Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

OBJECTIVES: This study aimed to evaluate the clinical application value of in-situ crown reattachment technique combined with pulpotomy in the treatment of complicated crown-root fractures in young permanent anterior teeth. METHODS: A prospective study was conducted on 50 children with complicated crown-root fractures in young permanent anterior teeth, who were treated at the Pediatric Dentistry Department, Hospital of Stomatology, Xi'an Jiaotong University from June 2023 to June 2024. All patients underwent in-situ crown reattachment technique combined with pulpotomy. Clinical examinations, radiographic evaluations, and subjective satisfaction surveys (using a Likert scale of 1-10) were conducted at 1, 6, and 12 months postoperatively. Data were analyzed using SPSS 23.0. RESULTS: The loss-to-follow-up rate was 12% (6/50), with 44 cases completing the 12 months of evaluation. The clinical success rate was 93.18% (41/44), and the radiographic success rate was 97.73% (43/44). The subjective satisfaction scores showed a significant improvement in masticatory function from 7.03±0.52 at 1 month to 8.07±0.92 at 12 months postoperatively (P<0.05), whereas the scores for aesthetics, comfort, and quality-of-life impact showed no statistically significant differences (P>0.05). CONCLUSIONS In-situ crown reattachment technique combined with pulpotomy effectively treats complicated crown-root fractures in young permanent anterior teeth, demonstrating a high short-term clinical success rate, significantly improved masticatory function, and minimally invasive preservation of pulp vitality and root development potential. This technique provides an optimized treatment option for dental trauma in children, although its long-term efficacy requires further validation.
Humans ; Pulpotomy ; Tooth Fractures/surgery* ; Child ; Prospective Studies ; Male ; Female ; Tooth Root/injuries* ; Tooth Crown/injuries* ; Treatment Outcome ; Incisor/injuries* ; Child, Preschool

Objective To investigate the analgesic effect of total saponins of Clematis(TSC)on trigeminal neuralgia(TN)rats by regulating the miR-26a-5p/Wnt5a signaling pathway.Methods The TN rat model was established through suborbital nerve constriction surgery.Fifty rats were divided into the TN group,the different doses of(50,200 mg/kg)TSC groups,the TSC+NC antagonist(200 mg/kg TSC+5 nmoL NC antagonist)group and the TSC+miR-26a-5p antagonist(200 mg/kg TSC+5 nmoL miR-26a-5p antagonist)group2025,with 10 mice per group.Another 10 rats were taken as the sham operation group,and only the infraorbital nerve of rats was exposed but not ligated.ELISA was used to detect the levels of tumor necrosis factor(TNF)-α and interleukin(IL)-6.HE staining was used to detect histopathological changes.Real-time fluorescence quantitative reverse transcription polymerase chain reaction was used to detect the expression levels of miR-26a-5p and Wnt5a mRNA.Western blot assay was used to detect protein expressions of glial neurotrophic factor(GDNF),Wnt5a and brain-derived neurotrophic factor(BDNF)in trigeminal ganglion tissue.Dual luciferase reporter gene system was applied to validate the targeting relationship between miR-26a-5p and Wnt5a.Results Compared with the sham operation group,the expression levels of TNF-α,IL-6,Wnt5a protein and mRNA were obviously increased in the TN group,and the mechanical pain threshold,the expression levels of miR-26a-5p,GDNF and BDNF were obviously reduced(P＜0.05).Compared with the TN group,the expression of TNF-α,IL-6,Wnt5a protein and mRNA were greatly reduced in the 50 and 200 mg/kg TSC groups,and the mechanical pain threshold,the expression levels of miR-26a-5p,GDNF and BDNF were greatly increased.There were differences in different doses of TSC between the different groups(P＜0.05).Inhibition of miR-26a-5p reversed the protective effect of TSC on TN rats.Conclusion TSC exerts analgesic effects on TN rats by regulating the miR-26a-5p/Wnt5a signaling pathway.

