Background Lung cancer, one of the most common malignant tumors worldwide, has long ranked first in cancer incidence and mortality, posing a severe challenge to public health systems. Objective To analyze the trends in incidence, mortality, and disability-adjusted life years (DALYs) of lung cancer among residents in Jing'an District, Shanghai, from 2002 to 2021, explore the impacts of population aging, population growth, and age-specific prevalence on disease burden, and provide a scientific basis for optimizing regional lung cancer prevention and control strategies. Methods Based on the cancer registration and cause-of-death surveillance data of registered residents in Jing'an District, Shanghai, from 2002 to 2021, Joinpoint regression models were used to analyze the annual change trends (APC) and average annual change trends (AAPC) of lung cancer incidence, mortality, DALY rate, and their age-standardized rates. Decomposition analysis was applied to quantify the contribution of population aging, population growth, and age-specific prevalence to changes in the number of new cases, deaths, and DALYs. Results From 2002 to 2021, the crude incidence rate of lung cancer in Jing'an District increased from 68.00 per 100000 to 144.36 per 100000 (AAPC=4.86%, P<0.001), and the age-standardized incidence rate rose from 43.09 per 100000 to 61.46 per 100000 (AAPC=2.89%, P<0.001). The growth rate of incidence was significantly higher in females (AAPC=6.73%) than in males (AAPC=3.62%). The crude mortality rate increased from 58.08 per 100000 to 66.11 per 100000 (AAPC=1.10%, P<0.001), while the age-standardized mortality rate decreased (AAPC=−1.54%, P<0.001). The crude DALY rate showed an upward trend (AAPC=0.94%, P=0.002), whereas the age-standardized DALY rate declined (AAPC=−1.63%, P<0.001). Significant differences were observed across genders and age groups: the mortality and DALY rates increased in males aged 60-64 years, while the fastest incidence growth occurred in females aged 45-64 years. The results of decomposition analysis indicated that the increase in new cases was primarily attributed to age-specific incidence (38.15%) and aging (37.31%); the growth in deaths and DALYs was driven by aging, while age-specific mortality and population growth showed offsetting effects. From 2002 to 2021, the probability of premature death from lung cancer among males (2.04%-2.52%) in Jing'an District showed no statistically significant trend (AAPC=−0.28%, P=0.440), while it presented a decreasing trend in the total population (1.37%-1.89%) and females (0.72%-1.26%) (AAPC=−0.80% and −2.23%, respectively; P=0.029 and <0.001, respectively). Conclusion From 2002 to 2021, the risk of lung cancer incidence in Jing’an District, Shanghai, continue to increase, with a disease burden exhibiting significant heterogeneity by gender and age: key features include a rapid increase in new cases and a trend toward younger onset among females, alongside rising mortality risk among males aged 60–64 years. Population aging and increasing age-specific incidence rates are primary drivers of the growing number of cases, while declining age-specific mortality rates mitigate the rise in mortality burden.

BACKGROUND:In recent years,deep learning technologies have been increasingly applied in the field of oral medicine,enhancing the efficiency and accuracy of oral imaging analysis and promoting the rapid development of intelligent oral medicine. OBJECTIVE:To elaborate the current research status,advantages,and limitations of deep learning based on oral imaging in the diagnosis and treatment decision-making of oral diseases,as well as future prospects,exploring new directions for the transformation of oral medicine under the backdrop of deep learning technology. METHODS:PubMed was searched for literature related to deep learning in oral medical imaging published from January 2017 to January 2024 with the search terms"deep learning,artificial intelligence,stomatology,oral medical imaging."According to the inclusion criteria,80 papers were finally included for review. RESULTS AND CONCLUSION:(1)Classic deep learning models include artificial neural networks,convolutional neural networks,recurrent neural networks,and generative adversarial networks.Scholars have used these models in competitive or cooperative forms to achieve more efficient interpretation of oral medical images.(2)In the field of oral medicine,the diagnosis of diseases and the formulation of treatment plans largely depend on the interpretation of medical imaging data.Deep learning technology,with its strong image processing capabilities,aids in the diagnosis of diseases such as dental caries,periapical periodontitis,vertical root fractures,periodontal disease,and jaw cysts,as well as preoperative assessments for procedures such as third molar extraction and cervical lymph node dissection,helping clinicians improve the accuracy and efficiency of decision-making.(3)Although deep learning is promising as an important auxiliary tool for the diagnosis and treatment of oral diseases,it still has certain limitations in model technology,safety ethics,and legal regulation.Future research should focus on demonstrating the scalability,robustness,and clinical practicality of deep learning,and finding the best way to integrate automated deep learning decision support systems into routine clinical workflows.

