With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Background In mainland China, patients with neovascular age-related macular degeneration (nAMD) have approximately an 40% prevalence of polypoidal choroidal vasculopathy (PCV). This disease leads to recurrent retinal pigment epithelium detachment (PED), extensive subretinal or vitreous hemorrhages, and severe vision loss. China has introduced various treatment modalities in the past years and gained comprehensive experience in treating PCV.Methods A total of 14 retinal specialists nationwide with expertise in PCV were empaneled to prioritize six questions and address their corresponding outcomes, regarding opinions on inactive PCV, choices of anti-vascular endothelial growth factor (anti-VEGF) monotherapy, photodynamic therapy (PDT) monotherapy or combined therapy, patients with persistent subretinal fluid (SRF) or intraretinal fluid (IRF) after loading dose anti-VEGF, and patients with massive subretinal hemorrhage. An evidence synthesis team conducted systematic reviews, which informed the recommendations that address these questions. This guideline used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach to assess the certainty of evidence and grade the strengths of recommendations. Results The panel proposed the following six conditional recommendations regarding treatment choices. (1) For patients with inactive PCV, we suggest observation over treatment. (2) For treatment-na?ve PCV patients, we suggest either anti-VEGF monotherapy or combined anti-VEGF and PDT rather than PDT monotherapy. (3) For patients with PCV who plan to initiate combined anti-VEGF and PDT treatment, we suggest later/rescue PDT over initiate PDT. (4) For PCV patients who plan to initiate anti-VEGF monotherapy, we suggest the treat and extend (T&E) regimen rather than the pro re nata (PRN) regimen following three monthly loading doses. (5) For patients with persistent SRF or IRF on optical coherence tomography (OCT) after three monthly anti-VEGF treatments, we suggest proceeding with anti-VEGF treatment rather than observation. (6) For PCV patients with massive subretinal hemorrhage (equal to or more than four optic disc areas) involving the central macula, we suggest surgery (vitrectomy in combination with tissue-plasminogen activator (tPA) intraocular injection and gas tamponade) rather than anti-VEGF monotherapy. Conclusions Six evidence-based recommendations support optimal care for PCV patients' management.

Objective:To develop an artificial intelligence system for detecting dental plaque on permanent teeth and find the influenced factors.Methods:Photos of the labial or buccal surfaces of the permanent teeth were taken by using an intraoral camera (1 280×960 pixels; TPC Ligang, Shenzhen, China) before and after applying the plaque-disclosing agent (Cimedical, Japan) in 25 volunteers [12 males, 13 femals, aged (23±3) years] recruided in accordance with the inclusion criteria from the students of Peking University School of Stomatology from October 2018 to June 2019. A total of 549 groups of photos were captured and then divided into a training dataset containing 440 groups of photos and a test dataset including 109 groups of photos. The scopes of teeth and dental plaque on photos were labeled using LabelMe (Windows 3.2.1, MIT, U S A). A DeepLab based deep learning system was designed for the intelligent detection of dental plaque on permanent teeth. The mean intersection over union (MIoU) was employed to indicate the detection accuracy. Matlab (Windows R2017a, MathWorks, U S A) was used to extract the plaque edge line of 109 groups of photos and to calculate the number of pixels for the measurement of the complexity of the plaque edge line. The percentage of dental plaque area was calculated. Multivariate linear regression was used to explore whether tooth site, plaque percentage, number of plaque edge line pixels and lens light spot location would influence the detection accuracy, of which P<0.05 was considered statistically significant. Results:The MIoU of the permanent tooth model was 0.700±0.191 when 440 photos were used for training and 109 photos were used for testing. In the regression model of significance test ( P<0.05), the percentage of plaque and the number of pixels on the edge of plaque had significant influence on the accuracy of dental plaque detection. The standardized coefficient of the number of pixels of the plaque edge line is -0.289, and the standardized coefficient of the percentage of plaque is -0.551. Conclusions:In the present study, an artificial intelligence system was built to detect dental plaque area on tooth photos collected by family intraoral camera. The system showed the ability to detect the dental plaque of permanent teeth. The more complex the marginal line of dental plaque and higher the percentage of dental plaque are, the lower the accuracy of plaque recognition is.

