Objective: To investigate the incidence and risk factors of open gingival embrasures (OGEs) in the incisor region after treatment with clear aligners in adult non-extraction patients and provide a reference for preventing the occurrence of an open gingival wedge gap in the incisal area after orthodontic treatment. Methods: This study has been reviewed and approved by the institutional medical ethics committee, and informed consent was obtained from the patients. A total of 125 adult patients with malocclusion who completed clear aligner treatment at Hefei Stomatological Hospital from September 2022 to December 2024 were selected as the study subjects. Based on the presence or absence of OGEs in the incisor region observed in frontal intraoral photographs taken immediately after treatment completion, the patients were divided into a normal group and an OGE group. Clinical data, including intraoral photographs, digital models, and cone-beam computed tomography before and after treatment, were analyzed. Measurements such as incisor overlap and rotation, crown morphology, number of attachments, and interproximal enamel reduction (IPR) were recorded and analyzed. Results: The incidence of OGEs between the maxillary and mandibular central incisors after clear aligner treatment in adult patients was 28.8% and 39.2%, respectively. No statistically significant differences were observed between the normal and OGE groups in terms of sex, Angle's classification, gingival biotype, overbite, overjet, IPR amount, age, treatment duration, tooth axis angulation, or horizontal movement distance of mandibular central incisors before and after treatment (P 0.05). However, significant differences were found in the number of attachments, anteroposterior distance between mesial incisal angles, distance from the interproximal contact point (ICP) to the alveolar bone crest (ABC) (ICP-ABC), horizontal distance between mesial cementoenamel junction (CEJ) of two adjacent central incisors (CEJ-CEJ) and labial alveolar bone thickness (P 0.05). IPR amount and mandibular incisor intrusion were significantly associated with the severity of OGEs (P 0.05). Regression analysis revealed that the number of attachments, anteroposterior distance between mesial incisal angles, ICP-ABC distance, and CEJ-CEJ horizontal distance were significantly correlated with the occurrence of OGEs. Conclusion The incidence of open gingival embrasures in the mandibular central incisor region is relatively high among adult patients treated with clear aligners. The number of attachments (n = 2), the anteroposterior distance between the mesio-incisal angles, the distance from the tooth contact point to the alveolar bone crest, and the horizontal distance between adjacent cementoenamel junctions have been identified as risk factors for the development of open gingival embrasures upon completion of orthodontic treatment.

BACKGROUND:Previous studies have found that neuronal damage caused by continuous excessive fluoride exposure is related to Ca2+overload,but the mechanism of Ca2+flow conversion between intracellular calcium stores and cell apoptosis damage is still unclear.OBJECTIVE:To investigate the effect of fluoride exposure on Ca2+transport channel proteins and apoptosis levels in the mitochondria-associated endoplasmic reticulum membrane of primary cultured neural cells.METHODS:Primary nerve cells of neonatal SD rats were cultured in vitro and identified by immunofluorescence staining with neuronal nucleus-specific antibody up to day 7.The nerve cells were divided into control group(containing 0 mmol/L sodium fluoride),low fluoride group(containing 0.5 mmol/L sodium fluoride),and high fluoride group(containing 1 mmol/L sodium fluoride).The cell morphological changes were observed by light microscope 24 hours after fluorine exposure.The expression levels of apoptosis-related protein BAX/BCL-2 and calcium transfer-related pathways VDAC1,GRP 75,and IP3R were detected using western blot assay.The expression levels of VDAC1,GRP 75,and IP3R mRNA were detected by RT-PCR.Ca2+levels were detected by Rhood-2AM Ca2+probe.Mitochondrial membrane potential detection kit was used to detect the change in mitochondrial membrane potential.The level of apoptosis was determined by flow cytometry and TUNEL staining.RESULTS AND CONCLUSION:(1)The purity of neurons cultured on day 7 had been determined to be over 90％,with few impurities,good growth status,and tight cell network connections,meeting the requirements of subsequent experiments.(2)Compared with the control group,growth of neural cell clusters in the low-fluoride group and the high-fluoride group increased;the processes were broken;the cell body was rounded,and the connection network between cells was destroyed.Compared with the low-fluoride group,the cell damage changes in the high-fluoride group were more obvious.(3)Compared with the control group,the protein expressions of VDAC1,GRP75,and IP3R were increased in the low-fluoride group and the high-fluoride group(P＜0.05),and the ratio of apoptosis-related protein BAX/BCL-2 was increased(P＜0.05).Compared with the control group,the expression of VDAC1 and GRP75 mRNA in the low-fluoride group was significantly increased(P＜0.05);the expression levels of VDAC1,GRP75,and IP3R mRNA in the high-fluoride group were significantly increased(P＜0.01).(4)The level of cell apoptosis increased significantly after fluoride exposure,and the high-fluoride group was significantly higher than the control and low-fluoride groups(P＜0.01).(5)After fluoride exposure,the concentration of mitochondrial Ca2+in nerve cells increased significantly(P＜0.05),the mitochondrial membrane potential decreased(P＜0.01),and the degree of damage in the high-fluoride group was more obvious(P＜0.05).The results show that fluoride exposure impairs the morphological structure of primary neural cells,resulting in upregulation of Ca2+transfer pathway protein expression between the endoplasmic reticulum and mitochondria,mitochondrial Ca2+overload,mitochondrial damage,and increased levels of apoptosis.

