDTA being superior in reducing microleakage and CHX being better in enhancing adhesion strength.

Objective:To investigate the clinical significance of prenatal screening and genetic analysis in the diagnosis of fetal aberrant right subclavian artery(ARSA).Methods:The ultrasonographic features of ARSA fetu-ses detected by prenatal ultrasound at the University of Hong Kong-Shenzhen Hospital from October 2017 to March 2022 were retrospectively analyzed.The fetuses were divided into isolated ARSA group and complicated ARSA group.Their genetic analysis results and pregnancy outcome were analyzed.Results:Among 30,260 preg-nant women,185 fetuses were diagnosed with ARSA by prenatal ultrasound screening,with an incidence of 0.6％;5 fetuses(2.6％)were diagnosed by ultrasound in the first trimester,and the remaining were diagnosed by fetal grade Ⅲ structural ultrasound examination at 20～24 weeks' gestation.Among them,158 fetuses(85.4％)had isolated ARSA,and 27(14.6％)had complicated ARSA.Among fetuses with ARSA and other structural abnormal-ities,cardiovascular system accounted for the highest proportion(44.4％),followed by nervous system(22.2％)and urinary system(22.2％).Through genetic analysis,8.3％(4/48)fetuses with isolated ARSA and 40.0％(4/10)fetuses with complicated ARSA were found to have chromosomal numerical or structural abnormalities,with statis-tically significant difference between the two groups(P=0.024).Genetic analysis was completed in 48 isolated ARSA,and the positive rate of pathogenic copy number variants(CNV)was 4.2％(2/48),which was not signifi-cantly different from the pathogenic CNV incidence rate of 0.4％(1/239)in elderly pregnant cases during the same period(P=0.074).The Down syndrome positive likelihood ratio(LR+)for isolated ARSA was 2.5 and the Down syndrome LR+for complicated ARSA was 49.6.Conclusions:Complicated ARSA is often associated with cardiovascular abnormalities and is more likely to develop Down syndrome than isolated ARSA.Although the inci-dence of pCNV in isolated ARSA is slightly higher than the natural incidence,the correlation between pCNV and i-solated ARSA has not been clearly determined by the current sample size.

Objective:To study the effects of chlorhexidine (CHX) and ethylene diamine tetraacetic acid (EDTA) on adhesive properties of moderate fluorosis dentin.Methods:From August to September 2024, a total of 30 freshly extracted, non-carious and non-defective mandibular molars with moderate dental fluorosis, extracted for impaction or orthodontic reasons, were collected from the patients at the Department of Oral and Maxillofacial Surgery at Guiyang Stomatological Hospital and randomly divided into three groups (Groups A, B, and C, n = 10) using a simple randomization method, and pretreated for 60 s with normal saline (Group A), 17%EDTA gel (Group B), and 2%CHX solution (Group C), respectively. Subsequently, microtensile bonding strength testing and microleakage evaluation were performed. Results:The immediate bonding strengths of Groups A, B, and C were (14.23 ± 4.75), (20.94 ± 7.46), and (28.76 ± 14.61) MPa, respectively, and the bonding strengths after aging were (9.89 ± 3.81), (19.05 ± 7.85), and (22.15 ± 8.67) MPa, respectively. There were statistically significant differences in both immediate and aged bonding strengths among the three groups ( F = 6.08, 8.07, P = 0.010, 0.002). The immediate bonding strength of Group C was significantly higher than that of Group A ( P < 0.05), and the post aging bonding strength of both Group B and Group C was significantly higher than that of Group A ( P < 0.05). The proportion of silver staining area with microleakage in Groups A, B, and C were 21.87% (14.65%, 40.15%), 2.34% (1.87%, 5.29%), and 17.54% (4.59%, 20.47%), respectively, with statistically significant differences among the three groups ( H = 27.36, P = 0.001). The proportion of silver stained area with microleakage in Group B was significantly lower than that in Group A and Group C, and the difference was statistically significant ( P < 0.05). Conclusions:Pretreatment of moderate fluorosis dentin with 2%CHX or 17%EDTA can improve resin bongding performance, with EDTA being superior in reducing microleakage and CHX being better in enhancing adhesion strength.