Objective To investigate the effects of liraglutide on the gut microbiota of db/db diabetic mice and the predictive value of the microbial structure for the hypoglycemic efficacy.Methods The db/db mice were randomly divided into control group and liraglutide group(0.4 μg/g).Fasting blood glucose levels were measured in the mice,and fecal samples were collected to determine the structure of the gut microbiota.Results Compared with the control group,the liraglutide group exhibi-ted a significant increase in the average number of operational taxonomic unit(OTU)(P＜0.01).The number of observed species,Chao1 index and ACE index were all significantly higher in the liraglutide group than those in the control group(P＜0.05).Additionally,the liraglutide group showed a signifi-cant increase in the relative abundance of Firmicutes and a significant decrease in the abundance of Actinobacteria compared with the control group(P＜0.01).The percentage decrease in blood glucose levels in db/db mice was positively correlated with the abundance of Pseudomonadaceae and negatively correlated with the abundances of Clostridiaceae and Peptostreptococcaceae.Conclusion Liraglutide treatment can modulate the structure of the gut microbiota,increasing the number of OTU and diversity,particularly enhancing the abundance of beneficial bacteria such as Clostridium,Lachnospira and Oscillospira.The gut microbiota structure in mice serves as a predictive factor for the hypoglycemic efficacy of liraglutide,with diabetic mice exhibiting a higher abundance of Pseudomonas being more likely to benefit from liraglutide-induced hypoglycemic therapy.

BACKGROUND: Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its incidence remains high. Phrenic nerve cryotherapy (PNC) temporarily inhibits phrenic nerve function, causing diaphragm elevation, which reduces thoracic cavity volume, enhances pleural apposition, and mitigates air leakage. This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy. METHODS: A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, from June 2023 to January 2025, were enrolled and randomly assigned to the control group (n=54) and the experimental group (n=54). The patients in both the two groups received VATS lobectomy and systematic lymph node dissection, with the experimental group also undergoing PNC during the operation. The baseline characteristics, intraoperative, postoperative indicators and dynamic changes in air leakage between the two groups were compared. RESULTS: The baseline clinical characteristics were comparable between the two groups (P>0.05). The incidence of pulmonary air leakage at 24 h after surgery (31.5% vs 29.6%) and the incidence of postoperative PAL (20.4% vs 14.8%) showed no significant differences between the two groups (P>0.05). The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases (32.0%) in the control group, compared to 14 cases (46.7%) in the experimental group. Moreover, during the progression from air leakage at 24 hours post-surgery to postoperative PAL, air leakage ceased in 6 cases (35.3%) in the control group and 8 cases (50.0%) in the experimental group, with a statistically significant difference (P<0.001). Compared to the control group, the patients in the experimental group exhibited more pronounced postoperative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery. CONCLUSIONS The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage, reducing the occurrence of postoperative PAL.
Humans ; Thoracic Surgery, Video-Assisted/adverse effects* ; Male ; Female ; Middle Aged ; Lung Neoplasms/surgery* ; Aged ; Phrenic Nerve/physiopathology* ; Cryotherapy ; Pneumonectomy/adverse effects* ; Postoperative Complications/etiology* ; Adult

