OBJECTIVE: To provide the experience and demonstration for the transformation of acupuncture-moxibustion techniques standards from Chinese national standards to international standards. METHODS: Questionnaire research, literature research, semi-structured interviews and expert consultation were used. RESULTS: The safety of acupuncture-moxibustion techniques was evaluated through literature research, and based on the results of the questionnaire survey, expert interviews, and expert consultation, 11 main bodies and structure of the former Chinese national standard, Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting, were adjusted and optimized in accordance with the requirements of international standard (including the language, normative references, purpose, scope, applicable environment, target population, work team, terms and definitions, general principles and basic requirements, structural elements and text structure, and compilation process); and the first international standard, World Federation of Acupuncture-Moxibustion Societis (WFAS) Technical Benchmark of Acupuncture and Moxibustion: General Rules for Drafting was formulated to specify the general rules for drafting. CONCLUSION The 3 key questions, "international compatibility", "technical operability" and "safety" should be solved technically on the basis of explicit international requirements. It is the core technical issue during transforming the national standards of technical benchmark of acupuncture and moxibustion into international standards.
Moxibustion/methods* ; Acupuncture Therapy/methods* ; Humans ; Translational Research, Biomedical/standards* ; Surveys and Questionnaires ; China ; Benchmarking/standards*

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

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 consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To investigate the clinical characteristics of urea cycle disorder (UCD), the efficacy and safety of glyceryl phenylbutyrate (GPB) therapy in pediatric patients with UCD.Methods:This study was a retrospective, single-arm, multicenter clinical study. The clinical data of 20 pediatric patients with UCD who received GPB treatment at 9 hospitals nationwide between December 2021 and August 2024 were collected. The clinical manifestations, laboratory results, and molecular genetic characteristics were analyzed, ammonia levels and other laboratory results were evaluated pre-post GPB therapy by paired t-tests or Wilcoxon tests. Results:Among the 20 pediatric patients with UCD, there were 8 males and 12 females, and the onset age was 2.8 (1.4, 5.7) years. The ammonia levels were 174 (125, 342) μmol/L at first onset. The symptoms included vomiting in 6 cases, drowsiness in 5 cases, epilepsy in 5 cases, developmental delay in 5 cases, psychiatric and behavioral abnormalities in 3 cases, and lethargy in 1 case, and 18 cases exhibited abnormal liver function. Twenty cases included 6 UCD subtypes, with 11 cases being ornithine transcarbamylase deficiency. A total of 27 variants were identified, 11 (41%) of which were novel. The age of patients who began GPB therapy was 4.0 (1.5, 6.6) years. Ten cases stopped GPB after 4.2 (3.4, 5.3) months, with 4 patients undergoing liver transplantation and 6 discontinuing for financial reasons. The remaining ten patients continued GPB therapy for 11.6 (8.6, 14.0) months. The duration of GPB treatment was 6.0 (4.2, 12.3) months, at the final visit, the levels of ammonia, platelets and aspartate aminotransferase were lower compared to those of pre-treatment (all P<0.05). The serum albumin level was higher than that of pre-treatment ( P=0.016). Two patients suffered only one episode of acute hyperammonaemia, with ammonia levels of 232 and 141 μmol/L, respectively. Nine cases experienced adverse effects potentially related to GPB, decreased appetite in 6 cases, vomiting in 3 cases, abnormal skin oil odor in 2 cases, somnolence, fatigue and diarrhea each in 1 case, with symptoms improved within 6 (3, 10) days. Conclusions:UCD primarily manifests with neurological and gastrointestinal symptoms, and early diagnosis of UCD could be achieved through the analysis of ammonia. GPB may effectively reduce ammonia levels in UCD pediatric patients, with favorable safety and tolerability.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.