Objective:To investigate the clinical significance of prenatal screening and genetic analysis in the diagnosis of fetal aberrant right subclavian artery(ARSA).Methods:The ultrasonographic features of ARSA fetu-ses detected by prenatal ultrasound at the University of Hong Kong-Shenzhen Hospital from October 2017 to March 2022 were retrospectively analyzed.The fetuses were divided into isolated ARSA group and complicated ARSA group.Their genetic analysis results and pregnancy outcome were analyzed.Results:Among 30,260 preg-nant women,185 fetuses were diagnosed with ARSA by prenatal ultrasound screening,with an incidence of 0.6％;5 fetuses(2.6％)were diagnosed by ultrasound in the first trimester,and the remaining were diagnosed by fetal grade Ⅲ structural ultrasound examination at 20～24 weeks' gestation.Among them,158 fetuses(85.4％)had isolated ARSA,and 27(14.6％)had complicated ARSA.Among fetuses with ARSA and other structural abnormal-ities,cardiovascular system accounted for the highest proportion(44.4％),followed by nervous system(22.2％)and urinary system(22.2％).Through genetic analysis,8.3％(4/48)fetuses with isolated ARSA and 40.0％(4/10)fetuses with complicated ARSA were found to have chromosomal numerical or structural abnormalities,with statis-tically significant difference between the two groups(P=0.024).Genetic analysis was completed in 48 isolated ARSA,and the positive rate of pathogenic copy number variants(CNV)was 4.2％(2/48),which was not signifi-cantly different from the pathogenic CNV incidence rate of 0.4％(1/239)in elderly pregnant cases during the same period(P=0.074).The Down syndrome positive likelihood ratio(LR+)for isolated ARSA was 2.5 and the Down syndrome LR+for complicated ARSA was 49.6.Conclusions:Complicated ARSA is often associated with cardiovascular abnormalities and is more likely to develop Down syndrome than isolated ARSA.Although the inci-dence of pCNV in isolated ARSA is slightly higher than the natural incidence,the correlation between pCNV and i-solated ARSA has not been clearly determined by the current sample size.

Objective:To study the effects of recombinant human erythropoietin (rhEPO) on cerebral blood flow (CBF) in preterm infants using arterial spin labeling (ASL) magnetic resonance imaging (MRI).Methods:From September 2021 to June 2022, preterm infants (gestational age ≤32 weeks, birth weight ≤1 500 g) admitted to NICU of our hospital within 24 h after birth were randomly assigned into rhEPO group and control group for this prospective study. The rhEPO group was given rhEPO (500 IU/kg iv, once every other day for 2 weeks) within 72 h after birth plus symptomatic supportive treatment. The control group received same amount of normal saline injection. Both groups received brain MRI, diffusion-weighted imaging and ASL at adjusted gestational age of 35~37 weeks and CBF values of interested areas were measured.Results:A total of 85 infants were enrolled, including 40 in the rhEPO group and 45 in the control group. No significant differences existed in the incidences of periventricular-intraventricular hemorrhage, periventricular leukomalacia, focal white matter injury and extensive white matter injury between the two groups ( P>0.05). The CBF values [ml/(100 g·min)] of frontal cortex [left 15.1±3.9 vs. 17.9±3.1, right 15.9 (12.5, 17.8) vs. 18.1(16.1,20.2)], temporal cortex [left 15.8±4.3 vs. 18.6±3.8, right 16.3(13.2,19.4) vs. 18.1(15.7,19.7)], occipital cortex (left 15.8±6.1 vs. 18.8±3.3, right 16.8±5.5 vs. 19.3±4.8), basal ganglia (left 24.7±7.2 vs. 28.7±6.2, right 26.0±7.9 vs. 29.3±6.4) and thalamus (left 32.7±11.8 vs. 37.9±8.6, right 32.1±11.6 vs. 37.6±10.2) in the rhEPO group were significantly lower than the control group ( P<0.05). No significant differences existed of CBF value at the parietal cortex between the two groups ( P>0.05). Conclusions:Early application of rhEPO can reduce CBF in premature infants, which may be related to the neuro-protective effects of EPO.

Objective:To summarize the experience of personalized treatment of pediatric prepuce trauma.Methods:The clinical data of children with prepuce trauma treated in the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from January 2019 to March 2021 were analyzed retrospectively. First, pediatric prepuce trauma was classified and graded before treatment, and then the treatment plans were developed with the informed consent of the children’s parents. Mild injuries were treated conservatively. In moderate injuries, in situ suture repair and frenuloplasty were performed. In severe injuries, modified circumcision and prepuce flap prepuceplasty were performed. In extremely severe injuries, composite flap (scrotal and mons pubis flap combined with prepuce flap) prepuceplasty was performed. The children were followed up for penile appearance and urinary and erectile function postoperatively.Results:A total of 36 male children, aged 6 months to 10 years, were enrolled in the study. Type of foreskin trauma: 7 cases of foreskin tie injury, 7 cases of inner plate injury, 12 cases of outer plate injury, and 10 cases of combined inner and outer plate injury; degree of foreskin trauma: 9 cases of mild injury, 6 cases of moderate injury, 19 cases of severe injury, and 2 cases of extremely severe injury. 9 of the 36 cases were treated conservatively; 4 cases were treated with in situ suture repair; 5 cases were treated with in situ suture repair + circumcision; 12 cases were treated with modified circumcision; 4 cases were treated with foreskin flap penile circumcision, and composite flaps (scrotal and mons pubis flaps as advancement flap + prepuce flap) were applied in 2 cases. All the children were followed up for 3~6 months. The appearance of the penis and scrotum was good, and the urination and erectile function were normal after treatment. The parents of the children were satisfied with the treatment results.Conclusions:For the treatment of pediatric prepuce trauma, it is necessary to comprehensively consider the location of the prepuce involved and the degree of prepuce injury and adopt an appropriate personalized treatment plan, which can achieve better results.

