Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

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*

Objective:To understand the current status of financial toxicity in patients with heart failure and the factors affecting it, and to provide ideas for making personalized and informed decisions.Methods:Using a scoping review methodological framework, PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, VIP, Wanfang, and SinoMed Databases were searched and screened for relevant literature on financial toxicity in patients with heart failure, with a timeframe of January 1, 2014-October 31, 2023, respectively. Relevant literature was identified based on inclusion and exclusion criteria, and data were extracted, collected, summarized, and the findings were reported.Results:Ten literatures that met the inclusion and exclusion criteria were identified. The results showed 5 cross-sectional surveys, 2 qualitative studies, and 1 each of reviews, mixed studies and commentaries. Heart failure patients generally faced high levels of financial toxicity, the incidence and severity of patient financial toxicity varied somewhat between study outcomes. Factors influencing financial toxicity in heart failure patients included age, education level, family income level, discussion of medical costs with physicians, type of insurance the patient had, and occupational status.Conclusions:In the future, we can develop and apply a specialized assessment tool for financial toxicity in heart failure patients in China, further explore the factors affecting financial toxicity in heart failure patients, and formulate personalized treatment plans and financial support strategies for patients according to the influencing factors, so as to reduce the impact of financial toxicity on heart failure patients.

Cancer cell membrane (CCM) derived nanotechnology functionalizes nanoparticles (NPs) to recognize homologous cells, exhibiting translational potential in accurate tumor therapy. However, these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts (CDX), ignoring the tumor heterogeneity and differentiation from inter- and intra- individuals and microenvironments between heterotopic- and orthotopic-tumors, limiting the therapeutic efficiency of such nanoplatforms. Herein, various biomimetic nanoplatforms (CCM-modified gold@Carbon, i.e., Au@C-CCM) were fabricated by coating CCMs of head and neck squamous cell carcinoma (HNSCC) cell lines and patient-derived cells on the surface of Au@C NP. The generated Au@C-CCMs were evaluated on corresponding CDX, tongue orthotopic xenograft (TOX), immune-competent primary and distant tumor models, and patient-derived xenograft (PDX) models. The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death. The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency, far above those with mismatched CCMs, resulting in distinct tumor ablation and tumor growth inhibition in all four models. This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC, can be further extended to other malignant tumors therapy.
Animals ; Humans ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Heterografts ; Photothermal Therapy ; Biomimetics ; Disease Models, Animal ; Head and Neck Neoplasms/therapy* ; Cell Line, Tumor ; Tumor Microenvironment

ObjectiveTo explore the association between social support， parent-child relationships， and depression， anxiety， and loneliness among adolescents， in order to provide a reference for improving mental health in youth. MethodsA total of 11，596 middle school students from two districts of Shanghai were investigated with the stratified random cluster sampling method. The Chinese version of Patient Health Questionnaire （PHQ-2-C）， Generalized Anxiety Disorder （GAD-7）， UCLA Loneliness Scale （ULS-6）， Perceived Social Support Scale and Parent-child Cohesion Questionnaire were used in the survey. Statistical inferences were made using t-test， ANOVA， and logistic regression analysis. ResultsGirls， non-graduates， students ranking in the top 25%， adolescents living with parents and with higher socioeconomic status had higher scores of social support and parent-child cohesion than boys， graduates， students ranking in the middle or in the bottom 25%， adolescents not living with parents and with lower socioeconomic status （P<0.05）. Adolescents' parent-child cohesion and social support were negatively correlated with all kinds of emotions. Parent-child cohesion was an associated factor of depression （OR=0.93， 95%CI：0.91‒0.94）， loneliness （OR=0.94， 95%CI：0.94‒0.95） and anxiety （OR_mild=0.98， 95%CI： 0.98‒0.99； OR_{moderate or severe}=0.96， 95%CI： 0.95‒0.98）， but there were differences in the correlation between emotions and social support in different dimensions. ConclusionSocial support and parent-child relationship are significantly associated with depression， anxiety and loneliness in adolescent students. Paying more attention to youth with different characteristics， taking targeted measures to improve the level of social support and establishing a good family relationship are conducive to promoting the mental health of adolescents.

Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.