Objective To investigate the analgesic effect of total saponins of Clematis(TSC)on trigeminal neuralgia(TN)rats by regulating the miR-26a-5p/Wnt5a signaling pathway.Methods The TN rat model was established through suborbital nerve constriction surgery.Fifty rats were divided into the TN group,the different doses of(50,200 mg/kg)TSC groups,the TSC+NC antagonist(200 mg/kg TSC+5 nmoL NC antagonist)group and the TSC+miR-26a-5p antagonist(200 mg/kg TSC+5 nmoL miR-26a-5p antagonist)group2025,with 10 mice per group.Another 10 rats were taken as the sham operation group,and only the infraorbital nerve of rats was exposed but not ligated.ELISA was used to detect the levels of tumor necrosis factor(TNF)-α and interleukin(IL)-6.HE staining was used to detect histopathological changes.Real-time fluorescence quantitative reverse transcription polymerase chain reaction was used to detect the expression levels of miR-26a-5p and Wnt5a mRNA.Western blot assay was used to detect protein expressions of glial neurotrophic factor(GDNF),Wnt5a and brain-derived neurotrophic factor(BDNF)in trigeminal ganglion tissue.Dual luciferase reporter gene system was applied to validate the targeting relationship between miR-26a-5p and Wnt5a.Results Compared with the sham operation group,the expression levels of TNF-α,IL-6,Wnt5a protein and mRNA were obviously increased in the TN group,and the mechanical pain threshold,the expression levels of miR-26a-5p,GDNF and BDNF were obviously reduced(P＜0.05).Compared with the TN group,the expression of TNF-α,IL-6,Wnt5a protein and mRNA were greatly reduced in the 50 and 200 mg/kg TSC groups,and the mechanical pain threshold,the expression levels of miR-26a-5p,GDNF and BDNF were greatly increased.There were differences in different doses of TSC between the different groups(P＜0.05).Inhibition of miR-26a-5p reversed the protective effect of TSC on TN rats.Conclusion TSC exerts analgesic effects on TN rats by regulating the miR-26a-5p/Wnt5a signaling pathway.

AIM: To analyze the clinical characteristics of acute acquired concomitant esotropia(AACE)in patients among different age groups.METHODS: Retrospective analysis of clinical data. A total of 112 non-Swan type AACE patients who underwent surgery at Peking University People's Hospital from January 2015 to December 2022 were retrospectively analyzed. Clinical data were collected and the characteristics were compared, including gender, age, diopter, duration of disease, daily time spent on near work, angles of deviation before and after surgery, stereopsis, etc. According to age, patients were divided into three groups: <18 years old group(22 cases), 18-45 years old group(67 cases), and >45 years old group(23 cases). The clinical characteristics of patients were compared in each group.RESULTS: A total of 112 patients were included in the study, comprising 56 males and 56 females, with a median age of 29.50(19.25, 41.75)years old. Among them, 97 patients had myopia(86.6%). There were 93 patients(83.0%)who spent more than 8 h on near work. The age group <18 years old had the shortest duration before surgery, with a median time of 1.00(0.50, 1.00)a, the minimum negative diopter, with a median diopter of -0.75(-3.19, -0.56)D in the right eye and the diopter of -1.25(-2.81, -0.75)D in the left eye, and the maximum preoperative near angle of deviation, with a median angle of 30.00(18.50, 80.00)PD, and the maximum preoperative distant angle of deviation, with a median angle of 35.00(23.75, 80.00)PD. All these differences were statistically significant compared with other two groups(both P<0.05). For the age group from 18 to 45 years old, the median near angle of deviation was 20.00(14.00, 30.00)PD, and the median distant angle of deviation was 25.00(20.00, 35.00)PD, both of which were higher than those in the age group >45 years old(both P<0.05). For the age group >45 years old, the median near angle of deviation after surgery was -4.50(-7.50, 0)PD, and the median distant angle of deviation after surgery was 4.50(0, 9.50)PD, which were smaller than those in other two groups(all P<0.05). The age group >45 years old had the hiughest surgical success rate(100%). The preoperative stereopsis was better in age group >45 years old than the group <18 years old(P<0.05). The postoperative stereopsis of the age group of 18 to 45 years old and the age group >45 years old was better than age group <18 years old(both P<0.05).CONCLUSION: Surgical patients with AACE are mainly in the age group from 18 to 45 years old. The characteristic of angle of deviation is that distant angle of deviation is greater than near angle of deviation. The patients <18 years old have larger preoperative angles of deviation than adults, while their stereoacuity is worse than adults in the early postoperative period. It is recommended that augmented-dose surgery should be performed in AACE patients who are in the age group of 18 to 45 years old(5-10 PD). A conservative surgery should be designed for hyperopia young children without established binocular vision.

