Objective: To explore the prospective association between multidimensional sleep indicators and the risk of newlyonset dental caries, providing a reference for childrens oral healthrelated sleep intervention. Methods: In October 2021, 1 417 students in grades 1 to 4 (aged 6 to 11) from two elementary schools in Bengbu, Anhui Province, were selected by cluster sampling method. Surveys and followup visits were conducted at baseline (T1), November 2022 (T2), May 2023 (T3), and November 2023 (T4), respectively, including parental questionnaires, oral health and physical examination. Bedtime, sleep duration, sleep midpoint, social jet lag, weekend catchup sleep, and sleep habits were collected and calculated. A multifactorial Cox proportional risk regression model was used to analyze the association between multidimensional sleep indicators and newlyonset caries in schoolaged children after 2 years. Results: The prevalence of dental caries in children was 65.1% at baseline, and the prevalence was 59.0% at the end of the 2year followup. Cox proportional risk regression model showed that for every 1point increase in the childrens bedtime resistance, nocturnal awakenings, parasomnias, and daytime sleepiness scores, the risk of newlyonset caries increased by 12% (HR=1.12, 95%CI=1.08-1.15), 22% (HR=1.22, 95%CI=1.15-1.29), 12% (HR=1.12, 95%CI=1.08-1.17), and 15% (HR=1.15, 95%CI=1.12-1.19), respectively; the risk of newlyonset caries increased by 23% for each 1 h increase in the length of weekend catchup sleep (HR=1.23, 95%CI=1.14 -1.33); compared with children who went to bed before 21:00 on school days, those who went to bed later than 22:00 had a 57% higher risk of newlyonset caries (HR=1.57, 95%CI=1.22-2.03). Compared to children who slept adequately (≥9 h/d), those with insufficient sleep had a 67% higher risk of new caries (HR=1.67, 95%CI=1.43-1.95) (P<0.01). Conclusions These findings suggest a significant association between sleep patterns/sleep disorders and the development of childhood dental caries. Incorporating sleep behavior optimization and sleep quality improvement into comprehensive caries prevention and oral health management protocols may represent a promising intervention strategy to enhance childrens oral health outcomes.

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Growth hormone deficiency (GHD) has become a serious healthcare burden, and presents a huge impact on the physical and mental health of patients. Here, we developed an actively separated microneedle patch (PAA/NaHCO₃-Silk MN) based on silk protein for sustained release of recombinant human growth hormone (rhGH). Silk protein, as a friendly carrier material for proteins, could be constructed in mild full-water conditions and ensure the activity of rhGH. After manually pressing PAA/NaHCO₃-Silk MN patch to skin for 1 min, active separation is achieved by absorbing the interstitial fluid (ISF) to trigger HCO₃ ^‒ in the active backing layer to produce carbon dioxide gas (CO₂). In rats, the MN patch could maintain the sustained release of rhGH for more than 7 days, and produce similar effects as daily subcutaneous (S.C.) injections of rhGH in promoting height and weight with well tolerated. Moreover, the PAA/NaHCO₃-Silk MN patch with the potential of painless self-administration, does not require cold chain transportation and storage possess great economic benefits. Overall, the PAA/NaHCO₃-Silk MN patch can significantly improve patient compliance and increase the availability of drugs, meet current unmet clinical needs, improve clinical treatment effects of GHD patients.

Objective:To explore the mediating role of self-perceptions of aging between frailty and cognitive function in community-dwelling older adults.Methods:From February to July 2021, a total of 528 elderly people in Xinxiang community were investigated with the frailty phenotype, the brief self-perceptions ageing questionnaire and the Mini-mental state examination(MMSE) scale.According to the MMSE total score and education level, the subjects were divided into cognitive impairment group (illiteracy≤17, primary school≤20, junior high school and above≤24, n=74) and cognitive normal group( n=454). SPSS 25.0 software was used for common method deviation test, descriptive statistics and correlation analysis, while AMOS 24.0 software was used to build structural equation model and Bootstrap method was used for intermediary effect test. Results:(1)The prevalence of cognitive impairment among the elderly in the community was 14.1%. The differences between the cognitively normal group and cognitively impaired group were statistically significant in terms of age, education, number of chronic diseases suffered and depression ( χ2=59.21, 6.53, 9.84, 25.47, all P<0.05). The differences were statistically significant in terms of frailty( χ2=75.65, P<0.001) and self-perceptions of aging ( t=77.67, P<0.001). (2)Self-perceptions of aging in the cognitively impaired group (47.39±8.66) was higher than that in the cognitively normal group (38.22±8.24) ( t=77.67, P<0.001) .Frailty score in cognitively impaired group (2.00 (1.00, 3.00)) was higher than that in the cognitively normal group (0.00 (0.00, 1.00))( Z=-8.63, P<0.001) . (3)Frailty was negatively correlated with cognitive function ( r=-0.492, P<0.01), and positively correlated with self-perceptions of aging ( r=0.540, P<0.01). Self-perceptions of aging was negatively correlated with cognitive function ( r=-0.541, P<0.01) . After controlling the influencing factors such as age, education level, chronic diseases and depression, the correlation was still significant (all P<0.01) . (4) Self-perceptions of aging played a partially mediating role in the relationship between frailty and cognitive function, the mediating effect accounted for 58.5% of the total effect. Conclusion:Frailty and self-perceptions of aging have a significant impact on the cognitive function of the elderly in the community, and self-perceptions of aging plays a partial intermediary role between the frailty and cognitive function of the elderly in the community.