Sufficient bone tissue is required to ensure the long-term stability of implants. Based on the principles of guided bone regeneration, Dr. Istvan Urban proposed the “sausage technique”. Research indicates that the horizontal bone augmentation observed with the sausage technique averages (5.3 ± 2.3) mm and the vertical bone augmentation averages (4.2 ± 1.9) mm, which is significantly greater than the outcomes achieved with traditional guided bone regeneration techniques. The sausage technique is reliable because the biological membrane has sufficient elasticity and toughness with the application of membrane screws, which stabilizes the mixture of autologous bone and bone graft materials in the bone grafting area and prevents the grafting materials from being displaced. Using substitute materials for autologous bone graft balances the osteogenic activity and the low graft absorption rate. A ball drill is used to prepare nourishing holes in the cortical bone of the recipient area, providing a pathway for mesenchymal stem cells and bone progenitor cells to migrate to the bone regeneration area. Furthermore, this method accelerates the early angiogenesis of wound healing, fully reduces tension during suturing, and ensures that excessive pressure is not applied to the healing area during suturing. Thus, the sausage technique is consistent and reliable. Despite the good outcomes demonstrated by the sausage technique in clinical applications, its potential complications related to soft and hard tissue have attracted widespread attention. These complications negatively affect the patient’s recovery process and influence the final results of the surgery. Therefore, a complete understanding of the complications associated with the sausage technique and their underlying causes is necessary to enhance the clinical safety and effectiveness of the sausage technique. This article summarizes the application principles, clinical effects, barrier membrane applications, selection of bone transplant materials, and related complications of the sausage technique, aiming to provide a reference for clinical application.

Objective:To provide theoretical support and practice model for improving the clinical medical education supervision system of university-affiliated hospitals.Methods:This study focused on the group of reserve teaching supervision experts. Through literature research, questionnaire survey, and expert interview, the Competency Evaluation Criteria for Reserve Teaching Supervision Experts was constructed, which was implemented according to the training framework of "theory, practice, summary, and feedback". The paired t-test was performed using SPSS 24.0. Results:The research team formulated the Competency Evaluation Criteria for Reserve Teaching Supervision Experts through expert interviews. Six basic competencies and three advanced competencies for reserve teaching supervision experts were identified and their weights were assigned. A supervision team was established with supervision experts (including reserve teaching supervision experts) and teaching staff at a ratio of 1∶6.9, achieving an increase in the coverage of supervised specialties. A toolkit for enhancing the supervision capabilities of reserve experts was developed, and its effectiveness was analyzed. Statistical analysis showed that the overall score gap between reserve teaching supervision experts and senior supervision experts gradually narrowed. In terms of teaching demeanor and teaching effectiveness, there were no significant differences between the two types of experts. However, in terms of teaching content scores, there was a significant difference between reserve teaching supervision experts and senior supervision experts ( P<0.05). Conclusions:The training mechanism of reserve teaching supervision experts can effectively bridge the structural defects of the traditional supervision team. However, further emphasis is needed on the standardization and professionalization of teaching content supervision.