Objective:To investigate the clinical characteristics of urea cycle disorder (UCD), the efficacy and safety of glyceryl phenylbutyrate (GPB) therapy in pediatric patients with UCD.Methods:This study was a retrospective, single-arm, multicenter clinical study. The clinical data of 20 pediatric patients with UCD who received GPB treatment at 9 hospitals nationwide between December 2021 and August 2024 were collected. The clinical manifestations, laboratory results, and molecular genetic characteristics were analyzed, ammonia levels and other laboratory results were evaluated pre-post GPB therapy by paired t-tests or Wilcoxon tests. Results:Among the 20 pediatric patients with UCD, there were 8 males and 12 females, and the onset age was 2.8 (1.4, 5.7) years. The ammonia levels were 174 (125, 342) μmol/L at first onset. The symptoms included vomiting in 6 cases, drowsiness in 5 cases, epilepsy in 5 cases, developmental delay in 5 cases, psychiatric and behavioral abnormalities in 3 cases, and lethargy in 1 case, and 18 cases exhibited abnormal liver function. Twenty cases included 6 UCD subtypes, with 11 cases being ornithine transcarbamylase deficiency. A total of 27 variants were identified, 11 (41%) of which were novel. The age of patients who began GPB therapy was 4.0 (1.5, 6.6) years. Ten cases stopped GPB after 4.2 (3.4, 5.3) months, with 4 patients undergoing liver transplantation and 6 discontinuing for financial reasons. The remaining ten patients continued GPB therapy for 11.6 (8.6, 14.0) months. The duration of GPB treatment was 6.0 (4.2, 12.3) months, at the final visit, the levels of ammonia, platelets and aspartate aminotransferase were lower compared to those of pre-treatment (all P<0.05). The serum albumin level was higher than that of pre-treatment ( P=0.016). Two patients suffered only one episode of acute hyperammonaemia, with ammonia levels of 232 and 141 μmol/L, respectively. Nine cases experienced adverse effects potentially related to GPB, decreased appetite in 6 cases, vomiting in 3 cases, abnormal skin oil odor in 2 cases, somnolence, fatigue and diarrhea each in 1 case, with symptoms improved within 6 (3, 10) days. Conclusions:UCD primarily manifests with neurological and gastrointestinal symptoms, and early diagnosis of UCD could be achieved through the analysis of ammonia. GPB may effectively reduce ammonia levels in UCD pediatric patients, with favorable safety and tolerability.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Objective:To investigate the hemodynamic characteristics of frontal cortex and bilateral temporal lobes in patients with obsessive-compulsive disorder (OCD) during verbal fluency tasks using functional near-infrared spectroscopy (fNIRS), and assess the value of fNIRS in aiding OCD diagnosis.Methods:Clinical data of 30 OCD patients who visited the Psychology Department at Ruijin Hospital, affiliated with the Shanghai Jiaotong University School of Medicine between June 2022 and June 2023 were prospectively collected. There were 17 males and 13 females aged 16-41 years, and the education level was 9-19 years. Another 30 healthy control participants voluntarily participated in the study, including 12 males and 18 females aged 19-54 years with 9-19 years of education. Cerebral hemodynamic changes in the prefrontal and bilateral temporal lobes were detected using fNIRS during verbal fluency tasks. Specific parameters including integral values, centroid values, and slopes for both the prefrontal and bilateral temporal lobes were analyzed using independent two-sample t-tests and non-parametric Mann-Whitney U tests. Influencing indicators for OCD were analyzed using a binary logistic regression model. Receiver Operating Characteristic (ROC) curve analysis was plotted to evaluate the diagnostic performance of fNIRS indicators in distinguishing OCD patients from healthy controls, and the optimal cutoff value were calculated. Results:OCD patients generated significantly less words during the verbal fluency task compared to healthy controls ( M( Q1, Q3)) (Number of 9.0 (7.0, 12.0) vs 12.0 (10.0, 16.3), Z=2.80, P=0.005). The integral values and slopes of the frontal lobe, and the integral values of the bilateral temporal lobes, were significantly lower in OCD patient group (32.3 (-7.8, 62.2) vs 123.7 (96.2, 181.3), Z=5.76; 0.000 5±0.001 2 vs 0.001 5±0.001 6, t=-2.54; 87.0±71.4 vs 186.1±90.3, t=-4.71), while centroid values of both the frontal and bilateral temporal lobes were higher ((60.4±13.8) seconds vs (54.4±7.8) seconds, t=2.80; 60.3 (55.5, 65.0) seconds vs 56.2 (52.7, 59.2) seconds, Z=-2.42), with all the differences statistically significant (all P<0.05). No significant difference was observed in slope of bilateral temporal lobes between two groups ( t=-1.60, P=0.116). Binary logistic regression showed that integral value of frontal cortex significantly influenced OCD occurrence ( OR=0.958, 95% CI: 0.932-0.985, P=0.003). ROC analysis indicated ideal diagnostic performance of integral value of frontal lobe in distinguishing OCD patients from healthy controls with an optimal cut-off value of 68.2, sensitivity of 0.900, specificity of 0.833, and AUCs of 0.931 (95% CI: 0.869-0.993, P<0.001). AUCs of number of words generated, integral value of frontal cortex, slope of frontal cortex, integral value of bilateral temporal lobes, and centroid value of bilateral temporal lobes were 0.709 (95% CI: 0.580-0.839), 0.931 (95% CI: 0.869-0.993), 0.665 (95% CI: 0.527-0.803), 0.793 (95% CI: 0.683-0.904), and 0.682 (95% CI: 0.542-0.822), respectively (all P<0.05). Centroid value of frontal cortex showed poor diagnostic performance (AUC=0.637, 95% CI: 0.493-0.781, P=0.069). Conclusion:OCD patients generated less words and have decreased integrated values and increased centroid values of frontal cortex and bilateral temporal lobes during verbal fluency tasks. Integral values of frontal cortex significantly influence OCD occurrence and demonstrate high sensitivity and specificity in distinguishing OCD patients from healthy controls.