OBJECTIVE: To evaluate the outcomes and to find out the influence factors of indirect pulp treatment in primary teeth. METHODS: Children who received indirect pulp treatment in primary teeth in the Department of Pediatric Dentistry in Peking University School and Hospital of Stomatology from August, 2014 to September, 2016 were collected in the Electronic Medical Record Database of Peking University School and Hospital of Stomatology, via the database for scientific research provided by the corporation of Kaientai. The children selected as the subjects of this study were followed up over 1.5 years, and they were under 9 years old if in the group of primary molars while the children in the group of primary anterior teeth were under 4 and a half years old. Those children who were not reviewed regularly or didn't have complete medical records were removed. Basic information, the relevant medical records and radiographic records of those children were collected. All teeth were examined clinically and classified into 2 outcomes, teeth in group H were regarded as succeeded, and teeth in group P were regarded as failed. Survival analysis was applied. The survival rate and survival time of the deciduous teeth calculated. Multivariate analysis was performed by using Cox proportional hazard model. RESULTS: One hundred and six children were finally included, aged from 1.6 to 8.8 years, with the mean age of (5.0±1.7) years. 168 primary teeth (122 primary molars, 46 primary anterior teeth) were included, and the average follow up time was (729±244) days. Thirty-five primary teeth (23 primary molars, 12 primary anterior teeth) failed upon clinical or radiographic examinations by September, 2018. The cumulative survival probability of half a year, one year, one year and a half, two years, two and a half years for the indirect pulp treatment was 93.5%, 92.9%, 87.5%, 82.7%, and 75.5% through the KaplanMeier method, respectively. Through the analysis of Cox proportional hazard model, in primary molars, the survival probability tended to be lower when the number of tooth surface affected by caries was greater (OR=1.709, P<0.05). Compared with primary molars, the survival probability of primary anterior teeth was lower, but the difference was not significant. CONCLUSION Complying the current instructions in our department, the cumulative survival probability of two and a half years after the indirect pulp treatment in primary teeth was 75.5%. In primary molars, the survival probability tended to be lower when the number of tooth surfaces affected by caries increased.
Child ; Child, Preschool ; Dental Caries ; Dental Pulp ; Humans ; Infant ; Molar ; Retrospective Studies ; Tooth, Deciduous

Objective To observe the protein expression patterns of matrix metalloproteinase (MMP)-2 and MMP-9 in the liver tissue of liver contusion rats at different time after impact. Methods Fifty healthy adult male SD rats were randomly and evenly divided into control group and experimental groups (1 h, 3 h, 6 h, 12 h, 18 h, 24 h, 3 d, 5 d, 7 d after liver contusion). A rat liver contusion model was established by a free-falling device. The rats were killed at corresponding time, and the contused hepatic lobes were extracted. The protein expressions of MMP-2 and MMP-9 in contused liver tissue of the rats in each group were observed by immunohistochemical staining (SP method) and Western blotting. Results After the liver contusion, the expression of positive cell and the protein semiquantitative result showed that the protein expression of MMP-2 enhanced at 6 h and peaked at 24 h, then decreased gradually at 3-5 d, and returned to normal levels at 7 d. The difference of expression between group and its previous adjacent group after 6 h (except 18 h) had statistical significance (P<0.05). The protein expression of MMP-9 rose obviously at 1 h after liver contusion and peaked at 18 h, then decreased gradually at 3-7 d which still higher than control group. The expression difference between group and its previous adjacent group (except 12 h and 24 h) had statistical significance (P<0.05). Conclusion The protein expressions of MMP-2 and MMP-9 in contused liver tissue after impact show good time-dependent patterns, which may provide important reference indicators for the time estimation of liver contusion.

OBJECTIVE To observe the cross section diameter and the effects of pricking blood therapy on acute gouty ar-thrits rats model's interleukin-1β(IL-1β),interleukin-10(IL-10)mRNA expression and promoter methylation in local ankle,and explore the epigenetics mechanisms of pricking blood therapy's treatment.METHODS 36 SD rats were randomly divided into normal control group,urate arthritis group,ibuprofen group and bloodletting group.The acute gouty arthrits model set up by injecting uric acid into the right ankle joint cavity.The ibuprofen group was treated by gastric perfusion of ibuprofen,while the bloodletting group was pricked at the right Kunlun points.The swelling index of the modeling joint was evaluated,and the morphological changes were observed under light microscope.The mRNA expression levels and promoter methylation status of IL-1βand IL-10 in rats local ankle were detected by qPCR and pyrosequencing detection.RESULTS Compared with the urate arthritis group and ibuprofen group,the joint swelling index in the bloodletting group was decreased(P<0.01)after the treatment.Pricking blood therapy reduced intracellular deposition of uric acid in the joint cavity,and inhibited inflammato-ry cells to improve the synovial membrane tissue.Compared with urate arthritis group,the IL-1βmRNA expression levels of blood group was decreased significantly(P<0.01).IL-1βpromoter methylation and mRNA expression didn't showed a nega-tive correlation.Compared with normal control group,urate arthritis group and ibuprofen group,the expression levels of IL-10 mRNA in blood group increased significantly(P<0.01),and the average methylation rate of IL-10 among blood group de-creased significantly(P<0.05～0.01).IL-10 promoter methylation and mRNA expression showed a strong negative correla-tion(r=-0.899,P<0.01).CONCLUSION In epigenetics,the methylation of IL-10 can regulate the gene expression,which can be one of important mechanisms which shows anti-inflammatory effects of pricking blood therapy,.

