BACKGROUND:Clear aligners,due to their special material properties,are more prone to the"roller coaster effect"during the process of extracting the maxillary first premolar and closing the gap by retracting the anterior teeth,tilting and moving the teeth,leading to deepening of the anterior overjet and opening of the posterior teeth.There are fewer related studies at present concerning whether the thickness or stiffness of the aligner can be changed to reduce the"roller coaster effect"and better control the orthodontic tooth movement,.OBJECTIVE:To analyze the differences in tooth movement control ability of clear aligners of different thicknesses and stiffness when internally retracting maxillary anterior teeth by means of the three-dimensional finite element method.METHODS:Cone beam CT data of patients with convex profile were imported into Mimics and other software to simulate clinical cases.Three-dimensional finite element models were constructed to remove the first premolars,including the maxilla,teeth,and periodontal ligaments,while the diaphragms of clear aligners with thicknesses of 0.50 mm and 0.75 mm were assembled.Four sets of working conditions were created by loading the material properties of two Young's modulus of 1 000 MPa and 2 000 MPa.According to the clinical design to close of the extraction gap,and analyze the distribution of periodontal ligament stress,the displacement trend and the initial displacement of the teeth after loading and calculating in Workbench 2023 R1 software.RESULTS AND CONCLUSION:(1)The Von-Mises stress distribution pattern of periodontal ligament was consistent among the four working conditions,with the maximum value mainly distributed at the cervical part of teeth.The thicker diaphragm of the aligner,the higher the Von-Mises stress;the higher Young's modulus of the aligner,the higher the Von-Mises stress.(2)Under the four working conditions,the overall displacement trend of the maxillary dentition was that the crowns of the anterior teeth moved towards the lingual side and the roots towards the labial side,while the crowns of the posterior teeth moved towards the proximal-medial side and the roots towards the distal-medial side,and it was observed that the crown-root displacements of the teeth were in the opposite direction in all the conditions,and that the displacement of the crowns was greater than the displacement of the roots.Except for canines,the thicker the aligner diaphragm,the lower the R/C value(root-crown displacement ratio);the higher the modulus of elasticity of the aligner diaphragm,the lower the R/C value.(3)The results showed that when the maxillary anterior teeth were internally retracted using invisible aligners,the teeth showed a tendency to tilt and move without incisor torque compensation being designed;the greater the thickness of the aligner and the elastic modulus,the greater the control of the teeth,and the tendency of the teeth to tilt and move decreased;and the cuspids had to be controlled by other auxiliary means.

Blonanserin,a second-generation atypical antipsychotic agent,acts as an antagonist for dopamine D2,D3,and serotonin 5-HT2A receptors.Clinical studies have demonstrated that blonanserin is non-inferior to other antipsychotics,such as haloperidol and risperidone,in alleviating the symptoms of schizophrenia.Moreover,it exhib-its beneficial effects on cognitive symptoms and social functioning,with a favorable safety profile,making it one of the key treatment options for schizophrenia.With extensive clinical experience accumulated in China,this expert consensus aims to provide psychiatrists with updated and localized guidance on the optimal use of blonan-serin.Based on a systematic review of the latest evidence-particularly studies in Chinese population,this paper pres-ents the updated Chinese expert recommendations for the clinical use of blonanserin in 2024.

Objective:To explore the relationship between impulsivity traits,anxiety,and symptoms of eating disorders,with a focus on the mediating effect of anxiety between impulsivity and eating disorder symptoms.Me-thods:A total of 244 patients with eating disorders meeting the DSM-5 diagnostic criteria for anorexia nervosa(AN)and bulimia nervosa(BN)were enrolled,and the Eating Disorder Inventory-1(EDI-1),Barratt Impulsive-ness Scale(BIS-11),and the State Anxiety Inventory(SAI)were assessed.Mediation role analysis was performed by SPSS macro PROCESS program.Results:There was a significant positive correlation between the total score of BIS-11,SAI and EDI-1 in AN and BN patients(AN,r=0.56,0.63,0.72;P＜0.001.BN,r=0.51,0.31,0.56;P＜0.001 or P＜0.01).The total score of SAI played a mediating effect between the total score of BIS-11 and the total score of EDI-1,but the total score of SAI played a partial mediating effect(effect ratio was 46.9％)in patients with AN,and the total score of SAI played a full mediating effect in patients with BN.Conclusion:Impulsive trait and anxiety may be positive predictors of eating disorder symptoms.Anxiety mediates the relationship between impul-sivity trait and eating disorder symptoms,with a partial mediating effect in patients with AN and a full mediating effect in patients with BN.