OBJECTIVE To investigate the requirements for infusion sets specified in the package inserts of monoclonal antibody drugs commonly used for intravenous infusion in China， and to provide a reference for the rational selection of infusion sets for this class of drugs in clinical practice. METHODS The “Drug Query” section of the official website of the National Medical Products Administration， including the “Domestically Manufactured Drugs” and “Overseas Manufactured Drugs” databases， as well as the DXY “Yongyao Zhushou” database， were searched to collect the package inserts of monoclonal antibody drugs available on the domestic market as of November 2025 that had requirements for intravenous infusion sets. Relevant requirements for infusion set materials， filter pore size， and filter materials were extracted， classified， and analyzed. RESULTS A total of 55 monoclonal antibody drugs for intravenous infusion were included， comprising 45 anticancer drugs （81.82%）， 5 immunomodulatory drugs （9.09%）， and 5 drugs for other diseases （9.09%）. The package inserts of 44 drugs （80.00%） had clear requirements for the filter pore size of infusion sets， of which 36 drugs （65.45%） required a pore size of 0.2 μm or 0.22 μm. The package inserts of 16 drugs （29.09%） specified the filter material， all of which recommended polyethersulfone. The package inserts of 25 drugs （45.45%） specified the infusion set material， primarily polyvinyl chloride， polyethylene， or polypropylene. CONCLUSIONS The requirements for infusion sets vary among different monoclonal antibody drugs， with differences mainly concentrated in two aspects： material compatibility and filter pore size. In clinical practice， the selection should be based on the drug package inserts， following the principles of “compatibility first， appropriate filtration， and system integration”， and standardized management should be achieved through the development of quick-reference manuals specifically addressing the requirements for infusion sets and the integration of relevant requirements into the prescription review and dispensing systems.

BACKGROUND:Previous studies have found that neuronal damage caused by continuous excessive fluoride exposure is related to Ca2+overload,but the mechanism of Ca2+flow conversion between intracellular calcium stores and cell apoptosis damage is still unclear.OBJECTIVE:To investigate the effect of fluoride exposure on Ca2+transport channel proteins and apoptosis levels in the mitochondria-associated endoplasmic reticulum membrane of primary cultured neural cells.METHODS:Primary nerve cells of neonatal SD rats were cultured in vitro and identified by immunofluorescence staining with neuronal nucleus-specific antibody up to day 7.The nerve cells were divided into control group(containing 0 mmol/L sodium fluoride),low fluoride group(containing 0.5 mmol/L sodium fluoride),and high fluoride group(containing 1 mmol/L sodium fluoride).The cell morphological changes were observed by light microscope 24 hours after fluorine exposure.The expression levels of apoptosis-related protein BAX/BCL-2 and calcium transfer-related pathways VDAC1,GRP 75,and IP3R were detected using western blot assay.The expression levels of VDAC1,GRP 75,and IP3R mRNA were detected by RT-PCR.Ca2+levels were detected by Rhood-2AM Ca2+probe.Mitochondrial membrane potential detection kit was used to detect the change in mitochondrial membrane potential.The level of apoptosis was determined by flow cytometry and TUNEL staining.RESULTS AND CONCLUSION:(1)The purity of neurons cultured on day 7 had been determined to be over 90％,with few impurities,good growth status,and tight cell network connections,meeting the requirements of subsequent experiments.(2)Compared with the control group,growth of neural cell clusters in the low-fluoride group and the high-fluoride group increased;the processes were broken;the cell body was rounded,and the connection network between cells was destroyed.Compared with the low-fluoride group,the cell damage changes in the high-fluoride group were more obvious.(3)Compared with the control group,the protein expressions of VDAC1,GRP75,and IP3R were increased in the low-fluoride group and the high-fluoride group(P＜0.05),and the ratio of apoptosis-related protein BAX/BCL-2 was increased(P＜0.05).Compared with the control group,the expression of VDAC1 and GRP75 mRNA in the low-fluoride group was significantly increased(P＜0.05);the expression levels of VDAC1,GRP75,and IP3R mRNA in the high-fluoride group were significantly increased(P＜0.01).(4)The level of cell apoptosis increased significantly after fluoride exposure,and the high-fluoride group was significantly higher than the control and low-fluoride groups(P＜0.01).(5)After fluoride exposure,the concentration of mitochondrial Ca2+in nerve cells increased significantly(P＜0.05),the mitochondrial membrane potential decreased(P＜0.01),and the degree of damage in the high-fluoride group was more obvious(P＜0.05).The results show that fluoride exposure impairs the morphological structure of primary neural cells,resulting in upregulation of Ca2+transfer pathway protein expression between the endoplasmic reticulum and mitochondria,mitochondrial Ca2+overload,mitochondrial damage,and increased levels of apoptosis.

