Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective:To study the reproductive toxicity of lithium chloride (LiCl) in male mice and to explore the molecular mechanism of the protective effect of quercetin on testosterone production dysfunction.Methods:Twenty-five male C57BL/6 mice aged 4-5 weeks were randomly divided into five groups according to the random number table method: control group, LiCl infected group [38.4 mg/(kg·d) LiCl+corn oil, noted as LiCl group], quercetin control group [50 mg/(kg·d) quercetin, noted as High-Quer group], low-dose quercetin combined with LiCl infection group [38.4 mg/(kg·d) LiCl+10 mg/(kg·d) quercetin, noted as Low-Quer+LiCl group] and high dose quercetin combined with LiCl infected group [38.4 mg/(kg·d) LiCl+50 mg/(kg·d) quercetin, noted as High-Quer+LiCl group]. The structure of testicular tissue, semen parameters, and the ultrastructure of Leydig cells in mice were detected by HE staining, computer-aided sperm analysis system (CASA), and transmission electron microscopy, respectively. TM3 mouse Leydig cells were treated with 0 mmol/L, 5 mmol/L, 10 mmol/L, 20 mmol/L LiCl for 24 h. The activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), mitochondrial membrane potential (MMP), lipid peroxidation levels, and expression levels of testosterone-related protein were measured by SOD and GSH-Px kits, TMRE probe, Image-iT TM lipid peroxidation probe, and Western blotting, respectively. Intracellular Fe 2+ concentration was detected by Fe 2+ detection kit and FerroOrange probe. The levels of testosterone, progesterone, and estradiol were measured using enzyme-linked immunosorbent assay kits. Results:In the LiCl group, the total sperm count [(36.78±1.81)×10 6], sperm concentration [(18.39±0.90)×10 6/mL], sperm motility [(25.70±3.32)%] and serum testosterone level [(7.26±0.29) μg/L] were lower than those of control group [(51.60±4.96)×10 6, P=0.002; (25.80±2.48)×10 6/mL, P=0.002; (41.47±2.83)%, P=0.001; (7.87±0.29) μg/L, P=0.013], the expression levels of Cyp11a1, StAR and Cyp17a1, Leydig cell biomarkers (3β-HSD1, 17β-HSD3) and ferroptosis regulatory proteins (GPX4, SLC7A11 and Nrf2) in testis were significantly down-regulated compared with control group (all P<0.001). LiCl also induced mitochondrial vacuoles and swelling of Leydig cells. However, low-dose quercetin intervention could significantly ameliorate the above LiCl-induced damage (total sperm count: P<0.001, sperm concentration: P<0.001, sperm motility: P=0.015, serum testosterone level: P=0.026, Cyp11a1, StAR, Cyp17a1, 3β-HSD1, 17β-HSD3, GPX4, SLC7A11, and Nrf2: all P<0.001). In 20 mmol/L LiCl group, the testosterone level [(7.28±0.24) μg/L] in TM3 cells was lower than that of 0 mmol/L LiCl group [(12.50±0.38) μg/L, P<0.001], the protein levels of Cyp11a1, StAR and Cyp17a1 were significantly down-regulated compared with 0 mmol/L LiCl group (all P<0.001), the activities of SOD [(2.42±0.11) U/mg], GSH-Px [(1.29±0.03) mU/mg] and MMP [(57.24±1.69)%] were lower than those of 0 mmol/L LiCl group [(3.11±0.09) U/mg, (1.54±0.01) mU/mg, (100.00±0)%, all P<0.001], the level of lipid peroxidation [(211.18±3.60)%] and the concentration of Fe 2+ [(26.44±0.94) μmol/L] were higher than those of 0 mmol/L LiCl group [(100.00±0)%, (7.12±0.29) μmol/L, all P<0.001], and the expression of ferroptosis regulatory proteins was significantly down-regulated compared with 0 mmol/L LiCl group (all P<0.001). Compared with 20 mmol/L LiCl group cells [lipid peroxidation: (194.46±3.16)%, (194.70±3.93)%; MMP: (78.74±0.52)%, (75.32±1.29)%], ferroptosis inhibitors Fer-1 and quercetin significantly decreased the level of lipid peroxidation [(181.71±3.80)%, P=0.004; (166.88±3.22)%, P<0.001], increased the level of MMP [(86.26±0.79)%, P=0.040; (81.09±1.32)%, P=0.001], and significantly up-regulated the expression of key enzymes in testosterone synthesis and ferroptosis regulatory proteins (all P<0.05). Conclusion:Quercetin may protect LiCl-induced Leydig cells injury and testosterone production dysfunction by inhibiting cell ferroptosis.