Objective:To investigate the effects of thioredoxin reductase 1 (TXNRD1) on ferroptosis and immune function of dendritic cells (DCs) in septic mice, and to provide a basis for improving the immunosuppression in sepsis caused by wound infection.Methods:This study was an experimental research. Sixty male C57BL/6J mice aged 6-8 weeks were subjected to cecal ligation and puncture (CLP) to establish sepsis models. Ten mice were selected at 0 (immediately), 6, 12, 24, 48, and 72 h after CLP surgery, respectively, according to the random number table method. Mouse splenic DCs were isolated using CD11c-positive magnetic beads. The protein expressions of TXNRD1, and anti-ferroptosis proteins solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) in the cells were detected by Western blotting, the reduced glutathione (GSH) content in the cells was measured by colorimetric assay, the lipid peroxidation level was assessed via live-cell imaging technology, and the levels of major histocompatibility complex class Ⅱ subtype I-A/I-E and leukocyte differentiation antigens CD80 and CD86 were detected by flow cytometry. Another 100 male C57BL/6J mice aged 6-8 weeks were divided into corn oil+sham injury group, corn oil+CLP group, inhibitor+sham injury group, and inhibitor+CLP group according to the random number table method, with 25 mice in each group. Mice in the two inhibitor groups were intraperitoneally injected with TXNRD1 inhibitor auranofin, while mice in the two corn oil groups were intraperitoneally injected with corn oil. One hour later, mice in the two CLP groups underwent CLP surgery to establish sepsis models, while mice in the two sham injury groups underwent sham surgery. Twenty mice from each group were selected to observe survival within 7 d post-surgery, and the survival rate was calculated. At 24 h post-surgery, mouse splenic DCs from the remaining 5 mice in each group were collected for corresponding assays as above.Results:Compared with those at 0 h after CLP surgery, the protein expressions of TXNRD1, GPX4, and SLC7A11 in mouse cells at 24 h after CLP surgery and the protein expression of TXNRD1 in mouse cells at 48 h after CLP surgery were significantly decreased ( P<0.05), the GSH content in mouse cells was significantly decreased at 24 and 48 h after CLP surgery ( P<0.05). The lipid peroxidation level in mouse cells was low at 0, 6, and 12 h after CLP surgery, slightly lower than that at 72 h after CLP surgery; the lipid peroxidation levels in mouse cells at 24 and 48 h after CLP surgery were significantly higher than those at 0, 6, 12, and 72 h after CLP surgery. Compared with those at 0 h after CLP surgery, the levels of I-A/I-E and CD80 in mouse cells at 6, 12, 24, 48, and 72 h after CLP surgery and the levels of CD86 in mouse cells at 12, 24, and 48 h after CLP surgery were significantly increased ( P<0.05). At 24 h post-surgery, the protein expressions of TXNRD1, SLC7A11, and GPX4 in mouse cells in corn oil+CLP group were significantly lower than those in corn oil+sham injury group ( P<0.05), while the protein expressions of TXNRD1, SLC7A11, and GPX4 in mouse cells in inhibitor+CLP group were significantly lower than those in corn oil+CLP group and inhibitor+sham injury group ( P<0.05). At 24 h post-surgery, the content of GSH in mouse cells in corn oil+CLP group was (239±32) μg/mg, which was significantly lower than (366±59) μg/mg in corn oil +sham injury group ( P<0.05); the content of GSH in mouse cells in inhibitor+CLP group was (134±19) μg/mg, which was significantly lower than (355±31) μg/mg in inhibitor+sham injury group and that in corn oil+CLP group (with both P values <0.05). At 24 h post-surgery, the lipid peroxidation level of mouse cells in inhibitor+CLP group was significantly higher than that in the other three groups ( P<0.05). At 24 h post-surgery, the levels of I-A/I-E, CD80, and CD86 in mouse cells in corn oil+CLP group were significantly higher than those in corn oil+sham injury group ( P<0.05), while the levels of I-A/I-E and CD80 in mouse cells in inhibitor+CLP group were significantly higher than those in inhibitor+sham injury group ( P<0.05) but significantly lower than those in corn oil+CLP group ( P<0.05); the level of CD86 in mouse cells in inhibitor+sham injury group was significantly higher than that in corn oil+sham injury group ( P<0.05). Within 7 d post-surgery, the survival rate of mice in inhibitor+CLP group was significantly lower than that in inhibitor+sham injury group and corn oil+CLP group (with χ2 values of 31.19 and 3.91, respectively, both P values <0.05). Conclusions:In septic mice, the expression of TXNRD1 in DCs is reduced, cell ferroptosis is enhanced, and immune function is weakened. The inhibition of TXNRD1 in DCs will exacerbate cell ferroptosis and immune function suppression, and is closely related to the poor prognosis of sepsis.