The dynamic changes of cognitive function has been paid more and more attention by foreign scholars.Dynamic assessment based on ecological momentary assessment(EMA)can capture subtle changes in cognitive function and provide more comprehensive information for early identification and timely intervention of people with cognitive impairment, which is an effective supplement to traditional cognitive assessment.This paper reviewed the concept of ecological momentary assessment, its advantages in cognitive assessment, its feasibility and effectiveness, and its application status in the evaluation of cognitive function in the elderly, so as to provide a reference for making ecological assessment of the cognitive function for older adults that is in line with China's national conditions.

China is one of the countries with the highest population aging rate in the world, and the oral health of the elderly population has become increasing significant for the realization of healthy aging. Tooth loss is considered as the marker of oral disease burden. In recent years, a growing number of findings have suggested an association between tooth loss and cognitive decline. Also, given that cognitive function plays a crucial role in oral health, future researches should elucidate their bidirectional causal relationship, based on prospective cohort design that regularly monitors tooth loss and cognitive function. This article reviews the current research threads in terms of epidemiological evidences of the association, brain structure and function, and possible bidirectional associations and mechanisms, providing a theoretical basis for promoting healthy aging.

Objective:To investigate the factors influencing the prognosis of patients with estrogen receptor (ER)-positive de novo stage Ⅳ breast cancer.Methods:The clinical data of 339 patients with ER-positive de novo stage Ⅳ breast cancer treated in Tianjin Medical University Cancer Hospital and Cangzhou Hospital of Integrated TCM-WM from February 2010 to December 2017 were retrospectively analyzed. Related factors such as age, time of chief complaint, the clinical T/N stage, site of metastasis, expressions of molecular markers and treatment mode were included. Univariate log-rank test and multivariate Cox regression model were used to analyze the effects of prognostic factors on patients' overall survival (OS).Results:Univariate analysis showed that there were statistically significant differences in the OS of patients stratified by clinical N stage at first diagnosis, metastasis sites at first diagnosis, ER expression, progesterone receptor (PR) expression, Ki-67 positive index and p53 expression, endocrine therapy, chemotherapy at first diagnosis, surgery and radiotherapy of the primary lesions (all P < 0.01). Multivariate Cox regression analysis results showed that metastasis sites at first diagnosis, Ki-67 positive index, surgery and radiotherapy of the primary lesions were all independent influencing factors of OS for breast cancer patients (all P < 0.01). Conclusions:Patients with ER-positive de novo stage Ⅳ breast cancer have a good prognosis when they have oligometastasis, Ki-67 positive index ≤ 20%, and they receive surgery and radiotherapy of the primary lesions.

Major hepatectomy (MH) is a common treatment for benign and malignant liver diseases. Controlled low central venous pressure (CLCVP) is an important measure to reduce the intraoperative blood loss and transfusion requirement during MH. In this paper, the application standard of CLCVP at MH is discussed, and the specific measures to achieve CLCVP including fluid restriction, drug application, body gesture adjustment, reduction of tidal volume, suspension of respiratory ventilation, and infrahepatic inferior vena cava clamping (complete and partial) are systematically summarized.

The role of Nod-like receptor pyrin domain 3 (NLRP3) inflammasome and pyroptosis in bronchial asthma (asthma) has attracted increasing attention in recent years.The activation of NLRP3 leads to the recruitment and activation of Cysteinyl aspartate specific proteinase-1 and the release of interleukin-1β(IL-1β) and interleukin-18(IL-18), which aggravates the airway inflammation in asthma.Meanwhile, NLRP3 further results in the clea-vage of Gasdermin D and pyroptosis.Finally, the cell damage stimulates the airway remodeling of asthma.This article focused on the mechanisms of NLRP3 inflammatory response and pyroptosis as well as its role in asthma.

Objective: To describe the influence of post-operative anatomical structure changes on nasal airflow characteristics by 3D reconstruction and numerical simulation in real cases after nasalisation with Draf Ⅲ so as to explore the correlation between the changes of anatomical structure and subjective symptoms as well as airflow characteristics. Methods: Ten patients underwent nasalization with Draf Ⅲ in Department of Rhinology in Beijing Tongren Hospital from 2006 to 2018 were selected retrospectively. Postoperative follow-up of all patients was more than 1 year. All patients had no abnormalities in their paranasal sinus CT scans and Lund-Kennedy scores were 0 except scar. VAS scores including nasal obstruction, stimulation in frontal sinus, and headache were collected at the same period. The control model was a normal person. Numerical simulation was used for calculating airflow characteristics in deep inspiratory period of both models. Independent sample Mann-Whitney U test and Spearman correlation test were used by software SPSS 22.0. Results: The airflow pressure in frontal sinus ostium was (7.21±1.39)×10⁴ Pa (Mean±SD), which was lower than that in normal subjects (8.99×10⁴ Pa) under deep inspiratory simulation. But, the velocities in frontal sinus ostium and frontal sinus were (40.10±2.46) m/s and (28.19±1.73) m/s respectively, which were higher than those in normal one (2.70 m/s, 0.73 m/s). The airflow patterns of the two models were basically similar. There was no significant difference in the opening size and volume of frontal sinus between different groups after grouped by three symptoms respectively. No correlation could be found between the opening size and volume of the frontal sinus with the appearance and severity of three subjective symptoms. Conclusions The airflow pattern and distribution after nasalisation with Draf Ⅲ are like those of normal person. There is no correlation between the changes of anatomy in frontal recess and frontal sinus and nasal airflow characteristics as well as subjective symptoms.