Objective To explore the feasibility of the endoscopic occipital transtentorial transpineal-recess (EOTT-TR) approach for treatment of craniopharyngiomas within the third ventricle. Methods The clinical and imaging data of a 54-year-old female patient with craniopharyngioma was reviewed. The patient was presented with progressive visual impairment and headache for six months. Endocrine evaluation indicated mild impairment of the pituitary-hypothalamic axis function. Imaging revealed a large solid tumor was entirely confined within the third ventricle, maximal diameter of approximately 4.7 cm. The lesion was resected via right EOTT-TR approach, which involved upward retraction of the pineal gland under the 3D endoscopy, and accessing the third ventricle through the pineal recess. Following resection, pathological diagnosis was performed, and postoperative complications were observed. Results Subtotal resection was achieved. Postoperatively, central diabetes insipidus, diplopia and upward gaze dysfunction occurred, but improved after 3 months of follow-up. MRI confirmed subtotal resection of the tumor, and the vision of the patient was improved, and the Karnofsky performance status (KPS) score increased from 80 points to 90 points at 3 months after operation. The pathological diagnosis was papillary craniopharyngioma (WHO grade Ⅰ). Conclusions The EOTT-TR approach provides a unique postero-superior to antero-inferior perspective, allowing full exposure of the third ventricle. It is particularly advantageous for treating craniopharyngiomas originating from the antero-inferior wall of the third ventricle, enabling tumor resection while preserving hypothalamic function without affecting visual acuity or visual fields. Therefore, for craniopharyngiomas strictly confined within the third ventricle, the EOTT-TR approach is a feasible surgical approach.

Objective:To evaluate the long-term protective efficacy of the recombinant Chinese hamster ovary cell-derived hepatitis B vaccine（CHO-HepB）26 years post-vaccination in the rural China.Methods:Zhengding county，Hebei province was designated as a rural monitoring site for CHO-HepB efficacy. Study participants included individuals born between 1997 and 1999 who had completed the three-dose CHO-HepB primary series without booster doses. A cross-sectional survey was conducted in late 2024 using random sampling. Demographic and vaccination history data were collected via questionnaires，and hepatitis B virus（HBV）serological markers were detected using chemiluminescence. Historical surveillance data were integrated to infer infection statuses of HBsAg-positive individuals and evaluate longitudinal trends in anti-HBs seropositivity and antibody titers.Results:Among 178 participants（mean time since vaccination：26.2 years），the seroprevalence rates were 0.6% for HBsAg（95% CI：0.0%-1.6%），64.6% for anti-HBs（95% CI：57.6%-71.6%），and 1.1% for anti-HBc（95% CI：0.0%-2.7%）. Compared to the pre-vaccination baseline HBsAg positivity of 11.3% in children under 10 years of age，the estimated vaccine protection rate was 95%. Two notable cases were identified：one with concurrent HBsAg and anti-HBc positivity and one with anti-HBs and anti-HBc positivity，suggestive of transient HBV exposure（1999—2009）without chronicity. Natural immune boosting was inferred for the latter case based on anti-HBs titer dynamics. Longitudinal analysis of four prior cross-sectional surveys（2005，2009，2013，and 2017）revealed no significant upward trends in HBsAg and anti-HBc positivity（both P>0.05）over 26 years，while anti-HBs seropositivity declined significantly（ P<0.05）from 6 to 26 years post-vaccination. Conclusion:The CHO-HepB vaccine demonstrates sustained immunological persistence and robust long-term protection up to 26 years post-immunization. Continued emphasis on rigorous implementation of mother-to-child transmission prevention strategies is critical for future hepatitis B control.

