Oral and maxillofacial CBCT(cone beam computed tomography)as a kind of oral imaging techniques,can accurately show the tooth pulp in an all-round way.Especially for showingthe morphologyof special root canals,it has incomparable advantages over two-dimensional X ray film.With the development of digital technology and artificial intelligence technology,CBCT has been widely used in stomatology.In this paper,we will systematically review the applicationprogress of CBCT combined with oral digital technology and arti-ficial intelligence technology,with a view to providing references for clinical diagnosis and treatmentand technical development of the discipline.

Background and Aims:Tumor deposits(TDs)may influence prognosis beyond the current 8th edition AJCC pTNM nodal classification in gastric cancer(GC).This study investigates the prognostic value of TD number and proposes an improved pN staging(mpN)that classifies patients with TD number>1 as pN3b.We validated the mpN staging against the 8th AJCC pN staging.Methods:A dual-center retrospective cohort study was performed,including 1 327 patients who underwent radical gastrectomy at Sun Yat-sen University Cancer Center(2011-2015;test cohort)and 340 patients from Guangdong Provincial People's Hospital(2015-2022;validation cohort).Patients were dichotomized into low-TD(≤1)and high-TD(>1)groups.Outcomes were overall survival(OS)and disease-free survival(DFS).Survival analyses used Kaplan-Meier curves,IPTW,and Cox regression.Predictive performance of staging systems was assessed by time-dependent ROC(tROC)/tAUC,concordance index(C-index)and Akaike information criterion(AIC).Results:TDs were present in 435/1 327(32.7%)in the test cohort.Presence of TD was associated with worse OS(IPTW-adjusted HR=2.69,95%CI=2.18-3.31,P<0.01)and DFS(HR=2.82,95%CI=2.32-3.42,P<0.01).In multivariable models,TD remained an independent adverse factor for OS(HR=1.65,95%CI=1.34-2.05;P<0.01)and DFS(HR=1.74,95%CI=1.43-2.11,P<0.01).Increasing TD number correlated with progressively poorer survival;X-tile identified>1 as an optimal cutoff,with high-TD patients showing markedly worse outcomes(OS:adjusted HR=3.65,95%CI=2.74-4.88;DFS:adjusted HR=3.74,95%CI=2.85-4.91;both P<0.01).Incorporation of TD number into the mpN staging(assigning TD>1 to pN3b)improved prognostic discrimination:in the test cohort 5-year OS tAUC was 0.746 for mpN vs.0.703 for AJCC pN(C-index 0.738 vs.0.721,AIC 5 805.27 vs.5 849.30);similar improvements were observed in the validation cohort.Conclusion:TD presence and number exert significant negative prognostic impact in GC.Classifying patients with TD number>1 as pN3b enhances prognostic accuracy.Routine reporting of TD counts and further prospective multicenter validation of mpN staging are warranted.

Objective To investigate the biological behavior of EMP1 in pancreatic cancer cells and the molecular mechanism of EMP1 in promoting tumor progression.Methods A stable EMP1 knockdown cell line was obtained by lentivirus transfection.The effect of EMP1 on the proliferation of cancer cells was determined by CCK-8 and clonal formation assay.The effect of EMP1 on the migration and invasion of cancer cells was detected by scratch test and Transwell test.The influence of EMP1 on downstream signaling pathways was investigated by Western blot.Results The results of qRT-PCR and Western blot showed that EMP1 was highly expressed in pancreatic cancer cells.The results of CCK-8,colony formation,scratch,and Transwell assays indicated that EMP1 promoted the proliferation,migration,and invasion of pancreatic cancer cells.Western blot results revealed that EMP1 might promote tumor progression through the PI3K/AKT signaling pathway.Conclusion This study suggested that EMP1 may activate the PI3K/AKT signaling pathway to promote the proliferation,migration,and invasion of pancreatic cancer cells,thereby positively regulating tumor progression.

