Objective The aim of this study was to demonstrate a novel jaw position adjustment technique derived from digital twins and evaluate the application ef-fect of digital technology-assisted optimization in the pro-cess of adjusting jaw position on patients with temporo-mandibular disorders(TMD).Methods A total of 74 patients with TMD who attended the Department of Temporomandibular Joint,West China Hospital of Stomatology,Si-chuan University,between June 2022 and May 2023 were selected.The patient's initial computed tomography(CT)and bilateral temporomandibular joint data obtained by magnetic resonance imaging(MRI)were collected.The 148 joints were divided into the normal disc-condyle relationship(N)group,disc displacement with reduction(DDWR)group,and disc displacement without reduction(DDWoR)group.Assisted by digital technology,the patient's CT data were recon-structed,and a personalized reference plane was established to adjust the jaw position.A three-point bite guiding splint was designed by the adjusted occlusal space and then fabricated by 3D printing technology.It was worn by the patients and then reviewed by MRI.Before and after the adjustment of jaw position,the amount and direction of condyle and disc displacement and the angle between condyle and disc were measured as the evaluation indexes of the effect of the adjust-ment.The correlation with condylar displacement was evaluated.Results In the N group,the disc moved backward and downward along the X and Z axes by(-0.60±0.62)and(0.51±0.71)mm,respectively.In the DDWR group,the disc moved backward and upward along the X and Z axes by(-1.33±1.38)and(-0.09±1.31)mm,respectively.In the DDWoR group,the disc moved forward and downward along the X and Z axes by(0.49±1.76)and(1.35±1.76)mm,re-spectively.The angle between the condyle and the disc decreased after adjustment of the jaw position in all three groups.All patients showed improvement in symptoms after adjustment.Conclusion Digital technology-assisted jaw position adjustment can simplify the process,reduce the sensitivity of the technique,and improve patients'disc-condyle structure and symptoms.Therefore,its application in the treatment of patients with TMD is of great clinical significance.

Objective:To investigate the clinical efficacy of modified Ligustrum lucidum and oyster decoction combined with tomoxetine hydrochloride in the treatment of attention deficit hyperactivity disorder in children.Methods:A total of 152 children with attention deficit hyperactivity disorder who were treated at Jinhua Maternal & Child Health Care Hospital from February 2020 to June 2022 were included in this study. Using a prospective study approach, the patients were divided into two groups based on the propensity score matching method: 76 patients in the control group and 76 patients in the observation group. The control group was treated with tomoxetine hydrochloride, while the observation group received modified Ligustrum lucidum and oyster decoction combined with tomoxetine hydrochloride. Clinical treatment effects on the children were evaluated using the Swanson, Nolan, and Pelham Rating Scale-version Ⅳ (SNAP-Ⅳ). Six months after treatment, the clinical efficacy of both groups was observed and compared. In addition, changes in relevant indicators from before treatment to 6 months post-treatment were compared.Results:At 2 months of treatment, the SNAP-Ⅳ scores for the control and observation groups were (24.21 ± 4.19) points and (20.75 ± 4.74) points, respectively, which were significantly lower than those measured at 1 month of treatment [(32.45 ± 3.23) points, (31.56 ± 4.90) points, t = 13.57, 13.82, both P < 0.05]. At 3 months of treatment, the SNAP-Ⅳ scores for the control and observation groups were (20.56 ± 3.03) points and (17.28 ± 3.06) points, respectively, which were significantly lower than those measured at 1 and 2 months of treatment ( t = 23.40, 21.54, 6.15, 5.36, all P < 0.05). At 6 months of treatment, the SNAP-Ⅳ scores for the control and observation groups were (18.34 ± 4.28) points and (13.87 ± 2.89) points, respectively, which were significantly lower than those measured at 1, 2 and 3 months of treatment ( t = 22.94, 27.10, 8.54, 10.80, 3.69, 7.06, all P < 0.05). At 2, 3, and 6 months of treatment, the SNAP-Ⅳ scores for the observation group were significantly lower than those in the control group at the respective time points ( t = 4.76, 6.64, 7.54, all P < 0.001). The total response rate in the observation group was 81.58% (62/76), which was significantly higher than that in the control group [60.53% (46/76), χ2 = 8.18, P < 0.05]. There was no significance in incidence of adverse reactions between the observation and control groups [5.26% (4/76) vs. 9.21% (7/76), P > 0.05]. Conclusion:Modified Ligustrum lucidum and oyster decoction, when combined with atomoxetine hydrochloride, exhibits better efficacy in the treatment of attention deficit hyperactivity disorder in children compared with atomoxetine hydrochloride alone. The combined therapy has no obvious adverse reactions.