Major depressive disorder is a prevalent and debilitating mental disorder worldwide. Suicidal ideation and behavior represent a severe clinical manifestation closely associated with high mortality and disease burden. Current antidepressants have a delayed onset of action and fail to address the urgent need for rapid symptom relief in patients with major depressive disorder with suicidal ideation or behavior (MDSI). The glutamatergic antidepressant esketamine has demonstrated rapid antidepressant efficacy and a tolerable safety profile in patients with MDSI in multiple clinical trials, making it a promising therapeutic option. Esketamine is a non-selective, non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist. In 2023, the nasal spray formulation was approved in China for use in combination with oral antidepressants to alleviate depressive symptoms in adults with MDSI. This review summarizes the latest clinical research progress on esketamine nasal spray for MDSI, providing evidence-based guidance for psychiatrists in clinical decision-making.

Objective:To explore the relationship between impulsivity traits,anxiety,and symptoms of eating disorders,with a focus on the mediating effect of anxiety between impulsivity and eating disorder symptoms.Me-thods:A total of 244 patients with eating disorders meeting the DSM-5 diagnostic criteria for anorexia nervosa(AN)and bulimia nervosa(BN)were enrolled,and the Eating Disorder Inventory-1(EDI-1),Barratt Impulsive-ness Scale(BIS-11),and the State Anxiety Inventory(SAI)were assessed.Mediation role analysis was performed by SPSS macro PROCESS program.Results:There was a significant positive correlation between the total score of BIS-11,SAI and EDI-1 in AN and BN patients(AN,r=0.56,0.63,0.72;P＜0.001.BN,r=0.51,0.31,0.56;P＜0.001 or P＜0.01).The total score of SAI played a mediating effect between the total score of BIS-11 and the total score of EDI-1,but the total score of SAI played a partial mediating effect(effect ratio was 46.9％)in patients with AN,and the total score of SAI played a full mediating effect in patients with BN.Conclusion:Impulsive trait and anxiety may be positive predictors of eating disorder symptoms.Anxiety mediates the relationship between impul-sivity trait and eating disorder symptoms,with a partial mediating effect in patients with AN and a full mediating effect in patients with BN.

Blonanserin,a second-generation atypical antipsychotic agent,acts as an antagonist for dopamine D2,D3,and serotonin 5-HT2A receptors.Clinical studies have demonstrated that blonanserin is non-inferior to other antipsychotics,such as haloperidol and risperidone,in alleviating the symptoms of schizophrenia.Moreover,it exhib-its beneficial effects on cognitive symptoms and social functioning,with a favorable safety profile,making it one of the key treatment options for schizophrenia.With extensive clinical experience accumulated in China,this expert consensus aims to provide psychiatrists with updated and localized guidance on the optimal use of blonan-serin.Based on a systematic review of the latest evidence-particularly studies in Chinese population,this paper pres-ents the updated Chinese expert recommendations for the clinical use of blonanserin in 2024.

BACKGROUND:Clear aligners,due to their special material properties,are more prone to the"roller coaster effect"during the process of extracting the maxillary first premolar and closing the gap by retracting the anterior teeth,tilting and moving the teeth,leading to deepening of the anterior overjet and opening of the posterior teeth.There are fewer related studies at present concerning whether the thickness or stiffness of the aligner can be changed to reduce the"roller coaster effect"and better control the orthodontic tooth movement,.OBJECTIVE:To analyze the differences in tooth movement control ability of clear aligners of different thicknesses and stiffness when internally retracting maxillary anterior teeth by means of the three-dimensional finite element method.METHODS:Cone beam CT data of patients with convex profile were imported into Mimics and other software to simulate clinical cases.Three-dimensional finite element models were constructed to remove the first premolars,including the maxilla,teeth,and periodontal ligaments,while the diaphragms of clear aligners with thicknesses of 0.50 mm and 0.75 mm were assembled.Four sets of working conditions were created by loading the material properties of two Young's modulus of 1 000 MPa and 2 000 MPa.According to the clinical design to close of the extraction gap,and analyze the distribution of periodontal ligament stress,the displacement trend and the initial displacement of the teeth after loading and calculating in Workbench 2023 R1 software.RESULTS AND CONCLUSION:(1)The Von-Mises stress distribution pattern of periodontal ligament was consistent among the four working conditions,with the maximum value mainly distributed at the cervical part of teeth.The thicker diaphragm of the aligner,the higher the Von-Mises stress;the higher Young's modulus of the aligner,the higher the Von-Mises stress.(2)Under the four working conditions,the overall displacement trend of the maxillary dentition was that the crowns of the anterior teeth moved towards the lingual side and the roots towards the labial side,while the crowns of the posterior teeth moved towards the proximal-medial side and the roots towards the distal-medial side,and it was observed that the crown-root displacements of the teeth were in the opposite direction in all the conditions,and that the displacement of the crowns was greater than the displacement of the roots.Except for canines,the thicker the aligner diaphragm,the lower the R/C value(root-crown displacement ratio);the higher the modulus of elasticity of the aligner diaphragm,the lower the R/C value.(3)The results showed that when the maxillary anterior teeth were internally retracted using invisible aligners,the teeth showed a tendency to tilt and move without incisor torque compensation being designed;the greater the thickness of the aligner and the elastic modulus,the greater the control of the teeth,and the tendency of the teeth to tilt and move decreased;and the cuspids had to be controlled by other auxiliary means.

