Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

This research study focuses on addressing the limitations of current neuropathic pain (NP) treatments by developing a novel dual-target modulator, E0199, targeting both Na_V1.7, Na_V1.8, and Na_V1.9 and K_V7 channels, a crucial regulator in controlling NP symptoms. The objective of the study was to synthesize a compound capable of modulating these channels to alleviate NP. Through an experimental design involving both in vitro and in vivo methods, E0199 was tested for its efficacy on ion channels and its therapeutic potential in a chronic constriction injury (CCI) mouse model. The results demonstrated that E0199 significantly inhibited Na_V1.7, Na_V1.8, and Na_V1.9 channels with a particularly low half maximal inhibitory concentration (IC₅₀) for Na_V1.9 by promoting sodium channel inactivation, and also effectively increased K_V7.2/7.3, K_V7.2, and K_V7.5 channels, excluding K_V7.1 by promoting potassium channel activation. This dual action significantly reduced the excitability of dorsal root ganglion neurons and alleviated pain hypersensitivity in mice at low doses, indicating a potent analgesic effect without affecting heart and skeletal muscle ion channels critically. The safety of E0199 was supported by neurobehavioral evaluations. Conclusively, E0199 represents a ground-breaking approach in NP treatment, showcasing the potential of dual-target small-molecule compounds in providing a more effective and safe therapeutic option for NP. This study introduces a promising direction for the future development of NP therapeutics.

Humans ; Aged ; Lung Diseases ; Pneumonia/drug therapy* ; Adrenal Cortex Hormones/therapeutic use* ; Pulmonary Disease, Chronic Obstructive/drug therapy* ; Administration, Inhalation ; Community-Acquired Infections/drug therapy*

Objective:To establish reference ranges of central nervous system-related fetal intracranial markers during the first trimester in a local population of Suzhou.Methods:Ultrasound images of fetuses with normal birth outcomes in singleton pregnancies who underwent nuchal translucency(NT) screening during the first trimester (11-13 + 6 gestational weeks) from January 2021 to July 2022 at the Affiliated Suzhou Hospital of Nanjing Medical University were retrospectively selected. The images including 3 planes: the midsagittal plane of the fetal head, also known as the plane for NT measurement, the trans-ventricular plane of the fetal head, and the axial plane of the fetal head at the posterior fossa level. The brainstem (BS) thickness, brainstem to occipital bone distance (BSOB), the ratio of BS to BSOB (BS/BSOB), intracranial translucency (IT) thickness, cisterna magna (CM) width, and the midbrain (MB) to falx (F) ratio MB/F were measured in the mid-sagittal plane of the fetal head. Choroid plexus length (CPL) to occipital frontal diameter (OFD) ratio CPL/OFD, and choroid plexus area (CPA) to head area (HA) ratio CPA/HA were measured in the trans-ventricular plane of the fetal head. Anteroposterior diameter of the fourth ventricle (4V) and CM were measured in the axial plane of the fetal head at the posterior fossa level.Statistical analysis was performed to obtain the corresponding normal reference range.Intra-class correlation coefficient (ICC) was used to analyze intra-observer and inter-observer consistency. Pearson correlation analysis and linear correlation analysis were used to study the correlations between crown-lump length (CRL) and intracranial markers, and the regression equation was derived. Results:A total of 2 331 fetuses were enrolled, providing 1 023 images of the midsagittal plane, 817 images of the trans-ventricular plane, and 567 images of the axial plane of the fetal head at the posterior fossa level. The intra-observer and inter-observer ICCs of intracranial markers BS, BSOB, BS/BSOB, IT thickness, CM width, MB/F in the mid-sagittal plane, the intracranial markers CPL/OFD, CPA/HA on the trans-ventricular plane, and the intracranial markers 4V and CM width in the axial plane at the posterior fossa level were all >0.75. Fetal intracranial markers were linearly correlated with CRL. The midsagittal plane: BS, BSOB, BS/BSOB, IT thickness, CM width, MB/F were linearly correlated with CRL ( r=0.508, 0.626, -0.234, 0.105, 0.508, -0.493; all P<0.05); the trans-ventricular plane: CPL/OFD, CPA/HA were linearly correlated with CRL( r=-0.324, -0.268; all P<0.001); the axial plane of the fetal head at the posterior fossa level: 4V, CM width were linearly correlated with CRL ( r=0.246, 0.467; all P<0.001). Conclusions:Quantitative analysis of fetal intracranial markers in the first trimester is feasible. This study constructed a normal reference range of multiple intracranial markers related to central nervous system in the first trimester with a local population of Suzhou. And the construction of this normal range can provide an objective basis for the detection of fetal central nervous system malformations in the first trimester.