Objective:To analyze the differences in screening neonatal glucose-6-phosphate dehydrogenase (G6PD) deficiency in different birth seasons, establish screening thresholds for G6PD concentration in each season using indirect methods, and verify the reliability of the results.Methods:This was a cross-sectional study.A total of 140 823 newborns were collected from the Neonatal Screening Center of Shanghai Children′s Hospital from January 2020 to December 2023, including 41 029 cases, 35 796 cases, 33 969 cases and 30 029 cases in spring, summer, autumn and winter groups, respectively.The concentration of G6PD on the dried blood filter paper was determined using an automatic fluorescence analyzer.The distribution and statistical index of concentration values in four seasons were analyzed.The Kolmogorov-Smirnov test was used for normal distribution.The skewed distribution data was converted into approximately normal distribution using Box-Cox.Outliers were eliminated using the interquartile range (Turkey) method.The cumulative frequency distribution map was drawn through R language programming.The linear regression equation Y=B X+ A was fitted.The 0.5th percentile ( P0.5) was used as the screening threshold, which was compared with the reference value given by the manufacturer or laboratory and with the reference change value (RCV). Results:In the spring group, the positive rate was 4.02‰, 91 cases were confirmed, and the incidence was 1∶451.In the summer group, the positive rate was 7.18‰, 90 cases were confirmed, and the incidence was 1∶398.In the autumn group, the positive rate was 3.21‰, 86 cases were confirmed, and the incidence was 1∶395.In the winter group, the positive rate was 2.26‰, 61 cases were confirmed, and the incidence was 1∶492.The incidence rate did not change significantly in the four seasons ( P>0.05).The G6PD concentrations in the four seasons were compared in pairs, and the result was winter>autumn>spring>summer.The thresholds for G6PD screening were established indirectly: 25.08 U/dL, 22.83 U/dL, 26.63 U/dL and 38.01 U/dL in spring, summer, autumn and winter groups, respectively.The relative deviation in the threshold between the summer group and the laboratory was lower than RCV, while that between the other groups was higher than RCV.According to the screening threshold, the negative and positive conformity rates of 12 batches of 120 samples in the inter-laboratory evaluation program of Chinese Taiwan Preventive Medicine Foundation of China reached 100%. Conclusions:There is no difference in the incidence of G6PD deficiency between birth seasons.It is feasible to establish the screening threshold in each season using indirect methods, which is conducive to improving the efficiency of screening.

Objective:To analyze the differences in screening neonatal glucose-6-phosphate dehydrogenase (G6PD) deficiency in different birth seasons, establish screening thresholds for G6PD concentration in each season using indirect methods, and verify the reliability of the results.Methods:This was a cross-sectional study.A total of 140 823 newborns were collected from the Neonatal Screening Center of Shanghai Children′s Hospital from January 2020 to December 2023, including 41 029 cases, 35 796 cases, 33 969 cases and 30 029 cases in spring, summer, autumn and winter groups, respectively.The concentration of G6PD on the dried blood filter paper was determined using an automatic fluorescence analyzer.The distribution and statistical index of concentration values in four seasons were analyzed.The Kolmogorov-Smirnov test was used for normal distribution.The skewed distribution data was converted into approximately normal distribution using Box-Cox.Outliers were eliminated using the interquartile range (Turkey) method.The cumulative frequency distribution map was drawn through R language programming.The linear regression equation Y=B X+ A was fitted.The 0.5th percentile ( P0.5) was used as the screening threshold, which was compared with the reference value given by the manufacturer or laboratory and with the reference change value (RCV). Results:In the spring group, the positive rate was 4.02‰, 91 cases were confirmed, and the incidence was 1∶451.In the summer group, the positive rate was 7.18‰, 90 cases were confirmed, and the incidence was 1∶398.In the autumn group, the positive rate was 3.21‰, 86 cases were confirmed, and the incidence was 1∶395.In the winter group, the positive rate was 2.26‰, 61 cases were confirmed, and the incidence was 1∶492.The incidence rate did not change significantly in the four seasons ( P>0.05).The G6PD concentrations in the four seasons were compared in pairs, and the result was winter>autumn>spring>summer.The thresholds for G6PD screening were established indirectly: 25.08 U/dL, 22.83 U/dL, 26.63 U/dL and 38.01 U/dL in spring, summer, autumn and winter groups, respectively.The relative deviation in the threshold between the summer group and the laboratory was lower than RCV, while that between the other groups was higher than RCV.According to the screening threshold, the negative and positive conformity rates of 12 batches of 120 samples in the inter-laboratory evaluation program of Chinese Taiwan Preventive Medicine Foundation of China reached 100%. Conclusions:There is no difference in the incidence of G6PD deficiency between birth seasons.It is feasible to establish the screening threshold in each season using indirect methods, which is conducive to improving the efficiency of screening.

Objective:To investigate the screening, clinical and genetic characteristics and prognosis of hereditary tyrosinemia type Ⅰ (HT-Ⅰ) in some areas of Shanghai, and to summarize the relevant characteristics of Chinese cases reported at home and abroad.Methods:From December 2010 to May 2023, the clinical data of children diagnosed with HT-Ⅰ by tandem mass spectrometry combined with genetic detection in Neonatal Screening Center of Shanghai Children′s Hospital were retrospectively analyzed, and the relevant literature was reviewed.Results:A total of 282 149 neonates were screened for genetic metabolic disease by tandem mass spectrometry, and 1 case of HT-Ⅰ was diagnosed, with an incidence of 1∶282 149. Complex heterozygous mutations of FAH genes c. 974C>T and c. 22G>T were found by genetic testing. c. 22G>T was not reported as a new mutation. Diet and drug therapy were given immediately after diagnosis. At present, the follow-up was up to 8 months, and the physical and intellectual development were normal. A total of 32 literatures meeting the inclusion criteria were obtained through database search, and 46 cases of HT-Ⅰ Chinese children were reported. Most of the clinical manifestations were abdominal distension, poor appetite, jaundice, etc., accompanied by different degrees of abnormal coagulation function, hepatosplenomegalysis, cirrhosis and even liver failure. A total of 25 alleles were reported, and the variation of c. 455G>A was the most common. Conclusions:HT-Ⅰ is rare in the population of Shanghai, China, and new mutations enrich the variation spectrum of HT-Ⅰ, which provides basis for family genetic counseling and prenatal diagnosis of children.

Objective:To provide theoretical support and practice model for improving the clinical medical education supervision system of university-affiliated hospitals.Methods:This study focused on the group of reserve teaching supervision experts. Through literature research, questionnaire survey, and expert interview, the Competency Evaluation Criteria for Reserve Teaching Supervision Experts was constructed, which was implemented according to the training framework of "theory, practice, summary, and feedback". The paired t-test was performed using SPSS 24.0. Results:The research team formulated the Competency Evaluation Criteria for Reserve Teaching Supervision Experts through expert interviews. Six basic competencies and three advanced competencies for reserve teaching supervision experts were identified and their weights were assigned. A supervision team was established with supervision experts (including reserve teaching supervision experts) and teaching staff at a ratio of 1∶6.9, achieving an increase in the coverage of supervised specialties. A toolkit for enhancing the supervision capabilities of reserve experts was developed, and its effectiveness was analyzed. Statistical analysis showed that the overall score gap between reserve teaching supervision experts and senior supervision experts gradually narrowed. In terms of teaching demeanor and teaching effectiveness, there were no significant differences between the two types of experts. However, in terms of teaching content scores, there was a significant difference between reserve teaching supervision experts and senior supervision experts ( P<0.05). Conclusions:The training mechanism of reserve teaching supervision experts can effectively bridge the structural defects of the traditional supervision team. However, further emphasis is needed on the standardization and professionalization of teaching content supervision.