Major depressive disorder is a prevalent and debilitating mental disorder worldwide. Suicidal ideation and behavior represent a severe clinical manifestation closely associated with high mortality and disease burden. Current antidepressants have a delayed onset of action and fail to address the urgent need for rapid symptom relief in patients with major depressive disorder with suicidal ideation or behavior (MDSI). The glutamatergic antidepressant esketamine has demonstrated rapid antidepressant efficacy and a tolerable safety profile in patients with MDSI in multiple clinical trials, making it a promising therapeutic option. Esketamine is a non-selective, non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist. In 2023, the nasal spray formulation was approved in China for use in combination with oral antidepressants to alleviate depressive symptoms in adults with MDSI. This review summarizes the latest clinical research progress on esketamine nasal spray for MDSI, providing evidence-based guidance for psychiatrists in clinical decision-making.

Objective To investigate the biomechanical characteristics of orthodontic tooth movement at different alveolar bone heights and provide a theoretical reference for orthodontic clinical treatment.Methods Four groups of mandibular dentition finite element models were established:the normal alveolar bone height,and 1/3,1/2,and 2/3 reductions in height.The lingual,distal,and intrusion movements of the mandibular central incisor were simulated under different loads.The distribution and variations in periodontal stress and tooth displacement were analyzed.Results Under three movements,the degree of stress concentration in the cervical area of the tooth and the periodontal equivalent force increased as the alveolar bone height decreased and the orthodontic force increased.Meanwhile,the displacement at each observation point and the crown-root displacement difference increased,and the tendency for inclination movement of the teeth aggravated.When the alveolar bone height was reduced to 2/3,the orthodontic force under lingual and distal movement increased to 150 g and that under intrusion movement increased to 100 g.The periodontal equivalent force increased to the maximum value,and the tendency of tooth inclination movement was most significant.Conclusions A reduction in the alveolar bone height aggravates the stress concentration at the top of the alveolar ridge and the tendency for inclination movement of the teeth.For orthodontic patients with an inferior periodontal condition,the orthodontic force should be reduced according to the alveolar bone height to ensure a safe and effective orthodontic treatment.

Objective:To evaluate the validity and reliability of the Chinese version of the Sensitivity to Pun-ishment and Sensitivity to Reward Questionnaire-Revised and Clarified(SPSRQ-RC)in patients with eating disor-ders.Methods:Totally 111 patients with eating disorders meeting diagnostic criteria of DSM-5 were assessed with SPSRQ-RC,Barratt Impulsiveness Scale-11(BIS-11),Trait Anxiety Inventory(TAI)and Eating Disorder Exami-nation Questionnaire 6.0(EDE-Q 6.0).Results:Three factors were extracted from the items by exploratory factor analysis with cumulative variance being 55.65％.The interclass correlation coefficient(ICC)of SR and BIS-11 was 0.26,the ICC of SP and TAI was 0.25,and the correlation coefficient of the SPSRQ-RC and EDE-Q 6.0 was 0.35.The Cronbach's α coefficient of the SPSRQ-RC was 0.83,the test-retest reliability of the scale was 0.82.Conclusion:The Chinese version of SPSRQ-RC shows good psychometric properties in patients with eating disor-ders.