Improper diving decompression can desaturate inert gases to form bubbles in the body and may lead to decompression sickness.In the process of decompression sickness,bubbles can directly or indirectly induce changes in platelet activation and coagulation.These abnormal changes play an important role in the rapid onset and continuous injury of decompression sickness.By systematically reviewing the relevant literatures,this article summarizes the effects of diving decompression on platelets,discusses the advantages and disadvantages of current prevention and treatment strategies,and outlines future research directions on the relationship between diving decompression and platelets.

Objective:Constructing a risk prediction model to assess the impact of various factors on the need for auxiliary bone grafting with implant placement following alveolar ridge preservation (ARP) in posterior teeth.Methods:According to the sample size calculation formula, the sample size was calculated using the pmsampsize package of R 4.1.3 software, based on inclusion and exclusion criteria, a total of 110 posterior teeth in 98 patients who underwent ARP at the Department of Periodontology, School and Hospital of Stomatology, China Medical University, from January 2018 to May 2024 were conducted. Teeth were randomly divided into modeling group and validation group with 7∶3 ratio according to the random number table. The modeling group was divided into direct implantation group and auxiliary bone grafting group on the basis of whether auxiliary bone grafting was performed 6 months after ARP. Univariate and multivariate analyses were conducted to identify factors influencing auxiliary bone grafting with implant placement following ARP. Nomogram was constructed using R software. Receiver operator characteristic (ROC) curve and calibration curve were drawn to evaluate model differentiation and consistency. The decision curve analysis (DCA) was used to assess the clinical application value of the model.Results:Age ( OR=1.06, P=0.001), maximum attachment loss (AL) ( OR=1.75, P<0.001), reason of tooth extraction ( OR=12.73, P<0.001), smoking [<10 cigarettes/d ( OR=7.59, P<0.001);≥10 cigarettes/d ( OR=28.12, P<0.001)] and stage of periodontitis [stage Ⅱ ( OR=2.57, P=0.430); stage Ⅲ ( OR=21.00, P=0.007); stage Ⅳ ( OR=76.50, P<0.001)] influenced the necessity for auxiliary bone grafting with implant placement after ARP. After multivariate analysis of the above influencing factors, it was found that smoking [<10 cigarettes/d ( OR=7.02, P=0.009);≥10 cigarettes/d ( OR=10.27, P=0.026)] was an independent risk factor for the need of auxiliary bone grafting with implant placement after ARP. The area under the ROC curve for internal verification was 0.90 (95 %CI: 0.84-0.97), and the H-L goodness of fit test results were χ 2=4.79, P=0.780, indicating a good agreement. The area under the externally verified ROC curve was 0.97 (95 %CI: 0.92-1.00), suggesting that the fitting effect was slightly lower than that of the modeling group, and the predicted value of the model was slightly lower than the true value, which might underestimate the risk of additional surgery in patients. Results:of H-L goodness of fit test were χ 2=5.03, P=0.754. The DCA curve showed that when the probability of high-risk threshold was between 0.06 and 0.93, the clinical application value of the prediction model was higher. Conclusions:Age, smoking, reason of tooth extraction, stage of periodontitis, and maximum AL of the affected teeth were related to the necessity for auxiliary bone grafting with implant placement 6 months after ARP. Smoking was an independent risk factor for auxiliary bone grafting surgery. The constructed nomogram model had good discrimination and consistency.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Objective:To fine-tune the mT5 (massively multilingual pre-trained text-to-text transformer) large language model, automatically generate report conclusions for teaching purposes from chest CT image descriptions, and assess the quality of automatically generated conclusions.Methods:The training set included 3 000 high-quality physical examination chest CT reports from one hospital, and the external validation set consisted of 600 physical examination chest CT reports from two other hospitals. Experienced radiology teaching physicians assessed the consistency between the generated conclusions and the original physician-written conclusions in the external validation set using a 5-point Likert scale across five linguistic indicators (correctness of examination information, correctness of lesion detection, standardization of terminology, applicability of the conclusions, and simplicity of conclusions). Using the original report conclusions as the reference, the accuracy of the conclusions generated based on the external validation set in describing four major thoracic conditions (pulmonary nodules, pneumonia, emphysema, pleural effusion) was evaluated. Perform chi square test using SPSS 25.0.Results:In the external validation set, the mean consistency score between the generated conclusions and the original conclusions given by the radiology teaching physicians was >4 points, indicating agreement with the original conclusions. In the generated conclusions, the description of the four major thoracic conditions demonstrated 0.95-1.00 (95% CI=0.91-1.00) accuracy, 0.76-1.00 (95% CI=0.59-1.00) sensitivity, and 0.97-1.00 (95% CI=0.91-1.00) specificity. Conclusions:The chest CT report conclusion generation system based on the mT5 large language model demonstrated high accuracy and is expected to provide immediate and efficient automated guidance for standardized residency training.