Background and Aims:Tumor deposits(TDs)may influence prognosis beyond the current 8th edition AJCC pTNM nodal classification in gastric cancer(GC).This study investigates the prognostic value of TD number and proposes an improved pN staging(mpN)that classifies patients with TD number>1 as pN3b.We validated the mpN staging against the 8th AJCC pN staging.Methods:A dual-center retrospective cohort study was performed,including 1 327 patients who underwent radical gastrectomy at Sun Yat-sen University Cancer Center(2011-2015;test cohort)and 340 patients from Guangdong Provincial People's Hospital(2015-2022;validation cohort).Patients were dichotomized into low-TD(≤1)and high-TD(>1)groups.Outcomes were overall survival(OS)and disease-free survival(DFS).Survival analyses used Kaplan-Meier curves,IPTW,and Cox regression.Predictive performance of staging systems was assessed by time-dependent ROC(tROC)/tAUC,concordance index(C-index)and Akaike information criterion(AIC).Results:TDs were present in 435/1 327(32.7%)in the test cohort.Presence of TD was associated with worse OS(IPTW-adjusted HR=2.69,95%CI=2.18-3.31,P<0.01)and DFS(HR=2.82,95%CI=2.32-3.42,P<0.01).In multivariable models,TD remained an independent adverse factor for OS(HR=1.65,95%CI=1.34-2.05;P<0.01)and DFS(HR=1.74,95%CI=1.43-2.11,P<0.01).Increasing TD number correlated with progressively poorer survival;X-tile identified>1 as an optimal cutoff,with high-TD patients showing markedly worse outcomes(OS:adjusted HR=3.65,95%CI=2.74-4.88;DFS:adjusted HR=3.74,95%CI=2.85-4.91;both P<0.01).Incorporation of TD number into the mpN staging(assigning TD>1 to pN3b)improved prognostic discrimination:in the test cohort 5-year OS tAUC was 0.746 for mpN vs.0.703 for AJCC pN(C-index 0.738 vs.0.721,AIC 5 805.27 vs.5 849.30);similar improvements were observed in the validation cohort.Conclusion:TD presence and number exert significant negative prognostic impact in GC.Classifying patients with TD number>1 as pN3b enhances prognostic accuracy.Routine reporting of TD counts and further prospective multicenter validation of mpN staging are warranted.

Objective To investigate the biological behavior of EMP1 in pancreatic cancer cells and the molecular mechanism of EMP1 in promoting tumor progression.Methods A stable EMP1 knockdown cell line was obtained by lentivirus transfection.The effect of EMP1 on the proliferation of cancer cells was determined by CCK-8 and clonal formation assay.The effect of EMP1 on the migration and invasion of cancer cells was detected by scratch test and Transwell test.The influence of EMP1 on downstream signaling pathways was investigated by Western blot.Results The results of qRT-PCR and Western blot showed that EMP1 was highly expressed in pancreatic cancer cells.The results of CCK-8,colony formation,scratch,and Transwell assays indicated that EMP1 promoted the proliferation,migration,and invasion of pancreatic cancer cells.Western blot results revealed that EMP1 might promote tumor progression through the PI3K/AKT signaling pathway.Conclusion This study suggested that EMP1 may activate the PI3K/AKT signaling pathway to promote the proliferation,migration,and invasion of pancreatic cancer cells,thereby positively regulating tumor progression.

Oral and maxillofacial CBCT(cone beam computed tomography)as a kind of oral imaging techniques,can accurately show the tooth pulp in an all-round way.Especially for showingthe morphologyof special root canals,it has incomparable advantages over two-dimensional X ray film.With the development of digital technology and artificial intelligence technology,CBCT has been widely used in stomatology.In this paper,we will systematically review the applicationprogress of CBCT combined with oral digital technology and arti-ficial intelligence technology,with a view to providing references for clinical diagnosis and treatmentand technical development of the discipline.

Objective To investigate the effect of preoperative dexmedetomidine(DEX)combined with fascia iliac compartment block(FICB)analgesia on perioperative sleep quality and delirium in elderly patients with hip fracture.Methods A total of 90 elderly patients who received total hip replacement(THA)for hip fracture in our hospital from January 2021 to June 2023 were selectively included,and all patients were randomly divided into control group(n=30),FICB group(n=30)and combination group(n=30).Patients in control group were prepared according to routine surgical procedures before surgery.Patients in combination group and FICB group were given continuous ultrasus-guided iliofascial space block and analgesia two days before surgery after admission.Patients in combination group were given dexmedetomidine nose drops on the night before surgery,the day after surgery and the night after surgery.Visual analogue pain(VAS)scores were recorded at admission(Tl),30 minutes after nasal drops(T2),immediately after entry to the operating table(T3),and at the position of intraspinal anesthesia(T4).Hamilton Anxiety(HAM-A)score and Athens Insomnia Scale(AIS)score were recorded 1 day before surgery,1 day after surgery and 1 day after surgery.Adverse reactions and postoperative delirium(POD)were recorded one week after surgery.Results There were no significant differences in age,sex,body mass index(BMI),fracture type,anesthesia duration,operation time,blood loss and adverse reactions(except daytime sleepiness)among all groups(P＞0.05).The VAS scores of T2,T3 and T4 in the combination group were significantly lower than those in the other two groups.HAM-A and AIS scores were significantly lower than those of the other two groups(P＜0.05).The incidence and duration of postoperative delirium were significantly lower than those in the other two groups(P＜0.05).Conclusion Prospective randomized controlled trials show that FICB combined with DEX can relieve pain,improve perioperative sleep quality and relieve postoperative delirium in patients with THA.