Objective:To investigate the effects of thioredoxin reductase 1 (TXNRD1) on ferroptosis and immune function of dendritic cells (DCs) in septic mice, and to provide a basis for improving the immunosuppression in sepsis caused by wound infection.Methods:This study was an experimental research. Sixty male C57BL/6J mice aged 6-8 weeks were subjected to cecal ligation and puncture (CLP) to establish sepsis models. Ten mice were selected at 0 (immediately), 6, 12, 24, 48, and 72 h after CLP surgery, respectively, according to the random number table method. Mouse splenic DCs were isolated using CD11c-positive magnetic beads. The protein expressions of TXNRD1, and anti-ferroptosis proteins solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) in the cells were detected by Western blotting, the reduced glutathione (GSH) content in the cells was measured by colorimetric assay, the lipid peroxidation level was assessed via live-cell imaging technology, and the levels of major histocompatibility complex class Ⅱ subtype I-A/I-E and leukocyte differentiation antigens CD80 and CD86 were detected by flow cytometry. Another 100 male C57BL/6J mice aged 6-8 weeks were divided into corn oil+sham injury group, corn oil+CLP group, inhibitor+sham injury group, and inhibitor+CLP group according to the random number table method, with 25 mice in each group. Mice in the two inhibitor groups were intraperitoneally injected with TXNRD1 inhibitor auranofin, while mice in the two corn oil groups were intraperitoneally injected with corn oil. One hour later, mice in the two CLP groups underwent CLP surgery to establish sepsis models, while mice in the two sham injury groups underwent sham surgery. Twenty mice from each group were selected to observe survival within 7 d post-surgery, and the survival rate was calculated. At 24 h post-surgery, mouse splenic DCs from the remaining 5 mice in each group were collected for corresponding assays as above.Results:Compared with those at 0 h after CLP surgery, the protein expressions of TXNRD1, GPX4, and SLC7A11 in mouse cells at 24 h after CLP surgery and the protein expression of TXNRD1 in mouse cells at 48 h after CLP surgery were significantly decreased ( P<0.05), the GSH content in mouse cells was significantly decreased at 24 and 48 h after CLP surgery ( P<0.05). The lipid peroxidation level in mouse cells was low at 0, 6, and 12 h after CLP surgery, slightly lower than that at 72 h after CLP surgery; the lipid peroxidation levels in mouse cells at 24 and 48 h after CLP surgery were significantly higher than those at 0, 6, 12, and 72 h after CLP surgery. Compared with those at 0 h after CLP surgery, the levels of I-A/I-E and CD80 in mouse cells at 6, 12, 24, 48, and 72 h after CLP surgery and the levels of CD86 in mouse cells at 12, 24, and 48 h after CLP surgery were significantly increased ( P<0.05). At 24 h post-surgery, the protein expressions of TXNRD1, SLC7A11, and GPX4 in mouse cells in corn oil+CLP group were significantly lower than those in corn oil+sham injury group ( P<0.05), while the protein expressions of TXNRD1, SLC7A11, and GPX4 in mouse cells in inhibitor+CLP group were significantly lower than those in corn oil+CLP group and inhibitor+sham injury group ( P<0.05). At 24 h post-surgery, the content of GSH in mouse cells in corn oil+CLP group was (239±32) μg/mg, which was significantly lower than (366±59) μg/mg in corn oil +sham injury group ( P<0.05); the content of GSH in mouse cells in inhibitor+CLP group was (134±19) μg/mg, which was significantly lower than (355±31) μg/mg in inhibitor+sham injury group and that in corn oil+CLP group (with both P values <0.05). At 24 h post-surgery, the lipid peroxidation level of mouse cells in inhibitor+CLP group was significantly higher than that in the other three groups ( P<0.05). At 24 h post-surgery, the levels of I-A/I-E, CD80, and CD86 in mouse cells in corn oil+CLP group were significantly higher than those in corn oil+sham injury group ( P<0.05), while the levels of I-A/I-E and CD80 in mouse cells in inhibitor+CLP group were significantly higher than those in inhibitor+sham injury group ( P<0.05) but significantly lower than those in corn oil+CLP group ( P<0.05); the level of CD86 in mouse cells in inhibitor+sham injury group was significantly higher than that in corn oil+sham injury group ( P<0.05). Within 7 d post-surgery, the survival rate of mice in inhibitor+CLP group was significantly lower than that in inhibitor+sham injury group and corn oil+CLP group (with χ2 values of 31.19 and 3.91, respectively, both P values <0.05). Conclusions:In septic mice, the expression of TXNRD1 in DCs is reduced, cell ferroptosis is enhanced, and immune function is weakened. The inhibition of TXNRD1 in DCs will exacerbate cell ferroptosis and immune function suppression, and is closely related to the poor prognosis of sepsis.