Objective To observe the value of Swin2SR network based on Transformer architecture for reconstructing chest super-resolution CT images.Methods Chest CT data of 218 patients were retrospectively collected.Swin2SR model based on Transformer architecture was adopted to enhance standard 512 matrix(512 × 512)CT images(standard-512 group)into 1 024(SR-1 024 group)and 2 048(SR-2 048 group)matrix SR CT images,respectively.Subjective and objective evaluation of image quality were performed,and the results were compared among groups.Results The subjective scores of overall imaging quality and lesion clarity in SR-1 024 and SR-2 048 groups were both higher than those in standard-512 group(all P＜0.05),while no significant difference was found between the former two(P＞0.05).Meanwhile,no significant difference of objective indexes of imaging quality was observed among 3 groups(all P＞0.05).Conclusion Swin2SR model could reconstruct chest SR CT images without increasing noise and improve imaging quality.

Objective:Constructing a risk prediction model to assess the impact of various factors on the need for auxiliary bone grafting with implant placement following alveolar ridge preservation (ARP) in posterior teeth.Methods:According to the sample size calculation formula, the sample size was calculated using the pmsampsize package of R 4.1.3 software, based on inclusion and exclusion criteria, a total of 110 posterior teeth in 98 patients who underwent ARP at the Department of Periodontology, School and Hospital of Stomatology, China Medical University, from January 2018 to May 2024 were conducted. Teeth were randomly divided into modeling group and validation group with 7∶3 ratio according to the random number table. The modeling group was divided into direct implantation group and auxiliary bone grafting group on the basis of whether auxiliary bone grafting was performed 6 months after ARP. Univariate and multivariate analyses were conducted to identify factors influencing auxiliary bone grafting with implant placement following ARP. Nomogram was constructed using R software. Receiver operator characteristic (ROC) curve and calibration curve were drawn to evaluate model differentiation and consistency. The decision curve analysis (DCA) was used to assess the clinical application value of the model.Results:Age ( OR=1.06, P=0.001), maximum attachment loss (AL) ( OR=1.75, P<0.001), reason of tooth extraction ( OR=12.73, P<0.001), smoking [<10 cigarettes/d ( OR=7.59, P<0.001);≥10 cigarettes/d ( OR=28.12, P<0.001)] and stage of periodontitis [stage Ⅱ ( OR=2.57, P=0.430); stage Ⅲ ( OR=21.00, P=0.007); stage Ⅳ ( OR=76.50, P<0.001)] influenced the necessity for auxiliary bone grafting with implant placement after ARP. After multivariate analysis of the above influencing factors, it was found that smoking [<10 cigarettes/d ( OR=7.02, P=0.009);≥10 cigarettes/d ( OR=10.27, P=0.026)] was an independent risk factor for the need of auxiliary bone grafting with implant placement after ARP. The area under the ROC curve for internal verification was 0.90 (95 %CI: 0.84-0.97), and the H-L goodness of fit test results were χ 2=4.79, P=0.780, indicating a good agreement. The area under the externally verified ROC curve was 0.97 (95 %CI: 0.92-1.00), suggesting that the fitting effect was slightly lower than that of the modeling group, and the predicted value of the model was slightly lower than the true value, which might underestimate the risk of additional surgery in patients. Results:of H-L goodness of fit test were χ 2=5.03, P=0.754. The DCA curve showed that when the probability of high-risk threshold was between 0.06 and 0.93, the clinical application value of the prediction model was higher. Conclusions:Age, smoking, reason of tooth extraction, stage of periodontitis, and maximum AL of the affected teeth were related to the necessity for auxiliary bone grafting with implant placement 6 months after ARP. Smoking was an independent risk factor for auxiliary bone grafting surgery. The constructed nomogram model had good discrimination and consistency.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Type 2 diabetes (T2D) is an independent risk factor for cognitive impairment. The dysregulation of hypoxia inducible factor (HIF) signaling in T2D patients results in impaired adaptive responses to hypoxia, thereby accelerating the progression of complications. However, limited knowledge is available regarding its precise function in diabetes-associated cognitive impairment (DACI). Here, elevated HIF-1α levels were observed in brain endothelial cells (ECs) of db/db mice. Functionally, brain ECs-specific knockdown of H if1 a significantly ameliorated T2D-induced memory loss and neuronal damage. Glycolysis in brain ECs was inhibited in this process, as indicated by RNA-seq, leading to decreased hippocampal lactate production through reduced LDHA expression. Notably, T2D patients showed increased cerebrospinal fluid lactate levels, which were strongly associated with their cognitive dysfunction. Intrahippocampal injection of lactate accelerated cognitive dysfunction and impaired adult hippocampal neurogenesis (AHN) in db/db mice. Conversely, reducing hippocampal lactate levels through the intrahippocampal injection of oxamate delayed the onset of memory deficits. Furthermore, asiatic acid was discovered to protect db/db mice from cognitive impairment by decreasing brain endothelial HIF-1α expression and subsequently reducing hippocampal lactate-induced AHN damage. Overall, this study elucidates the inhibiting role played by endothelial HIF-1α-driven lactate in AHN and highlights a potential tactic of targeting HIF-1α in brain ECs for treating cognitive impairment.