Objective:To study the reproductive toxicity of lithium chloride (LiCl) in male mice and to explore the molecular mechanism of the protective effect of quercetin on testosterone production dysfunction.Methods:Twenty-five male C57BL/6 mice aged 4-5 weeks were randomly divided into five groups according to the random number table method: control group, LiCl infected group [38.4 mg/(kg·d) LiCl+corn oil, noted as LiCl group], quercetin control group [50 mg/(kg·d) quercetin, noted as High-Quer group], low-dose quercetin combined with LiCl infection group [38.4 mg/(kg·d) LiCl+10 mg/(kg·d) quercetin, noted as Low-Quer+LiCl group] and high dose quercetin combined with LiCl infected group [38.4 mg/(kg·d) LiCl+50 mg/(kg·d) quercetin, noted as High-Quer+LiCl group]. The structure of testicular tissue, semen parameters, and the ultrastructure of Leydig cells in mice were detected by HE staining, computer-aided sperm analysis system (CASA), and transmission electron microscopy, respectively. TM3 mouse Leydig cells were treated with 0 mmol/L, 5 mmol/L, 10 mmol/L, 20 mmol/L LiCl for 24 h. The activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), mitochondrial membrane potential (MMP), lipid peroxidation levels, and expression levels of testosterone-related protein were measured by SOD and GSH-Px kits, TMRE probe, Image-iT TM lipid peroxidation probe, and Western blotting, respectively. Intracellular Fe 2+ concentration was detected by Fe 2+ detection kit and FerroOrange probe. The levels of testosterone, progesterone, and estradiol were measured using enzyme-linked immunosorbent assay kits. Results:In the LiCl group, the total sperm count [(36.78±1.81)×10 6], sperm concentration [(18.39±0.90)×10 6/mL], sperm motility [(25.70±3.32)%] and serum testosterone level [(7.26±0.29) μg/L] were lower than those of control group [(51.60±4.96)×10 6, P=0.002; (25.80±2.48)×10 6/mL, P=0.002; (41.47±2.83)%, P=0.001; (7.87±0.29) μg/L, P=0.013], the expression levels of Cyp11a1, StAR and Cyp17a1, Leydig cell biomarkers (3β-HSD1, 17β-HSD3) and ferroptosis regulatory proteins (GPX4, SLC7A11 and Nrf2) in testis were significantly down-regulated compared with control group (all P<0.001). LiCl also induced mitochondrial vacuoles and swelling of Leydig cells. However, low-dose quercetin intervention could significantly ameliorate the above LiCl-induced damage (total sperm count: P<0.001, sperm concentration: P<0.001, sperm motility: P=0.015, serum testosterone level: P=0.026, Cyp11a1, StAR, Cyp17a1, 3β-HSD1, 17β-HSD3, GPX4, SLC7A11, and Nrf2: all P<0.001). In 20 mmol/L LiCl group, the testosterone level [(7.28±0.24) μg/L] in TM3 cells was lower than that of 0 mmol/L LiCl group [(12.50±0.38) μg/L, P<0.001], the protein levels of Cyp11a1, StAR and Cyp17a1 were significantly down-regulated compared with 0 mmol/L LiCl group (all P<0.001), the activities of SOD [(2.42±0.11) U/mg], GSH-Px [(1.29±0.03) mU/mg] and MMP [(57.24±1.69)%] were lower than those of 0 mmol/L LiCl group [(3.11±0.09) U/mg, (1.54±0.01) mU/mg, (100.00±0)%, all P<0.001], the level of lipid peroxidation [(211.18±3.60)%] and the concentration of Fe 2+ [(26.44±0.94) μmol/L] were higher than those of 0 mmol/L LiCl group [(100.00±0)%, (7.12±0.29) μmol/L, all P<0.001], and the expression of ferroptosis regulatory proteins was significantly down-regulated compared with 0 mmol/L LiCl group (all P<0.001). Compared with 20 mmol/L LiCl group cells [lipid peroxidation: (194.46±3.16)%, (194.70±3.93)%; MMP: (78.74±0.52)%, (75.32±1.29)%], ferroptosis inhibitors Fer-1 and quercetin significantly decreased the level of lipid peroxidation [(181.71±3.80)%, P=0.004; (166.88±3.22)%, P<0.001], increased the level of MMP [(86.26±0.79)%, P=0.040; (81.09±1.32)%, P=0.001], and significantly up-regulated the expression of key enzymes in testosterone synthesis and ferroptosis regulatory proteins (all P<0.05). Conclusion:Quercetin may protect LiCl-induced Leydig cells injury and testosterone production dysfunction by inhibiting cell ferroptosis.

