Salivary gland diseases are common disorders in the oral and maxillofacial region, mainly classified into two categories: Tumorous and non-tumorous. Non-tumorous salivary gland diseases include various types such as salivary gland inflammation, Sjögren syndrome, granulomatous diseases, and developmental abnormalities. Some of these diseases are local lesions, while others are closely associated with systemic diseases, often accompanied by impaired salivary secretion function, leading to xerostomia and secondary lesions. Over the past more than 20 years, the Salivary Gland Disease Research Center of Peking University School and Hospital of Stomatology has conducted systematic and in-depth studies focusing on the regulation of salivary secretion function by tight junction proteins, the clinicopathological characteristics, prevention and treatment of novel chronic sialadenitis [including immunoglobulin (Ig) G4-related sialadenitis, ¹³¹I-induced sialadenitis, and eosinophilic sialodochitis], stem cells from human exfoliated deciduous teeth-based therapy for Sjögren syndrome, and salivary gland developmental abnormalities. These studies provide important references for the basic research, clinical diagnosis and treatment of related diseases.

Objective: To investigate the role of microRNA miR-488-5p, which showed increased expression after the disconnection of the inferior alveolar nerve, in promoting the osteogenic and neurogenic differentiation of rat bone marrow mesenchymal stem cells (rBMSCs), as well as its effect on promoting the neuralized tissue engineered bone regeneration. Methods: rBMSCs were subjected to in vitro neural or osteogenic differentiation induction cultures. The expression levels of miR-488-5p at different time points (days 0, 2, 4, and 7) were detected by quantitative real-time polymerase chain reaction (qRT-PCR). miR-488-5p overexpression or low expression in rBMSCs was achieved by transfection with miR-488-5p mimics or inhibitors. Four groups, the miR-488-5p mimics, the miR-488-5p inhibitor, and their respective negative controls (NC), were established to investigate the effects of miR-488-5p on the neural differentiation and osteogenic differentiation of rBMSCs.A 5 mm diameter, full-thickness circular critical bone defect was created in the rat calvaria. The rats were treated with light-cured gelatin methacryloyl (GelMA) seeded with rBMSCs. The rats were divided into four groups: ①BLANK group: GelMA; ②BMSCs group: GelMA + rBMSCs; ③NC-BMSCs group: GelMA + rBMSCs transfected with miR-488-5p mimics NC; and ④miR-488-5p-BMSCs group: GelMA + rBMSCs transfected with miR-488-5p mimics. Specimens were obtained 4 and 8 weeks after surgery, and micro-CT was performed to measure and analyze bone mineral density (BMD), bone volume/total volume (BV/TV), bone surface area/total volume (BS/TV) and trabecular number (Tb.N). The effects of neuralized tissue engineering bone formation in the defect area were assessed using Hematoxylin-Eosin (HE) staining, Masson staining, and tissue immunofluorescence staining of the nerve-specific protein soluble protein-100 (S100). Results: As rBMSCs progressed toward neural or osteogenic differentiation, miR-488-5p expression increased significantly from day 0 to day 7. Regarding neural differentiation, the mimics group showed increased expression of neural-related genes and proteins compared with the mimics NC group, while the opposite result was observed in the inhibitor group. As for osteogenic differentiation, the mimics group showed increased expression of osteogenic genes and proteins, more intense alkaline phosphatase (ALP) and alizarin red staining (ARS) staining, and enhanced ALP activity compared with the mimics NC group, while the opposite result was observed in the inhibitor group. 4 and 8 weeks after critical calvarial defect construction in rats, the BLANK group had the least amount of new bone formation, while the BMSCs group and the NC-BMSCs group had similar and intermediate amounts of new bone formation. The miR-488-5p-BMSCs group had the most new bone formation. At 4 weeks, the BMD [(0.63±0.05) g/cm³ vs. (0.51±0.03) g/cm³], BV/TV (33.17%±6.43% vs. 18.11%±1.52%), BS/TV [(3.43±0.69) /mm vs. (2.46±0.20) /mm], and Tb.N [(0.92±0.21) /mm vs.(0.59±0.07) /mm] in the miR-488-5p-BMSCs group were significantly higher than those in the NC-BMSCs group. At 8 weeks, the BMD [(0.80±0.04) g/cm³ vs. (0.68±0.04) g/cm³], BV/TV (56.69%±6.22% vs. 42.36%±3.86%), and the number of S100-labeled nerve cells around the new bone (46.33±4.04 vs. 26.00±3.61) in the miR-488-5p-BMSCs group was also significantly higher than that in the NC-BMSCs group. Conclusion: miR-488-5p promoted the osteogenic and neurogenic differentiation of rBMSCs and promoted the formation of neuralized tissue-engineered bone in rat calvarial defects.

Objective: To evaluate the feasibility of using cell membrane vesicles (CMVs) as a delivery system for small interfering RNA (siRNA) and to assess their performance in a lipopolysaccharide (LPS)-induced inflammatory model of human dental pulp stem cells (DPSCs). Methods: CMVs were generated from cytochalasin B-treated 3T3 cells and characterized for their physicochemical properties, including morphology, size distribution, and zeta potential, using confocal microscopy and dynamic light scattering. To construct CMVs@siTNF-α, saponin-mediated transient permeabilization was used to facilitate siRNA loading, after which encapsulation efficiency was evaluated by flow cytometry and confocal imaging. Intracellular uptake behaviors were examined using flow cytometry in DPSCs. LPS (1 mg/L) was employed to establish a robust in vitro inflammatory microenvironment. DPSCs were subsequently treated with CMVs or CMVs@siTNF-α, and cell viability was assessed via CCK-8 (cell counting kit-8). The expression and secretion of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) were analyzed using quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme linked immunosorbent assay (ELISA) to evaluate both gene-silencing efficiency and downstream anti-inflammatory effects. Results: CMVs exhibited uniform spherical morphology with an average diameter of approximately 903 nm and a zeta potential of -9.39 mV, confirming successful vesicle formation. CMVs efficiently encapsulated FAM-labeled siRNA, as indicated by a pronounced fluorescence shift in flow cytometry and clear colocalization signals in confocal imaging. DPSCs cultured with CMVs@FAM-siTNF-α demonstrated increased intracellular fluorescence, reflecting efficient vesicle uptake and cytoplasmic siRNA release. Importantly, both CMVs and CMVs@siTNF-α displayed negligible cytotoxicity. LPS stimulation significantly elevated TNF-α, IL-1β, and IL-6 expression, validating the inflammatory model. CMVs alone did not affect cytokine levels, indicating biological inertness. In contrast, CMVs@siTNF-α significantly suppressed the LPS-induced upregulation of TNF-α at both mRNA and protein levels., demonstrating potent gene-silencing activity. Furthermore, suppression of TNF-α led to downstream attenuation of IL-1β and IL-6, with both transcription and secretion significantly decreased compared with the LPS group. These findings collectively confirmed that CMVs enabled efficient intracellular siRNA transport and effectively mitigate inflammatory responses in DPSCs. Conclusion: CMVs represent a biocompatible and effective siRNA delivery platform capable of achieving robust TNF-α knockdown and ameliorating inflammatory cytokine production in vitro, highlighting their potential for future nucleic acid-based anti-inflammatory therapies.

Objective: To assess the short-term adjunctive effect of systemic antibiotics on non-surgical periodontal therapy and to identify predictors of treatment response in the patients with stages Ⅲ/Ⅳ periodontitis, providing ideas for precise clinical medication. Methods: A retrospective study was conducted on the patients who received non-surgical periodontal treatment in the Department of Periodontology, Peking University School and Hospital of Stomatology from November 2007 to February 2015. A total of 521 patients with stages Ⅲ/Ⅳ periodontitis were included. Participants were divided into two groups: those who received systemic antibiotic therapy adjunctive to scaling and root planing (SRP) (antibiotic group, n=204) and those who underwent SRP only (non-antibiotic group, n=317). The timing of systemic antibiotic use is divided into before SRP, during SRP, and after SRP. The primary outcome was defined as the relative change in the percentage of sites with probing depth (PD) ≥5 mm. Univariable linear regression was used to identify the association between each variable and treatment efficacy, and multivariable linear regression was utilized to adjust for confounding factors and to determine the relationships of antibiotic therapy, age of the antibiotic group, and timing of antibiotic administration with the treatment efficacy. Furthermore, smooth curve fitting and piecewise linear regression model were employed to assess the potential nonlinear relationship and threshold effect between age and treatment response in the anti-biotic group. The threshold was identified by evaluating a series of potential turning points within predefined intervals and selecting the point with the maximum model likelihood. Results: Both treatment groups exhibited significant improvements in all periodontal parameters following therapy (P < 0.001). After adjustment for potential confounders, multivariable analysis revealed a significantly greater reduction in the percentage of sites with PD≥5 mm in the antibiotic group versus the non-antibiotic group (β=16.33, 95% CI: 13.40－19.27, P < 0.001). Within the antibiotic group, we identified a nonlinear association between age and therapeutic efficacy, with an inflection point at 38 years. The patients aged ≤38 years responded significantly better than those older than 38 years (P=0.022). Furthermore, the timing of antibiotic administration was a significant determinant of outcome. The most pronounced efficacy was achieved when antibiotics were administered concurrently with SRP, surpassing both pre- and post-SRP administration. Conclusion: Our findings suggest that the use of systemic antibiotics as an adjunct to SRP is associated with enhanced short-term clinical outcomes in stages Ⅲ and Ⅳ periodontitis. During SRP, treating younger patients (≤38 years old) with systemic antibiotics as an adjunct may yield better therapeutic effects.

Objective: To evaluate the short-term clinical treatment effects of erythritol air-polishing(EAP) and ultrasonic debridement (US) on peri-implant mucositis and to report patient-reported outcomes. Methods: This study is a single-blind, randomized controlled clinical trial. It enrolled patients diagnosed with peri-implant mucositis at the Department of Periodontology, Peking University School of Stomatology between June 2021 and May 2022. A total of 36 patients (with one implant included per patient) were randomly allocated to either the EAP group (n=18) or the US group (n=18). Clinical parameters were collected at baseline, 1 month, and 3 months. The primary outcome was the change in peri-implant probing depth (PPD). Secondary outcomes included the modified plaque index (mPLI), bleeding on probing (BOP), suppuration on probing (SoP), and the visual analogue scale (VAS) score for pain. As an exploratory analysis, the proportion of sites with PPD ≥ 4 mm was calculated. Oral hygiene instructions were reinforced, and the implant crown was polished at each visit. Results: Baseline clinical parameters were comparable between the EAP and US groups. Regarding the primary outcome of mean PPD, the EAP group showed a significant reduction from the baseline value (4.0±0.5) mm to (3.7±0.6) mm at 1 month and (3.4±0.5) mm at 3 months (P=0.011 and P < 0.001, respectively). Similarly, the US group showed a significant reduction from baseline (3.8±0.4) mm to (3.6±0.5) mm at 1 month and (3.5±0.4) mm at 3 months (P=0.038 and P=0.018, respectively). No statistically significant differences were observed between the groups (P>0.05). For the secondary outcomes, both groups showed significant improvement from baseline in mean mPLI (1 and 3 months, both P < 0.001) and BOP (1 month, P < 0.05; 3 months, P < 0.001). Pain VAS scores were low in both groups. However, no statistically significant differences were observed between the groups for these three outcomes (all P>0.05). At 3 months, the proportion of sites with PPD ≥ 4 mm was significantly lower in EAP group than in US group [(42.6±26.1) % vs. (57.4±25.1) %, P=0.029]. No adverse events were reported. Conclusion: Both EAP and US effectively treated peri-implant mucositis with comparable overall efficacy. However, EAP showed superior potential in reducing deep pockets over the short term, though this finding required further validation.

Objective: To compare the composition and structure of extraradicular bacterial communities in periapical lesions of teeth with post-treatment apical periodontitis (PoAP) between cases with and without sinus tracts. Methods: Patients requiring apical surgery were recruited from the Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology. Periapical lesion samples were collected from teeth with sinus tracts and without sinus tracts during apical microsurgery. The remaining lesion samples were submitted for pathological examination. Following the extraction of the bacterial DNA, the V3-V4 region of the bacterial 16S rRNA gene was subjected to high-throughput sequencing using Illumina NovaSeq 6000. Bioinformatics analysis was performed using QIIME2 software. α diversity indices (Shannon, Simpson, Chao1) were calculated, and intergroup differences were analyzed using Wilcoxon test. β diversity was assessed by principal coordinate analysis based on Weighted Unifrac test, and community composition differences were analyzed with permutational multivariate analysis of variance (PERMANOVA). Differences in relative abundance between the groups were compared using the Wilcoxon test, followed by Benjamini-Hochberg false discovery rate (FDR) correction to convert P value to q value. Results: A total of 66 subjects were enrolled, including 21 male and 45 female patients, with a mean age of (33.91±9.16) years. Three subjects each had two teeth enrolled. In total, 69 teeth were included. These teeth included 47 cases without sinus tracts and 22 cases with sinus tracts. No significant differences were observed between the two groups in the distribution of obturation quality or pathological types (P>0.05). No statistically significant differences were found in α diversity indices between the two groups (P>0.05). However, β diversity analysis revealed a significant difference between the two groups (P=0.008). At the phylum level, the relative abundance of Bacteroidota was significantly higher in the group with sinus tracts (16.98% vs. 9.22%, q < 0.01), while the relative abundance of Pseudomonadota was significantly lower in the group with sinus tracts (30.70% vs. 42.19%, q < 0.05). At the genus level, Porphyromonas, Tannerella, Segatella, Phocaeicola, and Hoylesella were significantly enriched in the group with sinus tracts (q < 0.05), whereas Bacillus was more abundant in the group without sinus tracts (q < 0.05). Conclusion: The extraradicular bacterial community structure significantly differs between PoAP with and without sinus tracts. Porphyromonas, Tannerella, Segatella, Phocaeicola, and Hoylesella may be associated with the formation and persistence of sinus tracts.

Objective: To isolate and cultivate Veillonella parvula (V. parvula) from the supragingival plaque of adult patients intact teeth surfaces with rampant caries, to investigate its growth and metabolic properties, and to preliminarily explore its interaction with Streptococcus mutans (S. mutans). Methods: V. parvula was isolated from the supragingival plaque of intact teeth surfaces in an adult patient with rampant caries using Veillonella agar medium. Identification was performed based on colony morphology, biochemical tests, and 16S rRNA gene sequencing. The clinically isolated strain was cultured in brain heart infusion broth (BHI) supplemented with 120 mmol/L lactate in an anaerobic chamber. Its growth curve and lactate metabolism over 24 h were assessed. Co-culture with S. mutans was conducted to measure lactate accumulation and pH value changes in the culture system. Biofilm structure was observed by scanning electron microscopy (SEM), and the biofilm biomass was compared using crystal violet staining, providing initial insights into their interaction. Results: Through biochemical identification and 16S rRNA gene sequencing, one wild type strain of V. parvula was isolated from the supragingival plaque of intact teeth surfaces in an adult patient with rampant caries. When the wild type V. parvula and the reference strain V. parvula were cultured over 24 h, their growth curves and the trends in the residual lactate concentration in the medium differed, with the differences being statistically significant (F=10.431, P < 0.001; F=5.641, P < 0.05). In co-culture with S. mutans, the group with the wild type V. parvula formed a denser bacterial biofilm structure and had a greater biofilm biomass at 12 h compared with the group with the reference strain V. parvula (P < 0.001). At 24 h, the cumulative lactate concentration produced by the co-culture group with the wild type V. parvula reached as high as 65 mmol/L, which was significantly higher than that in the co-culture group with the reference strain V. parvula and the S. mutans mono-culture group (P < 0.001). Conclusion: The strain of V. parvula which we isolated from supragingival dental plaque exhibited superior growth, lactate metabolism, and a greater capacity to promote S. mutans biofilm formation than the reference strain, ultimately accelerating the initiation of early carious lesions.

Objective: To preliminarily investigate the effects of direct treatment with cold atmosphere plasma (CAP) on the migration and proliferation capabilities of human gingival fibroblasts (HGFs), as well as the correlation between the doses and the effects. Methods: The CAP Bio-Med Platform was used to generate the CAP in this study. The characteristics of the CAP source were kept constant by fixing the discharge voltage, frequency, and gas flow rate. Different CAP doses were generated by adjusting the discharge time (20 s, 60 s, 120 s, 180 s) and used to treat HGFs. The temperature, pH, and reactive oxygen species (ROS) levels in the HGFs culture medium were measured following treatment with different CAP doses. The morphology of the HGFs after treatment was observed via immunofluorescence staining, and the cell perimeter and area were calculated. The migration ability of the HGFs after treatment was assessed using a scratch assay, and their proliferation ability was evaluated using a cell counting kit. Results: As the treatment duration increased, the CAP dose generated by the platform ranged from 0 J to 210.6 J. Different CAP doses did not affect the temperature of the HGFs culture medium. As the CAP dose increased, the pH of the HGFs culture medium first decreased from an initial 8.18±0.06 to 8.13±0.20, then gradually increased to 8.63±0.15 (P < 0.05). The concentration of H₂O₂ in the culture medium peaked at (55.96±1.51) μmol/L in the 60 s CAP treatment group. With an extension in treatment time, the concentration decreased gradually to (22.92±0.57) μmol/L (P < 0.05). Following low-dose CAP treatment (20 s), HGFs exhibited a larger surface area and more pseudopodia extensions. In contrast, following excessively high-dose CAP treatment(180 s), some HGFs displayed a narrow, elongated spindle shape with a smaller surface area than the low-dose group. Compared with the untreated group, low-dose CAP treatment significantly enhanced the migration and proliferation abilities of HGFs (P < 0.05), whereas excessively high-dose CAP treatment inhibited HGFs migration and proliferation (P < 0.05). Conclusion: Treatment with different doses of CAP alters the pH and ROS levels of the HGFs culture medium. CAP treatment has a dose-dependent effect on the biological behavior of HGFs: Low-dose treatment enhances migration and proliferation, while excessively high-dose treatment inhibits these abilities.

Objective: To clarify the diagnostic efficacy of various diagnostic methods through multi-index combined analysis, and to explore the core diagnostic value of direct immunofluorescence (DIF) in oral mucosal pemphigus vulgaris (PV). Methods: A total of 53 patients with confirmed oral mucosal PV were included, retrospectively. Their data of DIF, histopathology, serum enzyme-linked immunosorbent assay (ELISA) and clinical diagnosis were systematically analyzed, and diagnostic efficacy of each method was evaluated using indicators, such as sensitivity, specificity, and area under curve (AUC) of the receiver operating characteristic (ROC) curve. Results: The results showed that among the 53 patients, middle-aged and elderly females were predominant, the buccal mucosa was the most common involved site, and most patients had a history of blistering. The positive rate of DIF was 96.23%, mainly manifested as a reticular fluorescent deposition between epithelial spinous cells, demonstrating the highest diagnostic value with a sensitivity of 96.23%, specificity of 100.00%, and AUC of 0.981. Histopathology ranked second, with a sensitivity of 94.34%, a specificity of 100.00%, and an AUC value of 0.972. The ELISA test had a sensitivity of 82.61%, a specificity of 82.35%, and an AUC value of 0.825. Although the sensitivity of clinical diagnosis was acceptable, its specificity was relatively low. Additionally, DIF exhibited complementarity with histopathology, ELISA, and clinical diagnosis, and combined testing could improve diagnostic accuracy. Conclusion: DIF is the "gold standard" for the diagnosis of oral mucosal PV. A comprehensive diagnostic workflow of "clinical manifestation-DIF-histopathology-ELISA" is proposed. This integrated diagnostic system not only significantly improves the accuracy of oral mucosal PV diagnosis but also aligns with the core principles of precision medicine, providing a basis for indivi-dualized treatment.

Objective: To compare the clinical outcomes between xenogeneic bone graft materials primarily composed of deproteinized bovine bone mineral (DBBM) and synthetic bone graft materials primarily composed of hydroxyapatite (HA) used in micro crestal flap-alveolar ridge preservation (MCF-ARP) of periodontally compromised molars, so as to provide a reference for their application and promotion. Methods: In this retrospective case series study, patients who received treatment between October 2024 and April 2025 were enrolled. All the patients underwent MCF-ARP, using either DBBM or HA. Hard tissue changes and alveolar ridge contour collapse were evaluated and compared between the two groups preoperatively and 6 months postoperatively using cone beam computed tomography (CBCT) and intraoral scanning. Soft tissue healing process after the surgery was also assessed. Results: A total of 14 molars from 14 patients were included. No significant differences were found in hard tissue changes between the two groups 6 months after the surgery (P>0.05). Two weeks and 1 month postoperatively, the vertical collapse of the contour at the ridge center was significantly greater in the HA group compared with the DBBM group [2 weeks: (2.73±1.89) mm vs. (0.00±0.79) mm, P < 0.05; 1 month: (2.74±1.13) mm vs. (0.35±2.34) mm, P < 0.05]. No significant differences were found in other sites at any other follow-up points (P>0.05). In terms of wound healing, the HA group showed a significantly higher percentage of wound area lacking keratinized tissue coverage compared with the DBBM group both 2 weeks and 1 month after the surgery (2 weeks: 47.88%±6.56% vs. 29.43%±14.25%, P < 0.05; 1 month: 25.68%±13.06% vs. 7.19%±7.18%, P < 0.01). Conclusion: Within the limitations of this study, the analysis suggests that there is no statistically significant difference in hard tissue and alveolar ridge contour parameters 6 months after MCF-ARP following extraction of periodontally compromised molars. However, early soft tissue healing is faster when using DBBM. Future randomized controlled trials with histological analysis are warranted for further validation.

Objective: To investigate the effect of ultrasonic scaling on the torque of implant prosthetic abutment screws and to compare the differences in torque influence between ultrasonic tips of two different materials. Methods: In this study, a total of 22 implants were selected, and two distinct primary torque values (PTV) 15 N·cm and 35 N·cm were applied to the temporary and definitive restorations mounted on each implant, respectively. Subsequently, ultrasonic scaling was performed for one minute using either a traditional metal scaling tip (metal tip) or a carbon fiber scaling tip (fiber tip), followed by measurement of the removal torque value (RTV). Paired t-tests were used to compare the torque changes in the same prosthesis before and after ultrasonic scaling (significance level α=0.05, two-tailed) to evaluate the effect of ultrasonic scaling on torque. Under the same PTV condition, paired t-tests were also conducted to compare the RTV after scaling with different tips to analyze the influence of the tip material on RTV. Results: The RTVs in all the four groups were significantly lower than the corresponding PTVs after ultrasonic scaling (P < 0.05). At a PTV of 15 N·cm, the RTV of the fiber tip group was (14.1±1.27) N·cm, significantly higher than that of the metal tip group (12.3±1.56) N·cm, (P < 0.05). At a PTV of 35 N·cm, the RTV of the fiber tip group was (34.0±1.29) N·cm, while that of the metal tip group was (33.1±1.70) N·cm, with no statistically significant difference between the two groups (P>0.05). Conclusion: Ultrasonic scaling can lead to significant attenuation of torque in implant prosthetic abutment screws. Under a lower primary torque condition (15 N·cm), carbon fiber scaling tips significantly reduce torque attenuation compared with traditional metal scaling tips. However, under a higher primary torque condition (35 N·cm), no significant difference in the effect on screw torque was observed between the two tip types. These findings suggest that screw torque should be checked after clinical peri-implant maintenance to reduce the risk of screw loosening.

Objective: To construct a standardized unilateral molar occlusal interference model, to establish a comprehensive surface electromyography (sEMG)-based index system for orofacial muscle function, and to develop an accurate discriminant model, thereby providing an objective electrophysiological basis for occlusal interference diagnosis. Methods: Twenty-six healthy adult volunteers were recruited and provided written informed consent. Utilizing advanced digital dental technology, including intraoral scanning, computer-aided design (CAD), and additive manufacturing, a standardized occlusal inter-ference patch with a precise thickness was fabricated. This patch was adhesively bonded to the occlusal surface of the mandibular first molar to create a reversible unilateral occlusal interference model. A self-developed, multi-channel wireless sEMG system was employed to collect high-fidelity electromyographic signals from key bilateral masticatory muscles: the anterior temporal muscles, masseters, and the anterior bellies of the digastric muscles. Data were recorded during 10 standardized mandibular functional activities both before (baseline) and after the induction of interference. From the raw sEMG signals, a multi-dimensional index system comprising 56 distinct indicators across time, frequency, and complexity domains was constructed. Sophisticated statistical analyses, including paired-sample t-tests (or Wilcoxon signed-rank tests), principal component analysis (PCA) for dimensionality reduction, and stepwise Logistic regression analysis, were applied to screen for the most significant feature variables and to build the optimal discriminant model. Results: Forty valid interference models were successfully established. Statistical analysis revealed 253 sEMG indicators showed significant differences following interference induction (P < 0.05), with lateral-movement-related parameters demonstrating particular sensitivity. PCA extracted 19 principal components (PCs) explaining 85.5% of cumulative variance, where PC1 (muscle fatigue level) and PC2 (functional movement amplitude) represented the primary explanatory components. The optimal Logistic regression model incorporated 3 principal components. Cross-validation showed the model achieved a mean accuracy of 0.840, with mean sensitivity and specificity of 0.851 and 0.828, respectively, and a mean area under the curve (AUC) of 0.923. Conclusion: The Logistic regression discriminant model for unilateral molar occlusal interference constructed in this study can effectively identify the occlusal interference state under the experimental conditions, demonstrating promising diagnostic potential.

Objective: To digitally measure and analyze the anatomical characteristics of protrusive and intercuspal position (ICP) occlusal contacts in maxillary incisors, thereby establishing a standardized measurement protocol and obtaining characteristic functional data to optimize the incisal guidance design of prostheses. Methods: Thirty subjects with stable incisal guidance were recruited. Digital dental mo-dels were acquired via intraoral scanning, and protrusive movement data were captured using a modified patient-specific motion (PSM) technique. Computer-aided design software was used to record the distribution of the occlusal contacts during protrusive movement. Image analysis software was employed to measure the area proportion of guiding locations for each tooth. Reverse engineering software was used to measure and analyze the occlusal contacts in ICP and anatomical characteristics. Measured parameters included the area proportion and distribution of occlusal contacts in ICP, the area proportion of marginal ridges and incisal ridges, radius of curvature of lingual surface, lingual surface inclination, overbite, and overjet. Each parameter was measured twice to calculate the intraclass correlation coefficient for the assessment of test-retest reliability. Results: All measured parameters demonstrated good test-retest reliability. No significant differences were found in any parameters between homologous teeth (P>0.05). During protrusive movement, the area proportion of guiding locations was significantly larger for the central incisors than for the lateral incisors (73.4%±12.3% vs. 26.6%±12.3%, P < 0.001). The frequency of occlusal contacts was significantly higher on the mesial and distal marginal ridges and incisal ridges compared with the lingual fossa and cingulum (P < 0.05). In ICP, no significant difference was observed in the occlusal contact area proportion between the central and lateral incisors (48.8%±20.0% vs. 51.2%±20.0%, P=0.758). The frequency of the occlusal contact was significantly higher on the mesial and distal marginal ridges compared with the incisal ridge, lingual fossa, and cingulum (P < 0.05). Central incisors exhibited significantly higher overbite and overjet than lateral incisors (P < 0.05). The area proportion of mesial and distal marginal ridges was significantly smaller for the central incisors than for the lateral incisors (P < 0.05), but no significant difference was observed in the incisal ridge (P>0.05). No significant differences were observed in the lingual surface inclination or radius of curvature among the incisors (P>0.05). Conclusion: The anatomical characteristics of protrusive and ICP occlusal contacts in maxillary incisors demonstrated bilateral symmetry. Protrusive movement was primarily guided by the maxillary central incisors, with the guiding area of the central incisors being approximately three times that of the lateral incisors. The marginal ridges and incisal ridges were the main guiding locations. Central and lateral incisors exhibited comparable occlusal contact area in ICP.

Objective: To evaluate the surgical outcomes of maxillary medication-related osteonecrosis of the jaw (MRONJ) at different disease stages and to analyze the comparative efficacy of different surgical techniques on the prognosis of stage Ⅲ patients. Methods: A detailed retrospective analysis was conducted on the clinical data of 136 patients with maxillary MRONJ who underwent surgical treatment in the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology from April 2014 to February 2024. All patients were rigorously classified according to the 2022 American Association of Oral and Maxillofacial Surgeons (AAOMS) staging criteria: Stage Ⅰ (n=8), stage Ⅱ (n=30), and stage Ⅲ (n=98). The surgical interventions included local lesion resection with primary direct closure, buccal fat pad packing, and iodoform gauze packing. The patients were systematically followed up for a period of 1 year postoperatively to comprehensively assess several key outcome measures: Complete mucosal healing, resolution of pain, effective infection control, and radiological improvement of maxillary sinus inflammation based on serial computed tomography scans. Statistical analysis was performed using SPSS version 20.0. Continuous variables were expressed as mean±standard deviation and compared using the t-test, while categorical variables were expressed as numbers and percentages and compared using the χ² test or Fisher' s exact test as appropriate. A P-value < 0.05 was considered statistically significant for all analyses. Results: The overall short-term (3 months) cure rate was 91.2% (124/136), which improved to a long-term (1 year) cure rate of 94.9% (129/136). A stage-stratified analysis revealed excellent long-term cure rates: 100.0% (8/8) for stage Ⅰ, 96.7% (29/30) for stage Ⅱ, and 93.9% (92/98) for stage Ⅲ, with no statistically significant difference in outcomes across the different stages (P=0.611). Among the 98 stage Ⅲ patients, 34 were treated with buccal fat pad transfer (BFPT group) and 64 with iodine strip packing (ISP group), with no significant differences in baseline demographic or clinical characteristics between the two groups, ensuring comparability. The BFPT group demonstrated a statistically significant superior performance in achieving oroantral fistula closure both at the short-term (79.4% vs. 23.4%, P < 0.001) and long-term (85.3% vs. 54.7%, P=0.002) follow-up assessments. In contrast, the ISP group showed a markedly greater degree of improvement in maxillary sinus inflammation, as quantified by a standardized radiographic scoring system, with significantly greater reductions in inflammation scores at both the 3-month (P=0.029) and 12-month (P=0.014) follow-up intervals. Conclusion: Surgical management of maxillary MRONJ results in high rates of success with a favorable complication profile. For advanced (stage Ⅲ) disease, the choice of surgical technique entails a strategic trade-off: The buccal fat pad procedure is more conducive to achieving reliable soft tissue closure and oroantral fistula resolution, whereas iodoform gauze packing provides superior management and resolution of concomitant maxillary sinusitis. Consequently, the selection of surgical technique should be individualized, based on a careful consideration of the patient's specific anatomical defect, the extent of sinus involvement, and their overall clinical condition.

Objective: To explore a mathematical method for calculating key articulator parameters based on mandibular movement trajectory data, and to compare the results of this method with reference values provided by existing foreign mandibular movement recording system, thereby establishing an algorithmic basis for developing a domestic mandibular movement recording system. Methods: Twenty healthy volunteers (7 males, 13 females) meeting inclusion criteria were recruited, with a mean age of (31±8) years. Mandibular movement data during protrusive and left/right lateral movements were recorded using the JMA Optic foreign mandibular movement recording system. A reference plane coordinate system was established using reverse engineering software, the multi-source maxillofacial data were integrated, and the coordinate systems were then unified. The condylar apex, medial condylar pole, lateral condylar pole, condylar center, empirical hinge axis point, and mandibular incisor point were selected as reference points for mandibular movement trajectories. Three-dimensional movement trajectories were generated for each reference point to calculate the sagittal condylar inclination (SCI), transverse condylar inclination (TCI), immediate side shift (ISS), incisal guidance inclination and canine guidance inclination. The calculation results from different reference points served as distinct experimental groups. Reference values provided by the JMA Optic system were used as the control group for comparative analysis. Results: The SCI values of all the experimental groups were significantly higher than that of the control group (P < 0.001), with a systematic positive bias of approximately 3.1°, though the limits of agreement were relatively narrow. The TCI results varied depending on the reference point: Only the condylar apex group (5.7°±6.1°) was significantly lower than the control group (9.2°±6.6°) (t=5.023, P < 0.001). Differences between the remaining groups and the control group were not statistically significant. The empirical hinge axis point group showed the smallest mean bias and the narrowest limits of agreement, indicating optimal consistency with the control group's TCI. The ISS values were 0.0 (0.0) mm in all the groups. The incisal guidance inclination of the mandibular incisor point group (43.1°±8.6°) was significantly lower than that of the control group (50.6°±13.7°) (t=3.749, P=0.001) with poor consistency. However, the canine guidance inclination of the mandibular incisor point group showed no statistically significant difference compared with the control group (t=-1.873, P=0.069), with acceptable consistency. Conclusion: This study proposed a mathematical method for calculating key articulator parameters based on mandibular movement trajectory data, with a clear and traceable computational pathway. The proposed method showed acceptable consistency with the JMA Optic system algorithm in calculating TCI, ISS, and canine guidance inclination, but poor consistency in calculating SCI and incisal guidance inclination. The selection of reference points directly influenced the results of parameter calculation. This mathematical method provided a reliable theoretical foundation for achieving precise, personalized articulator parameter settings.

Objective: To explore the methodology and feasibility of reconstructing soft tissue morphology for fixed implant rehabilitation in edentulous patients using multi-view stereo vision technology, and to conduct a preliminary evaluation of the method's in vitro accuracy. Methods: A pair of edentulous resin models were designed and printed, with 6 implant analogs placed in the maxilla and 4 in the mandible. The experimental group (n=10) utilized a self-developed photogrammetric quad-camera system and the automated reconstruction software RealityScan 2.0.1. Self-developed scan bodies were attached to the analogs, and the handheld camera system was used to capture images of the models in vitro. The images were imported into the software to reconstruct the 3D models, and the data were exported as ".stl" files. The control group (n=10) used an intraoral scanner. Scan caps were attached to the analogs, and the models were scanned to generate ".stl" data. Reference data were obtained by scanning the maxillary and mandibular resin models once each with a desktop scanner (EX-PRO). All data were imported into Geomagic Wrap 2021. The root mean square (RMS) was calculated by comparing the 3D morphology of the experimental and control group data against the reference data to represent the magnitude of the 3D morphological deviation and evaluate accuracy. The evaluation was conducted in 4 specific regions: the alveolar ridge, peri-implant soft tissue, buccal, and lingual areas. Results: In the maxilla, the RMS of the experimental group was significantly higher than the control group in the alveolar ridge [(124.89±21.30) μm vs. (53.90±8.93) μm, P < 0.001], peri-implant soft tissue [(157.74±19.13) μm vs. (67.03±3.94) μm, P < 0.001], and lingual areas [(146.01±33.87) μm vs. (46.20±11.19) μm, P < 0.001]. The RMS in the buccal area was lower for the experimental group than the control group [(50.56±8.34) μm vs. (53.83±12.66) μm], but the difference was not statistically significant (P=0.571). In the mandible, the RMS of the experimental group was significantly higher than the control group in the alveolar ridge [(254.04±88.42) μm vs. (58.28±38.96) μm, P < 0.001], peri-implant soft tissue [(165.18±21.30) μm vs. (70.48±28.20) μm, P < 0.001], and lingual areas [(421.75±59.51) μm vs. (54.59±36.77) μm, P < 0.001]. When comparing the buccal and lingual sides, the lingual RMS was significantly higher than the buccal RMS for the experimental group in both the maxilla (P < 0.001) and mandible (P < 0.001). For the control group, the maxillary lingual RMS was significantly lower than the buccal RMS (P < 0.05), while the mandibular lingual RMS was higher than the buccal, but the difference was not statistically significant (P=0.378). Conclusion: The self-developed quad-camera system, combined with multi-view stereo vision reconstruction software, can successfully record the 3D morphology of soft tissue. This study provides a research foundation for the development of extraoral photogrammetric devices capable of simultaneously determining the spatial positions of multiple implant units and acquiring soft tissue morphology.

Objective: To address the mismatch between the support center and the occlusal load center in implant-supported overdentures, this study proposed a novel centralized occlusal scheme. This design aimed to utilize the supportive capacity of the anterior mandibular implants and the maxillary canine pillars by establishing occlusal contacts in the canine region. A preliminary evaluation of the clinical feasibility of this new occlusal scheme was conducted. Methods: In this study, five completely edentulous patients received two implants in the mandible. Each participant was provided with two complete prosthetic sets: mandibular implant-supported overdentures and corresponding complete maxillary dentures featuring either a conventional bilateral balanced occlusion or the novel centralized occlusal scheme, delivered in a randomized crossover sequence. For the new scheme, the maxillary canines were reshaped referencing the premolars, while preserving their labial contour and occlusal balance, the lingual fossa was modified to establish centric occlusal contacts. A comprehensive evaluation was conducted using standardized methods: chewing efficiency was measured using the two-color chewing gum method, occlusal contact area was calculated digitally using virtual articulating paper method, and patient satisfaction was assessed using validated questionnaires, and stress distribution patterns were examined through detailed three-dimensional finite element analysis. Results: Compared with the conventional occlusal scheme, the centralized occlusal scheme achieved M (P₂₅, P₇₅) improvements of 21.22% (17.48%, 26.01%) in occlusal contact area and 21.87% (17.51%, 24.18%) in masticatory efficiency, with the latter reaching 55.13% (43.73%, 59.09%) of the level observed in complete natural dentitions. Patient subjective evaluations indicated that the centralized scheme was comparable to the conventional scheme in terms of overall satisfaction, speech, and aesthetics. Finite element analysis revealed that the centralized scheme expanded the denture support area to the maxillary canine region. Conclusion: The proposed novel centralized occlusal scheme can enhance occlusal contact area and chewing efficiency by utilizing the support capacity of the anterior mandibular implants and the maxillary canine pillars, while maintaining denture stability, balance, aesthetics, and patient satisfaction. This study provides a new approach and preliminary evidence for improving the occlusal design of implant-supported overdentures.

Objective: To propose a novel method for constructing facial smile simulation sequence data based on static three-dimensional (3D) facial data captured at the start and end of smiling, and to preliminarily evaluate the accuracy and feasibility of the proposed method. Methods: The 3D dynamic facial data of participants transitioning from a neutral expression to a maximum smile were captured using the 3dMD dynamic facial scanning system. A structured 3D face template was deformed and registered to both the smile starting and ending facial data using the Procrustes analysis non-rigid iterative closest point (PA-NICP) registration algorithm developed by our research group, obtaining two sets of structured homologous data. In MATLAB software, the vertex displacements between the corresponding points of the starting and ending homologous datasets were calculated, and intermediate transitional data with a consistent triangular mesh topology were generated through linear interpolation, thereby constructing the facial smile simulation sequence data. The real 3D dynamic facial data captured from the 3dMD system were used as reference data, and the simulation sequence data constructed in this study were used as test data. The 3D morphological deviations between the reference and test data at multiple time points during the smiling process were calculated to evaluate the accuracy of the constructed smile simulation sequence data. Results: The 3D facial smile simulation sequence data were successfully constructed for one male and one female participants. The average 3D morphological deviation for the simulated sequence of the male participant was (0.31±0.04) mm, and the average 3D morphological deviation for the simulated sequence of the female participant was (0.44±0.08) mm. Conclusion: Based on the PA-NICP registration algorithm, the construction of facial smile simulation sequence data can be achieved. The intermediate transitional data can be parametrically generated and flexibly adjusted using interpolation functions, providing a novel method for 3D dynamic facial data generation that supports esthetic prosthodontic design, treatment outcome evaluation, and communication between clinicians and patients.

Objective: To establish a surgical planning workflow for orthognathic surgery based on similarity retrieval from a historical patient database and to evaluate its non-inferiority with the expert's surgical plan through a randomized controlled trial. Methods: A prospective randomized controlled trial was conducted involving 60 patients (19 males, 41 females; aged 18-35 years) scheduled for orthognathic surgery in the Department of Oral and Maxillofacial Surgery at Peking University School of Stomatology between June 2023 and June 2024. Participants were randomly assigned to a test group (n=30) or a control group (n=30). In the test group, surgical plans were generated using a database-driven similarity retrieval process while in the control group plans were developed by the expert based on clinical expe-rience. All surgeries were performed by the same expert. Outcome measures assessed at 6 months post-operatively included both subjective and objective indicators. Subjective evaluations comprised patient and surgeon visual analogue scale (VAS) scores, and FACE questionnaire (FACE-Q) scores, with surgeon assessments conducted by five independent senior surgeons. Objective measures included cephalometric angles [sella-nasion-A point (SNA), sella-nasion-B point (SNB), A point-nasion-B point (ANB)] and root mean square error (RMSE) of facial symmetry regions. Results: Postoperative subjective assessments demonstrated significant improvements from baseline in both groups (all P < 0.05). Specifically, the VAS scores increased by 30.10±19.67 in the test group versus 25.43±24.48 in the control group as rated by the patients, and by 28.19±10.21 versus 26.71±7.90 as evaluated by the surgeons. Similarly, the FACE-Q scores showed marked enhancements, with patient-reported scores increasing by 33.41±17.75 in the test group and 32.97±17.65 in the control group, and surgeon-assessed scores improving by 37.75±11.60 versus 38.63±10.23, respectively. However, the magnitude of improvement in all these subjective measures did not differ significantly between the test and control groups (all P>0.05 for intergroup comparisons of the change scores). Analysis of postoperative objective measurements revealed that cephalometric values were within the normal range for both groups: SNA angle was 84.06°±3.73° in the test group compared with 85.23°±3.71° in the control group; SNB angle was 81.78°±3.63° versus 83.51°±3.66°; and ANB angle was 2.28°±1.09° versus 1.72°± 1.25°. No statistically significant differences were observed between the two groups for these cephalometric parameters (all P>0.05). Furthermore, three-dimensional facial symmetry, quantified by the average RMSE value, exhibited significant improvement postoperatively compared with preoperative levels [Test group: from (10.39±2.83) mm to (8.35±2.72) mm; Control group: from (8.55±4.95) mm to (7.59±3.56) mm; P < 0.05 for within-group comparisons]. The postoperative average RMSE values between the test and control groups were not statistically different (P>0.05). Conclusion: Surgical planning based on similarity retrieval from a historical database demonstrated non-inferiority when compared with the conventional expert-driven approach, as evidenced by the absence of statistically significant diffe-rences in both subjective and objective postoperative outcome measures.

Objective: To analyze the demographic and clinical features of sialolithiasis based on a large sample size. Methods: Clinical and imaging data of patients with sialolithiasis treated at the Sialendoscopy Center of Peking University School and Hospital of Stomatology from January 2020 to December 2024 were retrospectively collected. Patient demographics, disease duration, and affected glands were recorded. Moreover, the number, size, location, and long-to-short diameter ratio of the stones were mea-sured. Results: A total of 1 812 patients with salivary gland stones were collected, including 855 males and 957 females. The age range was 4 to 97 years [mean: (39.0±15.0) years] with a median disease duration of 6.0 months (interquartile range: 1.0-24.0). Most stones involved unilateral glands (98.4%), and 64.2% of the affected glands had a single stone. The stone size averaged at a diameter of (6.5±4.6) mm. The cases included 1 541 cases with submandibular gland (SMG) stones (85.0%), 267 cases with parotid gland (PG) stones (14.7%), and 4 cases affecting both SMG and PG. The SMG stones were mostly located in the extra-glandular main duct (50.2%), followed by the hilum (41.5%), and only 8.2% of them were in the intra-glandular area. The majority of PG stones (75.2%) were in the extra-glandular main duct. The average diameter of SMG stones was significantly larger than that of PG stones [(6.9±4.8) mm vs. (4.5±2.5) mm]. The average age of SMG patients was younger than that of PG patients [(38.0±15.0) years vs. (48.0±16.0) years]. There was no significant difference in recurrence rate between PG and SMG stones (3.4% vs. 2.1%). The recurrence intervals ranged from 2 months to 10 years, with an average of (33.8±31.4) months. In 21 patients (1.2%), the stones originated from foreign body calcification, which accounted for 0.6% (9/1 541) of SMG cases and 4.5% (12/267) of PG cases. Conclusion: Among the cases analyzed, sialolithiasis was the most common in middle-aged individuals, with no significant gender difference. Unilateral gland involvement was the most frequent, and 2/3 of the cases had a single stone. Significant differences were observed in the location, size, and patient age between SMG and PG stones. The recurrence rate of sialolithiasis was relatively low. Stones originated from foreign body calcification was occasionally seen. Understanding of these demographic and clinical characteristics provided a basis for clarifying the pathogenesis of sialolithiasis and optimizing the diagnostic and therapeutic strategies.

Objective: The prevalence rate of chronic diseases among the floating population is increasing with the acceleration of the aging society. However, factors such as the characteristics of mobility, and the problem of medical insurance reimbursement in different places lead to underutilization of health service and poor health. Therefore, this study analyzed the impact of medical insurance on health service utilization of floating chronic disease patients and the moderating role of health risk perception from the perspective of behavioral economics, such work could shed light on the realization of "Healthy China" strategy and "the Medium- and Long-term Planning for the Prevention and Treatment of Chronic Diseases". Methods: We selected the data of China Migrants Dynamic Survey (CMDS) in 2017. A total of 5 640 migrants with chronic diseases were selected. Descriptive statistics was used to describe the basic characteristics of the sample, and binary Logistic regression model was used to analyze the relationship between the different types of medical insurance participation rate and the utilization of medical services, and the moderating role of health risk perception in this relationship. Results: The participation rate of medical insurance was 21.9%. There was still 12.5% migrants with chronic diseases who did not utilize health services when they felt unwell. Only having medical insurance in inflowing area could increase the utilization of health services among migrants with chronic diseases. Health risk perception significantly positively moderated the association of medical insurance for urban employee or public medical insurance with health service utilization among migrants with chronic diseases. Conclusion: The medical insurance and health risk perception can promote the utilization of health services among migrants with chronic diseases. The government should break the barrier of the medical insurance system, improve the level of medical insurance, and strengthen the propaganda and education of chronic diseases prevention and treatment, so as to improve the level of health risk perception of migrants with chronic diseases. In addition, it is necessary to rationally allocate health service supplies and focus more on trans-provincial floating male patients with chronic diseases, who have low health risk perception and limited access to medical services, to improve health service utilization.

Objective: To investigate the association between fat-to-muscle mass ratio (FMR) of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm. Methods: A total of 255 412 participants from the prospective cohort study United Kingdom biobank (UKB) were enrolled in the risk-related study of benign ovarian neoplasm. Cox proportional hazard model was used to evaluate the correlation between total and regional FMR and the risk of benign ovarian neoplasm. A priori stratified analysis was performed according to the body mass index (BMI) category to evaluate the correlation between FMR of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm in people with BMI < 25 kg/m²and BMI≥25 kg/m², respectively. The restricted cubic plot was used to further explore the curve of FMR associated with the risk of benign ovarian neoplasm. Finally, subgroup analysis was performed on the age of the subjects (< 50 years, 50-59 years, ≥60 years) to explore the association between FMR and the risk of benign ovarian neoplasm at different ages. Results: During a median 8.77 years of follow-up, we recruited 1 643 cases of benign ovarian neoplasms. After adjusting for demographic, reproductive, genetic, lifestyle, and hormone-related factors, total, arm, leg and trunk FMR were significantly positively correlated with the risk of benign ovarian neoplasm and higher than BMI with the risk of benign ovarian neoplasm, among which the whole body FMR had the strongest correlation with the risk of benign ovarian neoplasm (HR: 2.16; 95%CI: 1.67-2.79). Stratified analysis of FMR and the risk of benign ovarian neoplasm based on BMI showed that compared with people with BMI≥25 kg/m², people with BMI < 25 kg/m² had a stronger association between whole body, arm, leg and trunk FMR and the risk of benign ovarian neoplasm (P_interaction < 0.05). The restricted cubic plot showed that the association between FMR of the whole body, arm and trunk and the risk of benign ovarian neoplasm had an opposite trend between normal weight and overweight/obese people. Subgroup analysis showed that the association between the whole body and leg FMR and the risk of benign ovarian neoplasm decreased with age (P < 0.05). Among them, leg FMR was associated with benign ovarian neoplasm in people younger than 50 years (HR: 2.38; 95%CI: 1.39-4.08). Conclusion: There is a positive correlation between the total, arm, trunk FMR and the risk of benign ovarian neoplasm, and the correlation is stronger in people with BMI < 25 kg/m² and women aged 40-50 years.

Objective: To detect the expression levels of absence in melanoma 2 (AIM2), cysteine aspartate-specific protease-1 (caspase-1), and gasdermin D (GSDMD) in peripheral blood mononuclear cell (PBMC) of patients with idiopathic inflammatory myopathy (IIM) and to explore their role in the pathogenesis of IIM. Methods: A total of 30 IIM patients (IIM group) who visited the Department of Rheumatology and Immunology, General Hospital of Northern Theater Command from May 2020 to June 2022 were recruited. Concurrently, 30 healthy volunteers matched by gender and age were recruited from the hospital's Health Examination Center. Clinical information, biochemical and immunological mar-kers, and venous blood samples were collected from the study subjects. Serum double-stranded DNA (dsDNA) levels were detected by fluorescence quantitative method, and the mRNA expression levels of AIM2, caspase-1, GSDMD, interleukin 1β (IL-1β), and IL-18 in PBMC were detected by reverse transcription quantitative real-time PCR (RT-qPCR). The protein expression levels of AIM2, caspase-1, GSDMD, IL-1β, and IL-18 in PBMC were detected using the Western blot (WB) method, and the serum levels of IL-1β and IL-18 were detected by enzyme-linked immunosorbent assay (ELISA). Results: The IIM group included 10 cases of dermatomyositis (DM), 5 cases of polymyositis (PM), 11 cases of overlap syndrome (OM), and 4 cases of immune-mediated necrotizing myopathy (IMNM). Compared with the healthy control group, the serum levels of dsDNA, IL-1β, and IL-18 were significantly increased in the IIM group and its subgroups (P < 0.05). Except for the fact that there was no statistically significant difference in AIM2 mRNA levels in PBMC of the IMNM subgroup compared to the healthy control group, the expression of AIM2, caspase-1, and GSDMD mRNA was significantly increased in the IIM group and other subgroups (P < 0.05); Except for the comparison of IL-1β mRNA levels in PBMC of the IMNM and OM subgroups with the healthy control group showing no statistical difference, the expression of IL-1β and IL-18 mRNA was significantly increased in the IIM group and other subgroups (P < 0.05); Comparisons between subgroups indicated that the expression of IL-1β mRNA in the DM subgroup was significantly higher than that in the OM and IMNM subgroups, and the expression of IL-18 mRNA in the PM subgroup was significantly higher than that in the DM and OM subgroups (P < 0.05). The expression levels of AIM2, caspase-1, GSDMD, IL-1β, and IL-18 proteins in PBMC of the IIM group and its subgroups were significantly higher than those in the healthy control group (P < 0.05); Comparisons among subgroups revealed that the expression of IL-18 protein in the OM subgroup was significantly higher than that in the PM subgroup (P < 0.05). In the IIM group, the mRNA of caspase-1, GSDMD, and IL-18 showed a positive correlation with AIM2 mRNA, and the protein expression of caspase-1, GSDMD, IL-1β, and IL-18 also showed a positive correlation with AIM2 protein expression. Conclusion: The AIM2 inflammasome-mediated pyroptosis pathway may be involved in the pathogenesis of IIM, providing a theoretical basis for further research on the etiology of IIM and the development of new therapies.