Cancer stem cells (CSCs) are widely acknowledged as primary mediators to the initiation and progression of tumors. The association between microbial infection and cancer stemness has garnered considerable scholarly interest in recent years. Porphyromonas gingivalis (P. gingivalis) is increasingly considered to be closely related to the development of oral squamous cell carcinoma (OSCC). Nevertheless, the role of P. gingivalis in the stemness of OSCC cells remains uncertain. Herein, we showed that P. gingivalis was positively correlated with CSC markers expression in human OSCC specimens, promoted the stemness and tumorigenicity of OSCC cells, and enhanced tumor formation in nude mice. Mechanistically, P. gingivalis increased lipid synthesis in OSCC cells by upregulating the expression of stearoyl-CoA desaturase 1 (SCD1) expression, a key enzyme involved in lipid metabolism, which ultimately resulted in enhanced acquisition of stemness. Moreover, SCD1 suppression attenuated P. gingivalis-induced stemness of OSCC cells, including CSCs markers expression, sphere formation ability, chemoresistance, and tumor growth, in OSCC cells both in vitro and in vivo. Additionally, upregulation of SCD1 in P. gingivalis-infected OSCC cells was associated with the expression of KLF5, and that was modulated by P. gingivalis-activated NOD1 signaling. Taken together, these findings highlight the importance of SCD1-dependent lipid synthesis in P. gingivalis-induced stemness acquisition in OSCC cells, suggest that the NOD1/KLF5 axis may play a key role in regulating SCD1 expression and provide a molecular basis for targeting SCD1 as a new option for attenuating OSCC cells stemness.
Porphyromonas gingivalis/pathogenicity* ; Stearoyl-CoA Desaturase/metabolism* ; Humans ; Carcinoma, Squamous Cell/pathology* ; Mouth Neoplasms/metabolism* ; Animals ; Neoplastic Stem Cells/microbiology* ; Mice, Nude ; Mice ; Nod1 Signaling Adaptor Protein/metabolism* ; Kruppel-Like Transcription Factors/metabolism* ; Cell Line, Tumor

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic