Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans ; Consensus ; Orthodontic Appliance Design ; Orthodontic Appliances, Removable ; Tooth Movement Techniques/methods* ; Malocclusion/therapy* ; Orthodontics, Corrective/instrumentation*

Objective:To investigate the association between blood selenium levels and sex hormones in Chinese men aged 18-79 years.Methods:Data were derived from the China National Human Biomonitoring survey conducted in 2017-2018, with a final sample size of 5 414 men. General demographic characteristics, behavioral habits, and dietary frequency were collected through questionnaires and physical examinations. Fasting blood samples were collected to measure blood lead, serum testosterone, and estradiol levels. Complex sampling linear regression models were used to analyze the associations between blood selenium levels and testosterone, estradiol, and the testosterone/estradiol ratio, adjusting for confounding factors including age, education level, marital status, smoking status, alcohol consumption, seafood intake, soy product intake, protein supplement intake, BMI, and diabetes status.Results:The mean age of the 5 414 participants was (46.85±27.91) years; 4 774 (91.65%) were of Han ethnicity and 4 505 (86.68%) were married. The median ( Q1, Q3) blood selenium concentration in men was 97.80 (80.64, 116.99) μg/L. After adjusting for confounding factors, the complex sampling linear regression model revealed negative associations between blood selenium levels and both testosterone levels and the testosterone/estradiol ratio, with a significant linear trend ( Ptrend<0.05). Compared with the Q1 group, the β (95% CI) values for testosterone in the Q2, Q3, and Q4 groups were -0.02 (-0.06 to 0.02), -0.03 (-0.08 to 0.01), and -0.06 (-0.09 to -0.02), respectively. Similarly, the β (95% CI) values for the testosterone/estradiol ratio in the Q2, Q3, and Q4 groups were -0.01 (-0.03 to 0.02), -0.01 (-0.04 to 0.04), and -0.03 (-0.06 to -0.01), respectively. Subgroup analysis indicated stronger associations between blood selenium levels and testosterone/estradiol levels in non-smoking and obese men (BMI≥28 kg/m2). Conclusion:Blood selenium levels are negatively associated with testosterone levels and the testosterone/estradiol ratio in Chinese adult males.

Objective:To investigate the affection of high mobility group nucleosome-binding protein 5(HMGN5) gene in the hepatocellular cancer tissue and HepG2 cell and its function in the growth of HepG2 cell.Methods:70 Patients with hepatocellular carcinoma who under-went surgical resection and were confirmed by postoperative pathology in Sunshine Union Hospital of Weifang City from January 2017 to June 2020 were selected. Their clinical and pathological data, surgical resection of liver cancer tissue and adjacent normal liver tissue were collected, their survival time were also recorded. The contents of HMGN5 protein in the hepatocellular cancer tissues and adjacent normal liver tissues of 70 patients were detected by immunohistochemistry. Compare the expression of HMGN5 protein in liver cancer tissue and normal liver tissue and the positive expression rate of HMGN5 protein in liver cancer tissues of hepatocellular carcinoma patients with different clinical characteristics, to analyze the relationship between HMGN5 expression and prognosis of patients with hepatocellular carcinoma.The mRNA contents of HMGN5 gene in HepG2 cells and HL-7702 cells were determined by quantitative real time polymerase chain reaction(qRT-PCR) method. After transfectHepG2 cells with HMGN5 shRNA, the proliferation ability of HepG2 cells were evaluated by cell proliferation assay and the cell apoptosis was analyzed by flow cytometry. Measurement data with normal distribution were expressed as ±s, two independent samples t test was used for comparison between groups. Counting data was expressed as n(%), χ2 test was used for comparison between groups. Survival analysis of patients was performed by Kaplan-Meier method. Results:Immunohistochemical tests showed that HMGN5 staining is strong in liver cancer tissue, but weak in normal liver tissue. HMGN5 protein expression was positive in 48 of 70 patients with hepatocellular carcinoma. The positive expression rate of HMGN5 protein in hepatocellular carcinoma tissues of patients with pathological grade 3+4 and clinical stage Ⅲ+Ⅳ was higher than that of patients with grade 1+2 and stage Ⅰ+Ⅱ, respectively. There was no significant difference in cumulative survival rate between HMGN5 positive expression group and HMGN5 negative expression group ( χ2=3.81, P=0.051). The results of qRT-PCR showed that the expression level of HMGN5 mRNA in hepatoma HepG2 cells was higher than that in normal liver HL-7702 cells [(4.51±0.45) vs (1.35±0.27), the difference was statistically significant ( t=10.43, P=<0.001). After 24, 48 and 72h of the HMGN5 gene was knockout, the survival rate of HepG2 hepatoma cells was lower than that of HL-7702 hepatoma cells (all P<0.05) and the apoptosis rate of hepatoma HepG2 cells was higher than that of liver HL-7702 cells [(18.63±1.76)%vs(1.81±0.21)%] ,the difference was statistically significant ( t=16.44, P<0.001). Conclusions:HMGN5 genes and proteins are highly expressed in the hepatocellular cancer tissues and HepG2 cells. HMGN5 gene plays an important role in the growth of hepatocellular cancer and can be used as a potential target of treatment for hepatocellular cancer.