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female ; Humans ; Adolescent ; SARS-CoV-2 ; Smell ; COVID-19/complications* ; Cross-Sectional Studies ; COVID-19 Vaccines ; Incidence ; Olfaction Disorders/etiology* ; Taste Disorders/etiology* ; Prognosis

OBJECTIVE: To evaluate the efficacy and safety of Jianpi Jieyu Decoction (JJD) for treating patients with mild-to-moderate depression of Xin (Heart)-Pi (Spleen) deficiency (XPD) syndrome. METHODS: In this multi-center, randomized, controlled study, 140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019. They were randomly divided into JJD group and paroxetine group by using a random number table, with 70 cases in each group. The patients in the JJD group were given JJD one dose per day (twice daily at morning and evening, 100 mL each time), and the patients in the paroxetine group were given paroxetine (10 mg/d in week 1; 20 mg/d in weeks 2-6), both orally administration for a total of 6 weeks. The primary outcome was the change of 17-item Hamilton Depression Rating Scale (HAMD-17) score at week 6 from baseline. The secondary outcomes included the Hamilton Anxiety Scale (HAMA) score, Traditional Chinese Medicine Symptom Scale (TCMSS), and Clinlcal Global Impression (CGI) scores at the 2nd, 4th, and 6th weekends of treatment, HAMD-17 response (defined as a reduction in score of >50%) and HAMD-17 remission (defined as a score of ⩽7) at the end of the 6th week of treatment. Adverse events (AEs) were also recorded. RESULTS: From baseline to week 6, the HAMD-17 scores decreased 10.2 ± 4.0 and 9.1 ± 4.9 points in the JJD and paroxetine groups, respectively (P=0.689). The HAMD-17 response occurred in 60% of patients in the JJD group and in 50% of those in the paroxetine group (P=0.292); HAMD-17 remission occurred in 45.7% and 30% of patients, respectively (P=0.128). The differences of CGI scores at the 6th week were not statistically significant (P>0.05). There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week (P=0.001 and P=0.014). The HAMA scores declined 8.1 ± 3.0 and 6.9 ± 4.3 points from baseline to week 6 in the JJD and paroxetine groups, respectively (P=0.905 between groups). At 4th week of treatment, there was a significant difference in HAMA between the two groups (P=0.037). TCMSS decreased 11.4 ± 5.1, and 10.1 ± 6.8 points in the JJD and paroxetine groups, respectively (P=0.080 between groups). At the 6th week, the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group (7.14% vs. 22.86%, P<0.05). CONCLUSION Compared with paroxetine, JJD was associated with a significantly lower incidence of AEs in patients with mild-to-moderate depression of XPD syndrome, with no difference in efficacy at 6 weeks. (Trial registration No. ChiCTR2000040922).
Humans ; Paroxetine/adverse effects* ; Spleen ; Anxiety ; Syndrome ; Medicine, Chinese Traditional ; Treatment Outcome ; Double-Blind Method

Currently,the research or publications related to the clinical comprehensive evaluation of Chinese patent medicine are increasing,which attracts the broad attention of all circles. According to the completed clinical evaluation report on Chinese patent medicine,there are still practical problems and technical difficulties such as unclear responsibility of the evaluation organization,unclear evaluation subject,miscellaneous evaluation objects,and incomplete and nonstandard evaluation process. In terms of evaluation standards and specifications,there are different types of specifications or guidelines with different emphases issued by different academic groups or relevant institutions. The professional guideline is required to guide the standardized and efficient clinical comprehensive evaluation of Chinese patent medicine and further improve the authority and quality of evaluation. In combination with the characteristics of Chinese patent medicine and the latest research achievement at home and abroad,the detailed specifications were formulated from six aspects including design,theme selection,content and index,outcome,application and appraisal,and quality control. The guideline was developed based on the guideline development requirements of China Assoication of Chinese medicine. After several rounds of expert consensus and public consultation,the current version of the guideline has been developed.