Objective:To assess the epidemic characteristics of serum of viral hepatitis B infection ranging in age from 1 to 69 years old in Jilin province in 2024. The genotypes of hepatitis B virus-infected individuals were determined.Methods:In 2024，2 313 people ranging in age from 1 to 69 years old in Jilin province were selected by using multi-stage random sampling method for field epidemiological investigation of hepatitis B. The serum samples were collected and detected for the hepatitis B virus（HBV）surface antigen（HBsAg），HBV surface antibody（HBsAb），HBV core antibody（HBcAb），HBV E antigen（HBeAg）and HBV E antibody（HBeAb）by ELISA，and the data were analyzed by the national epidemiological dynamic data collection platform，SPSS 18.0 software. Genotyping is conducted based on the internationally recognized large S region gene fragment.Results:The vaccination rates for hepatitis B among people aged 1-4，5-14，15-29 and 30-69 were 97.00%，94.66%，74.59% and 2.88%，respectively. There were significant differences in hepatitis B vaccination rates across age groups surveyed in 2024（ χ2=1 041.41， P<0.05）. In 2024，the HBsAg carrying rate，HBsAb positive rate，HBV infection rate，HBeAb positive rate and HBeAg positive rate of people in Jilin province were 0. 86%，47.99%，2.25%，5.58% and 5.14%，respectively. The genotype of hepatitis B virus in the infected person is B2 and C2. Conclusions:In 2024，the indicators of HBV infection in Jilin province were good. The highest rate of hepatitis B infection was 11.54% in people with 30-69 years of age and the high vaccination rate of people should continue to be maintained，and the vaccination of hepatitis B vaccine for adults should be strengthened to reduce the risk of infection in these susceptible groups.

Objective:To review and analyze the results of cervical cancer screening for women aged 30-65 years in Tianjin from 2018—2023, and to explore the choice of cervical cancer screening strategies.Methods:The results of free cervical cancer screening in Tianjin from January 2018 to December 2023 were collected and divided into two periods: group A [2018—2020; screening programs included cervical cytology, Thinprep cytologic test (TCT), and human papillomavirus (HPV) DNA+TCT combined screening] and group B (2021—2023; the screening scheme of HPV E6/E7 mRNA primary screening and TCT diversion, referred to as “HPV E6/E7 mRNA primary screening”) according to the policy changes, and according to the primary screening method of cervical cancer, it was divided into four methods: cervical smear primary screening, TCT primary screening, HPV DNA+TCT combined primary screening and HPV E6/E7 mRNA primary screening. Cervical cancer and precancerous lesion detection rate, cervical cancer early diagnosis rate were analyzed.Results:(1) A total of 1 634 155 women of eligible age were screened, and the detection rate of cervical cancer and precancerous lesion was 216.3/100 000 (3 535/1 634 155), among which the detection rate of precancerous lesion was 200.3/100 000 (3 274/1 634 155) and cervical cancer was 16.0/100 000 (261/1 634 155). (2) The cervical cancer and precancerous lesion detection rate and cancer early diagnosis rate in group B were significantly higher than those in group A [480.3/100 000 (2 132/443 924) vs 117.9/100 000 (1 403/1 190 231), 97.56% (2 080/2 132) vs 92.37% (1 296/1 403); both P<0.001]. (3) The detection rates of cervical cancer and precancerous lesions in women who underwent initial screening with cervical cytology, TCT, HPV DNA+TCT combined screening, and HPV E6/E7 mRNA screening were 106.8/100 000 (10 980/1 028 227), 167.7/100 000 (190/113 319), 236.2/100 000(115/48 685) and 480.3/100 000 (2 132/443 924), respectively. HPV E6/E7 mRNA primary screening had the highest cervical cancer and precancerous lesion detection rate among the four screening methods ( χ2=2 017.59, P<0.001). Conclusion:After 2021, the cervical cancer screening method of HPV E6/E7 mRNA primary screening and TCT triage adopted in Tianjin is suitable for general screening of large populations and is an effective method for initial screening of cervical cancer.