Objective To investigate the short and long term effects of preincision of pancreatic duct sphincter in different types of patients with difficult intubation by endoscopic retrograde cholangiopancreatography(ERCP).Method A retrospective study was conducted on 100 patients with difficulty in ERCP intubation from January 2019 to June 2020.Patients were divided into a control group(50 cases)and a study group(50 cases)according to different treatment methods.The control group underwent routine ERCP intubation without pancreaticotomy,while the study group underwent preincision of pancreatic duct sphincter on the basis of routine ERCP intubation.Calculate the successful intubation time,successful intubation rate,and length of hospital stay for two groups;Enzyme linked immunosorbent assay was used to detect postoperative C-reactive protein(CRP),interleukin-6(IL-6),and blood amylase levels in two groups of patients;Calculate the incidence of complications related to pre incision surgery in two groups of patients;Follow up the incidence of reflux cholangitis and recurrent pancreatitis in two groups of patients at 3,6,and 12 months after surgery,and evaluate the long-term efficacy of the two groups of patients.Result Compared with the control group,the study group showed a shorter in successful intubation time,and an increase in successful intubation rate(P<0.05).There was no difference in hospital stay between the two groups(P>0.05);Compared with the control group,the study group showed a decrease in CRP,IL-6 and blood amylase levels on the first day after surgery(P<0.05);The postoperative complication rate of patients in the control group was 14.0%,including 4 patients with acute pancreatitis,2 patients with bleeding,and 1 patient with perforation.The postoperative complication rate of patients in the study group was 2.0%,with 1 patient with bleeding.Compared with the control group,the postoperative complication rate of patients in the study group decreased(P<0.05);Compared with the control group,the incidence of reflux cholangitis in the study group decreased at 12 months after surgery,and the incidence of recurrent pancreatitis decreased at 3,6,and 12 months after surgery(P<0.05).Conclusion Preincision of the pancreatic duct sphincter has a mild impact on systemic inflammation in patients with difficult ERCP intubation,with normal blood amylase indicators and no increase in the incidence of postoperative pancreatitis.It can improve the success rate of intubation and has significant long-term efficacy.It is a safe and effective technique which is worth recommending.

As a safety culture placed between a culture of punishment and that of exemption, just culture can effectively improve the reporting rate of medical adverse events, promote medical staff to learn from events, and continuously improve patient safety management. The authors searched for literature on the study of just culture in medical institutions both domestically and internationally, including such databases as CNKI, Wanfang Data, and PubMed from 2001 to January 2023. They reviewed the concept of just culture and its connotation in the field of patient safety management, as well as the current research status of just culture in medical institutions both domestically and internationally. On such basis, they proposed for the construction of just culture in medical institutions in China, for reference in the construction and evaluation of a just culture in such institutions.

Fibroblast growth factor 8 (FGF8) is a kind of secretory polypeptide that has crucial roles in the development of various tissues and organs. Current studies have found that FGF8 can regulate the differentiation of cranial neural crest cells by activating the mitogen-activated protein kinase (MAPK) signaling pathway and affect the establishment of mandibular arch polarity and the development of craniofacial symmetry by regulating the expression of target genes. Cleft lip with or without cleft palate, ciliopathies, macrostomia and agnathia are four developmental malformations involving the craniofacial region that seriously affect the quality of life of patients. The abnormal FGF8 signal caused by gene mutation, abnormal protein conformation or expression is closely related to the occurrence of craniofacial malformations, but the molecular mechanism and signaling pathway underlying these malformations have not been fully elucidated. Craniofacial development is a complex process mediated by a variety of signaling molecules. In the future, the role of various signaling molecules in craniofacial development and malformations need to be explored to provide a new perspective and vision for the prevention and treatment of these craniofacial malformations.

OBJECTIVEThis investigation aimed to examine how buccal mucosa microbiome succeeds in a healthy population with different ages and dentition stages.

METHODSTwenty-five subjects were recruited and subdivided into five groups: primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group. Individual mucosal microbiota was obtained by gently scraping both sides of the buccal mucosa with a cotton swab. Microbial diversity was analyzed by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE).

RESULTS1) The composition of buccal mucosa microbiota has great intra-individual divergence. 2) The average band numbers of the primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group were 21.2 +/- 4.0, 17.8 +/- 3.9, 15.8 +/- 4.3, 16.8 +/- 3.7, and 22.2 +/- 6.5, respectively. No between-group differences was observed (P > 0.05), indicating that predominant strains in the oral cavity may be stable throughout an individual's lifetime. 3) The Shannon indices of primary dentition group, mixed dentition group, adolescent group, adult group, and elderly group were 1.73 +/- 10.2, 1.43 +/- 0.1, 1.05 +/- 0.2, 1.45 +/- 0.2, and 1.63 +/- 0.3, respectively. A significant between-group difference was observed (P = 0.003), indicating that the microbial diversity of the buccal mucosa decreases from childhood through adolescence, but increases from adult through senescence. 4) The clustering analysis showed that most of the samples in the same group clustered together, indicating higher intra-group community structure similarity.

CONCLUSIONComposition of the buccal mucosa microbiota was different among age groups. Adolescence may be an essential turning point of microbial ecology succession throughout life.

Objective To compare the incidence of pancreatic fistula after hand and stapler suture in preventing pancreatic fistula after distal pancreatectomy.Methods The literatures published before December 2011 were retrieved from SinoMed and electronic database.Prospective controlled trials and retrospective reports were screened out for Meta analysis.The diagnostic criteria of pancreatic fistula were based on the criteria formulated by the International Study group of Pancreatic Fistula.The heterogeneity of the studies was analyzed using the Ⅰ2 test.The data were integrated using the fixed or random effect model.The results of the Meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results According to the selection criteria,lO literatures were selected which included 1 prospective randomized controlled study,3 prospective nonrandomized controlled studies and 6 retrospective studies.There were 1 441 cases in the hand suture group and 612 cases in the stapler suture group.There was no significant difference in the incidences of the pancreatic fistula between the hand suture group and the stapler suture group (OR =1.10,95％ CI:0.86-1.40,P ＞0.05).Six studies compared the incidences of severe pancreatic fistula (grade B or C) between the hand suture group and the stapler suture group.There were 1 182 cases in the hand suture group and 383 cases in the stapler suture group.There was no significant difference in the incidence of severe pancreatic fistula between the hand suture group and the stapler suture group (OR=1.33,95％CI:0.94-1.88,P＞0.05).Conclusion The efficacies of hand suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy are comparable.Stapler suture provides an another option in distal pancreatectomy.