To summarize Professor GAO Shuzhong's clinical experience in treating idiopathic tinnitus with a combination of acupuncture and Chinese meteria medica. It is believed that idiopathic tinnitus is mostly caused by weak lungs and spleen， kidney essence deficiency， liver constraint transforming into fire， and binding constraint of heart qi. Treatment advocates the combination of acupuncture and Chinese meteria medica in clinical practice. Acupuncture treatment mainly focus on the method of opening the orifices by syndrome identification in combination with Ermen （TE 21）， Tinggong （SI 19）， Tinghui （GB 2）， Shenmai （BL 62） to regulate qi and blood， and supporting with Baihui （GV 20）， Yintang （EX-HN 3）， Taichong （LR 3）， and Yanglingquan （GB 34） to soothe the liver， resolve constraint， and calm the mind. Oral administration of Chinese medicinal prescription usually includes modified Yiqi Congming Decoction （益气聪明汤） and Tongqi Powder （通气散）， and the external administration of Chinese medicinal prescription can apply self-prescribed Wenqing Powder （温清散） to navel moxibustion.

Objective To explore the preferences and needs of colorectal cancer patients for"Internet+TCM nursing services",aiming to provide a basis for the improvement of service quality and the formulation of relevant policies,so as to better meet the needs of patients.Methods A total of 189 patients with colorectal cancer who were admitted to a tertiary A Chinese Medicine hospital in Qingdao from September 2023 to July 2024 were selected as the research subjects.A general data questionnaire and Questionnaire on"Internet+Traditional Chinese Medicine Nursing Service"Preference of Colorectal Cancer Patients were used with 6 attributes,including average out-of-pocket cost,nurse qualification,service waiting time,service mode,comprehensiveness of service content,and platform service evaluation,each attribute with 2 to 3 levels.The preference,payment intention of"Internet+TCM nursing services"were analyzed by constructing a mixed Logit model,and the influencing factors of choice preference of different colorectal cancer patients was explored through subgroup analysis.Results Totally 189 questionnaires were sent out,and 156 valid questionnaires were collected,with an effective recovery rate of 82.54％.Among the respondents,112 patients(71.79％)actively accepted"Internet+TCM nursing services",and the attributes of"Internet+TCM nursing services"such as payment fee,service evaluation,service content and nurse qualification had an impact on nursing service preference of colorectal cancer patients(P＜0.05).Based on willingness to pay,the ranking of attributes was service evaluation,service content and nurse qualification.Factors such as education level and the presence of ostomy also affected the preference of"Internet+TCM nursing services"in patients with colorectal cancer(P＜0.05).Conclusion Patients with colorectal cancer prefer"Internet+TCM nursing services",which has an average service cost of 50 yuan per time,excellent platform service evaluation,comprehensive service content,specialized TCM nurses.The preferences and specific characteristics of patients with colorectal cancer can be considered to optimize the allocation of nursing resources and provide services in line with their preferences.