Objective:To summarize the experience of personalized treatment of pediatric prepuce trauma.Methods:The clinical data of children with prepuce trauma treated in the Department of Pediatric Surgery of the First Affiliated Hospital of Zhengzhou University from January 2019 to March 2021 were analyzed retrospectively. First, pediatric prepuce trauma was classified and graded before treatment, and then the treatment plans were developed with the informed consent of the children’s parents. Mild injuries were treated conservatively. In moderate injuries, in situ suture repair and frenuloplasty were performed. In severe injuries, modified circumcision and prepuce flap prepuceplasty were performed. In extremely severe injuries, composite flap (scrotal and mons pubis flap combined with prepuce flap) prepuceplasty was performed. The children were followed up for penile appearance and urinary and erectile function postoperatively.Results:A total of 36 male children, aged 6 months to 10 years, were enrolled in the study. Type of foreskin trauma: 7 cases of foreskin tie injury, 7 cases of inner plate injury, 12 cases of outer plate injury, and 10 cases of combined inner and outer plate injury; degree of foreskin trauma: 9 cases of mild injury, 6 cases of moderate injury, 19 cases of severe injury, and 2 cases of extremely severe injury. 9 of the 36 cases were treated conservatively; 4 cases were treated with in situ suture repair; 5 cases were treated with in situ suture repair + circumcision; 12 cases were treated with modified circumcision; 4 cases were treated with foreskin flap penile circumcision, and composite flaps (scrotal and mons pubis flaps as advancement flap + prepuce flap) were applied in 2 cases. All the children were followed up for 3~6 months. The appearance of the penis and scrotum was good, and the urination and erectile function were normal after treatment. The parents of the children were satisfied with the treatment results.Conclusions:For the treatment of pediatric prepuce trauma, it is necessary to comprehensively consider the location of the prepuce involved and the degree of prepuce injury and adopt an appropriate personalized treatment plan, which can achieve better results.

At present, the exact pathogenesis of dental fluorosis is not clear, and there is no exact standard of enamel acid etching in the adhesive restoration of dental fluorosis. Atomic force microscope represents a great progress in high-resolution imaging of biomaterials, and its advantage is that it can provide three-dimensional images and quantitative data of observed samples at the nanometer level. In recent years, the application of atomic force microscope in enamel study has made some progress. Whether the quantitative analysis of enamel ultrastructure can become a new way to study the pathogenesis of dental fluorosis and find the best repair method is worthy of further exploration. This paper reviews the application of atomic force microscope in the study of enamel with dental fluorosis.

Objective To detect the volume changes of cerebral gray and white matter in patients with maintaining hemodialysis using voxel-based morphometry(VBM) and to correlate these changes with cognitive function. Methods Forty-two patients with maintaining hemodialysis and 41 age and sex matched normal subjects were recruited in this study. MMSE was obtained to evaluate their neuropsychiatric conditions. Whole brain high-resolution T1WI was performed on 3.0 T MR scanner in both patients and normal controls. The data were analyzed by VBM based on SPM8, using analysis of functional neuroimages (AFNI) software package with the Monte Carlo simulation method(AlphaSim method) for multiple cluster level comparisons correction. Independent sample t test analysis was used to compare the volume of gray and white matter between the patients and normal controls. In addition, Stepwise multiple linear regression analysis was performed to explore the correlation between the voxel value of cerebral volume changes area and dialysis duration and clinical laboratory examination, and Spearman correlation analysis was used for the correlation between the left insula voxel values and neuropsychological test scores. Results Compared with normal controls, patients showed significantly decreased volume in the grey matter of the right putamen, the left putamen, the left insula (numbers of voxel in clusters were 455, 561, 162, t=-9.5681,-5.9516,-5.7185,P<0.001, AlphaSim-corrected). There was negative correlation between decreased grey matter volume of the right putamen[(0.53 ± 0.12)mm3]and the left putamen[(0.48 ± 0.12)mm3] and dialysis duration [19.0(1.5-114.0)months] (r=-0.330,-0.307,P<0.05). MMSE score of patients[29(21-30)score] was significantly lower than normal controls[30(28-30)score] (Z=-30.58,P<0.01). Decreased grey matter volume of the left insula [(0.39 ± 0.12) mm3] was positively correlated with MMSE(r=0.320, P<0.05). Conclusions The patients with maintaining hemodialysis show grey matter atrophy which is associated with neurocognitive dysfunction. Dialysis duration may be an important risk factor for decreased gray matter in patients with maintaining hemodialysis.