Objective:To investigate the clinical effect of reconstruction of the degloving injury of thumb and finger with free perforator flap of superficial peroneal artery.Methods:This is a retrospective study. From June 2020 to June 2023, 18 superficial peroneal artery perforator flaps from 14 calves were used to treat 15 degloved digital wounds of 14 patients in the Department of Hand Surgery, Suzhou Ruihua Orthopaedic Hospital. There were 13 single digital degloving wounds and 1 two-digital degloving wounds. Of which, 3 digits were reconstructed with 2 free perforator flaps of ipsilateral superficial peroneal artery and 12 with a single free perforator flap of superficial peroneal artery. The size of wounds was 4.0 cm×2.0 cm-10.0 cm×4.0 cm, and the flaps were 5.0 cm×3.0 cm-12.0 cm×4.0 cm in size. The donor sites in calves were sutured layer by layer with absorptive sutures. Postoperative follow-ups were conducted through regular outpatient visits, phone calls or WeChat. Survival of flaps, postoperative complications, therapeutic effect of the flaps and patient satisfaction were observed.Results:There was no vascular compromise or wound infection of the flaps. All patients were included in the 4 to 36 months of postoperative follow-up, with an average of 9.86 months. All flaps had good appearance, without obvious swelling. Colour and texture of the flaps was close to the surrounding skin. The flaps had no obvious pigmentation or ulcer and scar hyperplasia at recipient site. Sensation of the flaps recovered to S 2 to S 3. There was no obvious scar hyperplasia, pain or dysfunction at donor sites. According to the comprehensive evaluation scale of flap, the scores were found at 81 to 91, with an average score of 85 in the 14 patients, and of whom 2 were excellent and 12 were good. Patient satisfaction was evaluated according to the Michigan Hand Outcomes Questionnaire (MHQ) and 10 patients were very satisfied and 4 were satisfied. Conclusion:Free perforator flap of superficial peroneal artery is one of the ideal flaps in reconstruction of degloving injury of thumb and fingers. It features constant and multiple perforators, reliable blood supply, high survival rate, flexible in design, thin and a small damage to the donor site.

Objective:To evaluate the clinical efficacy of a novel reduction device in the treatment of A3N0/1 thoracolumbar fracture using navigation-assisted techniques.Methods:A retrospective analysis was conducted on 45 patients (29 males, 16 females; mean age 40.67±16.11 years, range 24-57) with thoracolumbar fractures who underwent fracture reduction and pedicle screw fixation via the Wiltse approach at Zhengzhou Orthopaedic Hospital between January 2022 and January 2023. Injury levels included: T 10 in 2 cases, T 11 in 5 cases, T 12 in 13 cases, L 1 in 20 cases, L 2 in 3 cases, L 3 in 2 cases. All patients underwent fracture reduction via the Wiltse approach using the spinal fracture reduction instrument for vertebral body reduction. Among them, 20 patients received O-arm navigation-assisted internal fixation and vertebral reduction (O-arm group), while 25 received C-arm fluoroscopy-guided internal fixation and vertebral reduction (C-arm group). Operative time, intraoperative blood loss, vertebral reduction time using the instrument, first-time screw placement success rate, screw placement accuracy, and complications were compared. Mid-vertebral body height ratio (MVBHr), local Cobb angle of the fractured vertebra, visual analogue scale (VAS) score, and Oswestry disability index (ODI) were compared preoperatively, at 1 week postoperatively, 3 months postoperatively, and final follow-up. Results:All surgeries were successfully completed in both groups. Operative time was significantly shorter in the O-arm group (106.8±14.4 min) than in the C-arm group (119.1±16.4 min, P<0.05). All patients were followed up for a mean duration of 15.9±3.9 months (range 12-20 months). Vertebral reduction time was significantly shorter in the O-arm group (11.0±2.2 min) than in the C-arm group (20.4±5.7 min, P<0.05). The first-time screw placement success rate was significantly higher in the O-arm group (100%) than in the C-arm group (95.3%, P<0.05). Screw placement accuracy (Grade I) was significantly higher in the O-arm group (117 screws, 97.5%) than in the C-arm group (136 screws, 90.7%, P<0.05). No cases of wrong-level surgery, infection, or spinal cord/nerve injury occurred. Both groups showed significant improvements in MVBHr, Cobb angle, VAS, and ODI at all postoperative time points compared to preoperative values ( P<0.05). At final follow-up, the O-arm group demonstrated significantly better outcomes than the C-arm group in MVBHr (90.6%±4.5% vs. 86.4%±6.9%, P<0.05), Cobb angle (7.6°±1.8° vs. 10.1°±3.2°, P<0.05), VAS (1.3±0.4 vs. 1.7±0.6, P<0.05), and ODI (4.6%±1.9% vs. 7.7%±2.0%, P<0.01). Conclusion:O-arm navigation-assisted intrasegmental push reduction for A3N0/1 type thoracolumbar fractures demonstrates advantages including faster and more accurate screw placement, precise reduction with improved outcomes, and significant postoperative pain relief.