BACKGROUND:Thermoresponsive hydrogels are widely used in bone tissue engineering due to their structural similarity to extracellular matrix and their intelligent temperature sensitivity.OBJECTIVE:To explain the mechanism of temperature-responsive hydrogels producing sol-gel phase transitions,classify them based on their sources,and summarize the applications of various temperature-responsive hydrogels in bone tissue engineering.METHODS:The first author searched for relevant literature on CNKI and PubMed databases from 2000 to 2024,using search terms"hydrogel,thermosensitive hydrogel,bone repair,bone regeneration,bone tissue engineering"in Chinese and English.A total of 70 eligible articles were finally selected for review.RESULTS AND CONCLUSION:The temperature-sensitive mechanism of thermosensitive hydrogels can be divided into negative sensitive and positive sensitive according to different reactions.Its composition is mainly divided into natural polymer and synthetic polymer.Current research has found that in addition to the traditional way of using temperature-sensitive hydrogels as scaffold materials for bone tissue engineering,3D printed scaffolds are also gradually emerging.In addition,thermosensitive hydrogels can also be used in 3D cell culture and drug slow release due to their own characteristics.At present,the development of thermosensitive hydrogels is not perfect enough.There are still problems such as the inability to accurately control the phase transition temperature,sustained release rate,low mechanical strength,and low biodegradability.Therefore,developing thermosensitive hydrogels with more stable properties is still a problem that we should solve at present.

Objective Based on the national drug sampling inspection program,this study aims to comprehensively and systematically evaluate the quality of Xuanmai Ganjie preparations,analyze existing quality issues,and provide references and suggestions for quality control of this variety.Methods A total of 237 batches of Xuanmai Ganjie preparations were tested using legal standards,and methods were established for detecting adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels,and determining the content of platycodin D in Xuanmai Ganjie preparations.These methods were applied to the quality control and evaluation of Xuanmai Ganjie preparations.Results Through statutory inspection,one batch of Xuanmai Ganjie granules was found non-compliant.Specific batches were identified to contain the following irregularities:adulteration of Ophiopogon japonicus with counterfeit varieties,paclobutrazol residue levels exceeding proposed limits,and platycodin D content below the established threshold.Conclusion The overall quality of Xuanmai Ganjie granules was average,while the overall quality of Xuanmai Ganjie capsules and lozenges was relatively good.Manufacturing enterprises should strengthen their sense of primary responsibility and enhance control over the entire drug production process.

Objective:To translate the English version of the Attitude Tool of Delirium (ATOD) into Chinese and test the reliability and validity of its application in Chinese nurses, and to provide an assessment tool for assessing nurses ′ attitudes towards delirium patients. Methods:After obtaining authorization from the source scale developer, the English version of the ATOD scale was translated, back-translated, expert-consulte, pre-surveyed and cross-culturally adapted according to the Brislin translation model. A questionnaire survey was conducted among 298 nurses with experience in caring for patients with delirium in three tertiary hospitals in Jiangsu Province using a convenience sampling method. The critical ratio value and correlation coefficient were used to analyze the scale items. Exploratory factor analysis was used to evaluate the structural validity of the scale, and experts were invited to evaluate the content validity of the scale. Cronbach α coefficient and test-retest reliability were used to evaluate the reliability of the scale. Results:The Chinese version of the ATOD scale contains 3 dimensions of cognitive attitudes, behavioral attitudes, and emotional attitudes toward patients with delirium, with a total of 23 entries. The Cronbach α coefficient for the entire scale was 0.896, with each dimension′s Cronbach α coefficient ranging from 0.614 to 0.912. The retest reliability of the scale was 0.868, with each dimension ′s retest reliability ranging from 0.603 to 0.927. Exploratory factor analysis extracted three eigenvalues with common factors greater than 1, and the cumulative variance contribution rate was 63.812%. Conclusions:The Chinese version of the ATOD scale has good reliability and validity, and can be used as an evaluation tool for evaluating nurses ′ attitudes towards delirium patients in China, so as to provide an effective basis for the formulation of corresponding interventions.