Medicine, Chinese Traditional ; Nonprescription Drugs ; Consensus ; China ; Reference Standards ; Drugs, Chinese Herbal

Advanced paternal age has been overlooked, and its effect on fertility remains controversial. Previous studies have focused mainly on intracytoplasmic sperm injection (ICSI) cycles in men with oligozoospermia. However, few studies have reported on men with semen parameters within reference ranges. Therefore, we conducted a retrospective cohort study analyzing the reproductive outcomes of couples with non-male-factor infertility undergoing in vitro fertilization (IVF) cycles. In total, 381 cycles included were subgrouped according to paternal age (<35-year-old, 35-39-year-old, or ≥40-year-old), and maternal age was limited to under 35 years. Data on embryo quality and clinical outcomes were analyzed. The results showed that fertilization and high-quality embryo rates were not significantly different (all P > 0.05). The pregnancy rate was not significantly different in the 35-39-year-old group (42.0%; P > 0.05), but was significantly lower in the ≥40-year-old group (26.1%; P < 0.05) than that in the <35-year-old group (40.3%). Similarly, the implantation rate significantly decreased in the ≥40-year-old group (18.8%) compared with that in the <35-year-old group (31.1%) and 35-39-year-old group (30.0%) (both P < 0.05). The live birth rate (30.6%, 21.7%, and 19.6%) was not significantly different across the paternal age subgroups (<35-year-old, 35-39-year-old, and ≥40-year-old, respectively; all P > 0.05), but showed a declining trend. The miscarriage rate significantly increased in the 35-39-year-old group (44.8%) compared with that in the <35-year-old group (21.0%; P < 0.05). No abnormality in newborn birth weight was found. The results indicated that paternal age over 40 years is a key risk factor that influences the assisted reproductive technology success rate even with good semen parameters, although it has no impact on embryo development.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Male ; Adult ; Paternal Age ; Retrospective Studies ; Semen ; Fertilization in Vitro ; Reproductive Techniques, Assisted ; Oligospermia

Background and Objectives: Osteoblasts are derived from bone marrow mesenchymal stem cells (BMMSCs) and playimportant role in bone remodeling. While our previous studies have investigated the cell subtypes and heterogeneity in osteoblasts and BMMSCs separately, cell-to-cell communications between osteoblasts and BMMSCs in vivo in humans have not been characterized. The aim of this study was to investigate the cellular communication between human primary osteoblasts and bone marrow mesenchymal stem cells. Methods: and Results: To investigate the cell-to-cell communications between osteoblasts and BMMSCs and identifynew cell subtypes, we performed a systematic integration analysis with our single-cell RNA sequencing (scRNA-seq) transcriptomes data from BMMSCs and osteoblasts. We successfully identified a novel preosteoblasts subtype which highly expressed ATF3, CCL2, CXCL2 and IRF1. Biological functional annotations of the transcriptomes suggested that the novel preosteoblasts subtype may inhibit osteoblasts differentiation, maintain cells to a less differentiated status and recruit osteoclasts. Ligand-receptor interaction analysis showed strong interaction between mature osteoblasts and BMMSCs. Meanwhile, we found FZD1 was highly expressed in BMMSCs of osteogenic differentiation direction. WIF1 and SFRP4, which were highly expressed in mature osteoblasts were reported to inhibit osteogenic differentiation. We speculated that WIF1 and sFRP4 expressed in mature osteoblasts inhibited the binding of FZD1 to Wnt ligand in BMMSCs, thereby further inhibiting osteogenic differentiation of BMMSCs. Conclusions Our study provided a more systematic and comprehensive understanding of the heterogeneity of osteogenic cells. At the single cell level, this study provided insights into the cell-to-cell communications between BMMSCs and osteoblasts and mature osteoblasts may mediate negative feedback regulation of osteogenesis process.