Peptide‒drug conjugates (PDCs) are drug delivery systems consisting of a drug covalently coupled to a multifunctional peptide via a cleavable linker. As an emerging prodrug strategy, PDCs not only preserve the function and bioactivity of the peptides but also release the drugs responsively with the cleavable property of the linkers. Given the ability to significantly improve the circulation stability and targeting of drugs in vivo and reduce the toxic side effects of drugs, PDCs have already been extensively applied in drug delivery. Herein, we review the types and mechanisms of peptides, linkers and drugs used to construct PDCs, and summarize the clinical applications and challenges of PDC drugs.

Discharge against medical advice (DAMA) conflicts with the purpose of disease treatment in children. Some research has shown that there are high proportions of extremely preterm infants and infants with asphyxia or congenital malformation in neonates with DAMA. This suggests that the sustainable development of neonatology needs cooperation and co-development with obstetrics, neonatal surgery, and radiology to reduce the rate of DAMA. With reference to the current status of research in both China and other countries, this article reviews the causes for DAMA and the strategies for reducing the rate of DAMA, in order to provide a theoretical basis for effectively reducing the rate of DAMA from the neonatal intensive care unit, improving treatment outcomes of the neonates, and increasing hospitals' comprehensive benefits.
Ethics, Medical ; Health Services Needs and Demand ; Humans ; Infant, Newborn ; Insurance, Health ; Intensive Care Units, Neonatal ; Patient Discharge ; Prenatal Care ; Treatment Refusal

OBJECTIVETo investigate the effect of insulin-like growth factor-1 (IGF-1), which can promote cell differentiation and inhibit cell apoptosis, on hyperoxia-induced apoptosis in A549 cells and its anti-apoptotic mechanism.

METHODSA549 cells were sub-cultured, exposed to hyperoxic conditions and were then treated with different concentrations of IGF-1 (1, 10, and 100 ng/mL) for 48 hours. Cell viability was measured by MTT assay. Cell apoptosis was evaluated by Annexin V-FITC/PI double-staining flow cytometry. Expression levels of Bax and Bcl-2 were measured by flow cytometry.

RESULTSThe middle-dose and high-dose IGF-1 intervention groups had higher cell viabilities than the hyperoxic exposure group [(64±3)% and (88±4)% vs (51±3)%; P<0.05]. Compared with the air control group, the hyperoxic exposure group had a significantly higher apoptotic rate [(38.3±5.4)% vs (2.4±0.9)%; P<0.05], a significantly lower expression level of Bcl-2 [(72±5)% vs (91±4)%; P<0.05], and a significantly higher expression level of Bax [(54±6)% vs (3±2)%; P<0.05]. Compared with the hyperoxic exposure group, the low-dose, middle-dose, and high-dose IGF-1 intervention groups had significantly lower apoptotic rates [(16.1±4.7)%, (9.2±2.8)%, and (6.9±2.5)% vs (38.3±5.4)%; P<0.05], significantly higher expression level of Bcl-2 [(79±4)%, (94±4)%, and (100±5)% vs (72±5)%; P<0.05], and significantly lower expression level of Bax [(26±4)%, （5±2)%, and (4±2)% vs (54±6)%; P<0.05].

CONCLUSIONSHyperoxia significantly inhibits proliferation and promotes apoptosis in A549 cells. IGF-1 may promote cell proliferation and inhibit hyperoxia-induced apoptosis in A549 cells by regulating the expression of Bcl-2 and Bax.

Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Survival ; drug effects ; Dose-Response Relationship, Drug ; Humans ; Hyperoxia ; pathology ; Insulin-Like Growth Factor I ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; bcl-2-Associated X Protein ; analysis