Metastatic triple-negative breast cancer (TNBC) is the most aggressive type of breast cancer. Combination of systemic chemotherapy and immune checkpoint blockade is effective but of limited benefit due to insufficient intratumoral infiltration of cytotoxic T lymphocytes (CTLs) and the accumulation of immunosuppressive cells. Herein, we designed a lenvatinib- and vadimezan-loaded synthetic high-density lipoprotein (LV-sHDL) for combinational immunochemotherapy of metastatic TNBC. The LV-sHDL targeted scavenger receptor class B type 1-overexpressing 4T1 cells in the tumor after intravenous injection. The multitargeted tyrosine kinase inhibitor (TKI) lenvatinib induced immunogenic cell death of the cancer cells, and the stimulator of interferon genes (STING) agonist vadimezan triggered local inflammation to facilitate dendritic cell maturation and antitumor macrophage differentiation, which synergistically improved the intratumoral infiltration of total and active CTLs by 33- and 13-fold, respectively. LV-sHDL inhibited the growth of orthotopic 4T1 tumors, reduced pulmonary metastasis, and prolonged the survival of animals. The efficacy could be further improved when LV-sHDL was used in combination with antibody against programmed cell death ligand 1. This study highlights the combination use of multitargeted TKI and STING agonist a promising treatment for metastatic TNBC.

Objective: This study aims to investigate the impact of individual and family factors on anxiety and loneliness of middle school students during quarantine in the COVID-19 pandemic and to provide reference for discussing the possible effective intervention paths in the stress process of public health emergencies. Methods: A total of 11 596 students from junior and high schools in Shanghai were selected to complete the questionnaire with the stratified random cluster sampling method. Generalized Anxiety Disorder(GAD-7) and UCLA Loneliness Scale, University of California at Los Angeles(ULS-6) were used for the survey. Results: The prevalence of anxiety and loneliness were 34.78% and 52.44% respectively. The rate of anxiety and loneliness in girls (36.13%, 54.62%) was higher than that of boys (33.44%, 50.28%)(χ 2=17.03, 21.82, P<0.05). Logistic regression analysis showed that graduates (OR=1.34, 95%CI=1.18-1.52), students ranking in the middle (OR=1.25, 95%CI=1.08-1.45) or in the bottom 25% (OR=1.76, 95%CI=1.50-2.05), non only children in the family (OR=1.25, 95%CI=1.09-1.43) and low socioeconomic status (OR=1.42, 95%CI=1.23-1.65) were associated with increased risk of moderate and severe level of anxiety(P<0.05). Girls(OR=1.20, 95%CI=1.12-1.30), graduates(OR=1.13, 95%CI=1.04-1.24), non residents(OR=1.20, 95%CI=1.09-1.33), lower level of grades(OR=1.72, 95%CI=1.55-1.91) and not living with parents(OR=1.32, 95%CI=1.18-1.48) were associated with increased risk of loneliness(P<0.05). Conclusion During the quarantine period caused by the COVID-19 pandemic, negative emotions such as anxiety and loneliness among adolescents need attention, especially females, graduates, only children and students with low rankings or low socioeconomic status.

Objective:To explore the differences of wear resistance of three kinds of glass ceramics and Wieland Zenostar zircona (Zenostar) , and to clarify their influencing factors.Methods:Zenostar were made into flat-shaped specimens (zirconia base sample group) and hemisphere-shaped specimens (zirconia pair grinding group) .There kinds of glass ceramics IPS Empress (Empress) , IPS e.max CAD (e.max) , VITA Suprinity (Suprinty) were used as base specimens.Each group was exposed to UMT-2testing machine to simulate the clinical service.The wear depthes of base specimens were detected by laser confocal scanning.Scanning electron microscope (SEM) was used to evaluate the wear surfaces.Results:In zirconia base sample group, there were no significant differences in the maximum wear depthes to Zenostar between the three kinds of glass ceramics (P＞0.05) .In zirconia pair grinding group, the maximum wear depthes ranked as follows:Zenostar group＜e.max group≈Empress group＜Suprinity group;there was no significant difference between e.max group and Empress group (P＞0.05) , but there were significant differences between other groups (P＜0.01) .The SEM results showed that the wearing surface of the Zenostar in zirconia base sample group was relatively smooth;whereas the wearing surface of Empress in zirconia pair grinding group was rougher with alarge area of clebris desquamation surface.Conclusion:The wear resistance of the three kinds of glass ceramics to Zenostar is related to the compositions and the chemical structures of materials.