OBJECTIVETo investigate the effects of cycle-dependent kinase (CDK) inhibitor SNS-032 on apoptosis in human acute myeloid leukemia (AML) HL-60 cells and its molecular mechanisms.

METHODSCultured AML HL-60 cells were treated with various concentrations of SNS-032. Cell apoptosis was determined with flow cytometry;cell viability was measured by MTT assay; the profiles of microRNA expression of HL-60 cells were analyzed by microRNA microarray;the protein expressions of JAK2/STAT3 pathway were detected by Western blotting.

RESULTSApoptosis of AML HL-60 cells was induced by SNS-032; the rate of apoptosis was (5.9±1.7)%, (12.1±3.1)% and (59.4±3.6)% when HL-60 cells were treated with 0,100 and 200 nmol/L SNS-032. MicroRNA microarray analysis revealed that the levels of miR-30a, miR-183, miR-20b, miR-26b, miR-20a, miR-589, miR-107, miR-181a, miR-106a, miR-17 and miR-378c were down-regulated by SNS-032,whereas the levels of miR-320a and miR-H7* were up-regulated. Western blotting showed that SNS-032 strongly inhibited phosphorylation of STAT3 and protein expression of JAK2,C-MYC and MCL-1.

CONCLUSIONCDK inhibitor SNS-032 can induce apoptosis of AML HL-60 cells, which is associated with the inhibition of MCL-1,C-MYC and JAK2/STAT3, and down-regulation of miR-17-92 family.

Apoptosis ; Cell Survival ; Down-Regulation ; Flow Cytometry ; HL-60 Cells ; Humans ; Janus Kinase 2 ; metabolism ; MicroRNAs ; metabolism ; Oxazoles ; pharmacology ; Phosphorylation ; STAT3 Transcription Factor ; metabolism ; Signal Transduction ; Thiazoles ; pharmacology

OBJECTIVETo evaluate the effects of Jiashen Prescription (, JSP) on myocardial infarction (MI) size and cardiac function at the early stage of MI in rats.

METHODSOne hundred male Sprague-Dawley rats were subjected to sham-operation or MI induced by ligating the left anterior descending coronary artery. The rats with MI were treated with vehicle, JSP 3 and 6 g/(kg·d), or losartan 10 mg/(kg·d) for 1 week.

RESULTSCompared with the vehicle-treated MI rats, 6 g/(kg·d) JSP reduced MI size 3 days after MI (P<0.05), and attenuated the MI-induced increases in left ventricular end-diastolic and end-systolic dimension and decreases in fractional shortening and ejection fraction 1 week after MI (P<0.05). In addition, 6 g/(kg·d) JSP and losartan were equally effective in reducing MI size and enhancing cardiac functional recovery.

CONCLUSIONJSP reduces MI size and improves cardiac function after MI, suggesting that JSP has potential as a therapy for MI.

Animals ; Body Weight ; Cardiotonic Agents ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Heart Function Tests ; Male ; Myocardial Infarction ; diagnostic imaging ; drug therapy ; pathology ; physiopathology ; Myocardium ; pathology ; Organ Size ; Rats, Sprague-Dawley ; Survival Analysis ; Ultrasonography

Objective: To discuss the effect of BRMS1 on the proliferation, migration and adhesion of mouse forestomach carcinoma. Methods: The constructed pCMV-myc- BRMS1 recombinant plasmid and blank plasmid were transfected into mouse forestomach carcinoma. MTT method was employed to measure the activity of gastric cancer cell; the scratch assay and Transwell assay to measure the migration and invasion of gastric cancer cell; the adhesion assay to measure the adhesion of gastric cancer cell; while the Western blot assay to measure the expression of The NF-κB signal pathway, downstream matrix metalloproteinase (MMP)-2, MMP-9 and osteopontin and E-cadherin in the gastric cancer cell. Besides, the transplanted animal model of gastric cancer in mice was constructed to measure the size of tumor xenograft. Results: Results of MTT assay showed that, compared with the empty vector control group, the activity of gastric cancer cell was not affected in the BRMS1 transfection group. The improved expression of BRMS1 could inhibit the adhesion, migration and invasion of gastric cancer cell (P < 0.01). Besides, compared with the empty vector control group, the phosphorylation of NF-κB p65 and IκBα was reduced in the BRMS1 transfection group, with the decreased expression of MMP-2, MMP-9 and osteopontin and the increased expression of E-cadherin (P < 0.01). Results of animal experiment also showed that the expression of BRMS1 did not affect the transplanted tumor. Conclusions: The expression of BRMS1 can significantly inhibit the adhesion, migration, invasion and metastasis of mouse forestomach carcinoma gastric cancer cell, which is related to The NF-κB signal pathway.