Objective:To analyze the hard tissue thickness in the crown of primary teeth by CBCT.Methods:The CBCT imaging data of 47 children were included,and the hard tissue thickness of primary teeth was measured by MIMICS software.SPSS 22.0 was used for data analysis.Results:The average thickness in the mesial surfaces was the smallest(P＜0.01),except for the libial surface of maxillary central incisor and the distal surface of mandibular first primary molar.In primary anteriors,the thickness in the same sur-face of maxillary teeth was greater than that of mandibular teeth significantly(P＜0.01)except for the libial surface of primary canine.In primary molars,the thickness of hard tissue in the same part of the distal and lingual side of the maxillary teeth was greater than that of the mandibular teeth(P＜0.01),and the thickness in the buccal side of maxillary teeth was lower than that of the mandibular teeth(P＜0.01).Conclusion:The distribution of hard tissue thickness of primary teeth in different position is different.

Objective To understand the current status of death anxiety in patients with primary liver cancer and analyze its influencing factors,so as to provide basis for developing individualized psychological guidance and intervention measures.Methods A convenient sampling method was used to select 302 patients with primary liver cancer who were hospitalized in a tertiary hospital in Jiangsu Province from March to November 2022.The General Demographic Information Questionnaire,the Templer's Death Anxiety Scale(T-DAS),the State-Trait Anxiety Inventory(STAI),the Rosenberg Self-esteem Scale(SES)and the Self-perceived Burden Scale(SPBS)were used to conduct questionnaire survey during hospitalization.Single factor analysis and multiple linear regression analysis were applied to analyze the factors influencing the death anxiety in patients with primary liver cancer.Results A total of 298 patients with primary liver cancer were included in the study.The effective recovery rate was 98.68％.The total score of the F-DAS was(7.10±3.43)points;56.38％of the patients had high death anxiety.Multiple linear regression analysis results showed that the factors influencing the death anxiety in patients with primary liver cancer included gender,China liver cancer staging,duration of diagnosis,self-esteem,trait anxiety and self-perceived burden.A total of 49.00％of the variation in death anxiety was explained.Conclusion The death anxiety of patients with primary liver cancer is at a high level.It is suggested that medical staff should pay more attention to female patients with China liver cancer staging IV,diagnosis time＞3 months and low self-esteem,high levels of trait-anxiety and self-perceived burden,in order to develop personalized intervention measures,carry out psychological counseling and emotional support to relieve patients'death anxiety.

Objective:To explore the effect of mobile health (mHealth) management system on dietary behavior of patients with coronary heart disease (CHD) .Methods:Using the convenient sampling method, CHD patients who were hospitalized in Department of Cardiology of Beijing Anzhen Hospital and Beijing Chaoyang Hospital of Capital Medical University were selected as the research objects from June 2019 to January 2020. The research objects were randomly divided into the intervention group and the control group using SAS software. Finally, 68 cases in the intervention group and 66 cases in the control group completed the study. The intervention group received mhealth management, while the control group received routine management, and they were followed up to 1 month after discharge. The proportion of patients with the low-salt and low-oil diet, the intake of salt, oil, staple food, vegetables, fruits, fish, shrimp, poultry and eggs, BMI and blood pressure were compared between the two groups.Results:At 1 month follow-up, the intervention group was better than the control group in terms of low salt and low oil diet, salt intake, oil intake and vegetable intake compliance, and the differences were statistically significant ( P<0.05) . At 1 month follow-up, there were no statistically significant differences in BMI and blood pressure between two groups ( P>0.05) . Conclusions:The mobile health system can effectively increase the proportion of patients with a low-salt and low-oil diet, and improve the intake compliance of salt, edible oil and vegetables in patients with CHD. In future studies, the intervention time should be extended to further explore the long-term intervention effect of mobile health and give full play to the role of mobile health in continuous behavior management of patients with CHD after discharge.