Tumor progression is closely related to tumor tissue metabolism and reshaping of the microenvironment.Oral squamous cell carcinoma(OSCC),a representative hypoxic tumor,has a heterogeneous internal metabolic environment.To clarify the relationship between different metabolic regions and the tumor immune microenvironment(TME)in OSCC,Single cell(SC)and spatial transcriptomics(ST)sequencing of OSCC tissues were performed.The proportion of TME in the ST data was obtained through SPOTlight deconvolution using SC and GSE103322 data.The metabolic activity of each spot was calculated using scMetabolism,and k-means clustering was used to classify all spots into hyper-,normal-,or hypometabolic regions.CD4T cell infiltration and TGF-β expression is higher in the hypermetabolic regions than in the others.Through CellPhoneDB and NicheNet cell-cell communication analysis,it was found that in the hypermetabolic region,fibroblasts can utilize the lactate produced by glycolysis of epithelial cells to transform into inflammatory cancer-associated fibroblasts(iCAFs),and the increased expression of HIF1A in iCAFs promotes the transcriptional expression of CXCL12.The secretion of CXCL12 recruits regulatory T cells(Tregs),leading to Treg infiltration and increased TGF-β secretion in the microenvironment and promotes the formation of a tumor immunosuppressive microenvironment.This study delineates the coordinate work axis of epithelial cells-iCAFs-Tregs in OSCC using SC,ST and TCGA bulk data,and highlights potential targets for therapy.

Objective To investigate the Carabelli's traits on permanent maxillary molars in Han Chinese college students.Methods Intraoral photos and plaster models from 803 Han Chinese college students were observed and the Carabelli's traits on permanent maxillary molars were categorized by the Arizona State University Dental Anthropology System.Chi-square tests were performed for the comparison of the differences between male and female,permanent maxillary first and second molars.Kendall's tau-b correlation analy-ses were performed for the correlation between bilateral antimeric molars.Results The frequencies of Carabelli's traits on permanent maxillary first and second molars were 37.61％and 3.99％respectively,46.73％and 6.30％in males,27.95％and 1.54％in females,which were statistically significant between permanent maxillary first and second molars(P＜0.01),male and female(P＜0.01).In the positive expression,the low-grade expression(ASUDAS 1-4)was predominant and accounted for 67.37％and 59.52％on the perma-nent maxillary first and second molars.The correlation between bilateral antimeric teeth were statistically significant on permanent max-illary first molars(tau-b=0.756,P＜0.01)and second molars(tau-b=0.477,P＜0.01).Conclusion The Carabelli's traits on perma-nent maxillary molars in Han Chinese college students mostly occur on permanent maxillary first molars with low-grade expression,and understanding this has great anthropological and clinical significance.

Tumor progression is closely related to tumor tissue metabolism and reshaping of the microenvironment.Oral squamous cell carcinoma(OSCC),a representative hypoxic tumor,has a heterogeneous internal metabolic environment.To clarify the relationship between different metabolic regions and the tumor immune microenvironment(TME)in OSCC,Single cell(SC)and spatial transcriptomics(ST)sequencing of OSCC tissues were performed.The proportion of TME in the ST data was obtained through SPOTlight deconvolution using SC and GSE103322 data.The metabolic activity of each spot was calculated using scMetabolism,and k-means clustering was used to classify all spots into hyper-,normal-,or hypometabolic regions.CD4T cell infiltration and TGF-β expression is higher in the hypermetabolic regions than in the others.Through CellPhoneDB and NicheNet cell-cell communication analysis,it was found that in the hypermetabolic region,fibroblasts can utilize the lactate produced by glycolysis of epithelial cells to transform into inflammatory cancer-associated fibroblasts(iCAFs),and the increased expression of HIF1A in iCAFs promotes the transcriptional expression of CXCL12.The secretion of CXCL12 recruits regulatory T cells(Tregs),leading to Treg infiltration and increased TGF-β secretion in the microenvironment and promotes the formation of a tumor immunosuppressive microenvironment.This study delineates the coordinate work axis of epithelial cells-iCAFs-Tregs in OSCC using SC,ST and TCGA bulk data,and highlights potential targets for therapy.