Objective:To investigate the hemodynamic characteristics of frontal cortex and bilateral temporal lobes in patients with obsessive-compulsive disorder (OCD) during verbal fluency tasks using functional near-infrared spectroscopy (fNIRS), and assess the value of fNIRS in aiding OCD diagnosis.Methods:Clinical data of 30 OCD patients who visited the Psychology Department at Ruijin Hospital, affiliated with the Shanghai Jiaotong University School of Medicine between June 2022 and June 2023 were prospectively collected. There were 17 males and 13 females aged 16-41 years, and the education level was 9-19 years. Another 30 healthy control participants voluntarily participated in the study, including 12 males and 18 females aged 19-54 years with 9-19 years of education. Cerebral hemodynamic changes in the prefrontal and bilateral temporal lobes were detected using fNIRS during verbal fluency tasks. Specific parameters including integral values, centroid values, and slopes for both the prefrontal and bilateral temporal lobes were analyzed using independent two-sample t-tests and non-parametric Mann-Whitney U tests. Influencing indicators for OCD were analyzed using a binary logistic regression model. Receiver Operating Characteristic (ROC) curve analysis was plotted to evaluate the diagnostic performance of fNIRS indicators in distinguishing OCD patients from healthy controls, and the optimal cutoff value were calculated. Results:OCD patients generated significantly less words during the verbal fluency task compared to healthy controls ( M( Q1, Q3)) (Number of 9.0 (7.0, 12.0) vs 12.0 (10.0, 16.3), Z=2.80, P=0.005). The integral values and slopes of the frontal lobe, and the integral values of the bilateral temporal lobes, were significantly lower in OCD patient group (32.3 (-7.8, 62.2) vs 123.7 (96.2, 181.3), Z=5.76; 0.000 5±0.001 2 vs 0.001 5±0.001 6, t=-2.54; 87.0±71.4 vs 186.1±90.3, t=-4.71), while centroid values of both the frontal and bilateral temporal lobes were higher ((60.4±13.8) seconds vs (54.4±7.8) seconds, t=2.80; 60.3 (55.5, 65.0) seconds vs 56.2 (52.7, 59.2) seconds, Z=-2.42), with all the differences statistically significant (all P<0.05). No significant difference was observed in slope of bilateral temporal lobes between two groups ( t=-1.60, P=0.116). Binary logistic regression showed that integral value of frontal cortex significantly influenced OCD occurrence ( OR=0.958, 95% CI: 0.932-0.985, P=0.003). ROC analysis indicated ideal diagnostic performance of integral value of frontal lobe in distinguishing OCD patients from healthy controls with an optimal cut-off value of 68.2, sensitivity of 0.900, specificity of 0.833, and AUCs of 0.931 (95% CI: 0.869-0.993, P<0.001). AUCs of number of words generated, integral value of frontal cortex, slope of frontal cortex, integral value of bilateral temporal lobes, and centroid value of bilateral temporal lobes were 0.709 (95% CI: 0.580-0.839), 0.931 (95% CI: 0.869-0.993), 0.665 (95% CI: 0.527-0.803), 0.793 (95% CI: 0.683-0.904), and 0.682 (95% CI: 0.542-0.822), respectively (all P<0.05). Centroid value of frontal cortex showed poor diagnostic performance (AUC=0.637, 95% CI: 0.493-0.781, P=0.069). Conclusion:OCD patients generated less words and have decreased integrated values and increased centroid values of frontal cortex and bilateral temporal lobes during verbal fluency tasks. Integral values of frontal cortex significantly influence OCD occurrence and demonstrate high sensitivity and specificity in distinguishing OCD patients from healthy controls.