Objective: To explore the gross classification of gallbladder cancer with primary lesion confined within the gallbladder wall, and its correlation with prognosis and precancerous lesions. Methods: A retrospective study was conducted on 123 patients who were admitted to Peking University Third Hospital from January 2006 to December 2020. These patients had preoperative imaging findings suggesting that the primary lesion was confined within the gallbladder wall and had postoperative pathology of adenocarcinoma. Based on CT, MRI, or gross specimens, they were divided into the following four types: Type 1, simple intraluminal lesion: Intraluminal lesions without focal thickening of the gallbladder wall; Type 2, complex intraluminal lesion: Intraluminal lesions associated with focal thickening of the gallbladder wall and/or outer surface dimpling at the tumor base; Type 3, focal wall thickening: Circumferential focal wall thickening with heterogeneous enhancement within 2 continuous parts of the gallbladder; Type 4, diffuse wall thickening: Circumferential diffuse wall thickening extending more than 2 continuous parts of the gallbladder with heterogeneous enhancement. The clinical pathological characteristics, types of precancerous lesions, and survival status were compared among the different types. Results: Both preoperative CT/MRI and intraoperative gross specimens could serve as the basis for gross classification, with gross specimens demonstrating the highest accuracy rate. Among the 123 patients, 13 could not be classified, while the remaining 110 underwent gross classification. The gross classification of gallbladder cancer was strongly or moderately correlated with histopathological parameters such as T-stage (P < 0.001, r_s=0.682), lymph node metastasis (P < 0.001, r_s=0.478), tissue differentiation degree (P < 0.001, r_s=0.484), nerve infiltration (P < 0.001, r_s=0.490), and vascular invasion (P < 0.001, r_s=0.334). The higher the classification, the more adverse histopathological parameters were observed. Additionally, the gross classification of gallbladder cancer was moderately strongly and highly strongly correlated with residual lesions after surgical treatment (P < 0.001, r_s=0.328) and postoperative recurrence (P < 0.001, r_s=0.619) in the patients. Survival analysis revealed that the higher the classification, the shorter the median survival time of the patients (Type 1: 96 months, Type 2: 73 months, Type 3: 30 months, Type 4: 14 months, P < 0.001). Multivariate Cox regression indicated that the gross classification of gallbladder cancer was an independent prognostic factor (HR=3.609, 95%CI: 2.177-5.983, P < 0.001). In the patients with the most heterogeneous biological behavior in stage T2, the gross classification of gallbladder cancer was also closely associated with prognosis (median survival times were 72, 70, 29, and 16 months, respectively, P < 0.001). Multivariate Cox regression further demonstrated that the gross classification of gallbladder cancer was an independent prognostic factor (HR=2.723, 95%CI: 1.566-4.736, P < 0.001). In terms of tumor origin, the gross classification of gallbladder cancer was significantly correlated with the type of precancerous lesions: Type 1 mainly originated from intracholecystic papillary neoplasm of the gallbladder, while Types 3 and 4 were mostly high-grade biliary intraepithelial neoplasm or without precancerous lesions. Analysis of the natural history of the tumor suggested that Type 1 progressed slowly, Type 4 progressed rapidly, and Type 2 exhibited greater heterogeneity. Conclusion: The gallbladder cancer with primary lesion confined within the gallbladder wall is closely related to prognosis and precancerous lesions, and can serve as an important reference for surgical decision-making and stratified management.

Objective: To explore risk factors of early complications (≤14 days) and the clinical characteristics in patients with amyotrophic lateral sclerosis (ALS) after percutaneous endoscopic gastrostomy (PEG). Methods: Patients diagnosed with ALS who underwent first PEG insertion between January 2011 and December 2020 were eligible. Medical records were retrospectively reviewed to determine clinical characteristics and outcomes (≤14 days) of patients who underwent the pull type PEG. Grouping was performed based on the presence and severity of complications, and SPSS 27.0 statistical software was used for data analysis. Finally, Logistic regression model was applied for multivariate factor analysis of risk factors related to complications. Results: In the study, 192 cases of PEG were all successfully completed, with 97 (51%) males, mean age of ALS onset disease (55±11) years and 93 (48%) bulbar onset symptoms included. Complications occurred in 40 (21%) cases after PEG within 14 days, all of which had fever, including 16 cases without clear infection focus, 18 cases of respiratory tract infections, and 6 cases of fistula site infections. In the study, 13 (7%) cases had major complications, including 11 cases of respiratory tract infection and 2 cases of stoma infection. Two cases of respiratory tract infection died due to respiratory failure, and the remaining 11 cases recovered after upgraded antibiotic. No complications, such as tube dislodgement, benign pneumoperitoneum, hemorrhage or buried bumper syndrome occurred. The operation time and postoperative hospital stay were longer in the complication group than in the non-complication group [(16±5) min vs. (13±5) min, P < 0.001; 6 (5, 9) d vs. 5 (3, 7) d, P=0.009]. Compared with the mild complication group, the creatinine and triglyceride in the major complication group were significantly lower [(46.5±16.2) μmol/L vs.(66.8±16.4) μmol/L, P＜0.001; (1.1±0.5) mmol/L vs.(1.6±0.7) mmol/L, P=0.038], and the operation time was significantly longer [(20±5) min vs. (15±5) min, P=0.002]. Further, Logistic regression model analysis revealed that the operation time was also independent associated with complications (OR=1.132, 95%CI: 1.051-1.220, P=0.001). Conclusion: PEG was a reliable method for ALS patients to put nutrition tube. Postoperative fever was the most common complications. Long surgical duration was an independent risk factor for the occurrence of complications (≤14 d).

Objective: To investigate the complex association between hemoglobin levels and resting pulse oxygen saturation (SpO₂) among surgical inpatients in a high-altitude environment, and to define precise, gender-specific physiological adaptation thresholds for hemoglobin, thereby providing evidence-based reference values for health management strategies in high-altitude populations. Methods: This cross-sectional study enrolled adult inpatients from People's Hospital of Xizang Autonomous Region (altitude: 3 650 m) between January 2023 and October 2024. To rigorously evaluate the relationship between hemoglobin and resting SpO₂, multivariate linear regression analysis was performed. Furthermore, restricted cubic spline models and likelihood ratio tests were utilized to explore potential non-linear threshold effects. Models were adjusted for potential confounding factors, including age, body mass index, hypertension, diabetes, smoking, alcoholism, and comorbid pulmonary diseases. Results: A total of 3 083 inpatients were enrolled in the final analysis, comprising 1 450 males and 1 633 females. The restricted cubic spline analysis revealed a significant non-linear relationship between hemoglobin levels and SpO₂ for the total population (non-linear test, P=0.006), indicating a distinct turning point in the dose-response curve. Two-piecewise linear regression models subsequently identified distinct inflection points for each sex. For female inpatients, the hemoglobin threshold was determined to be 15.482 g/dL; Above this level, SpO₂ significantly decreased as hemoglobin increased (β=-0.477, 95%CI: -0.760 to -0.193, P=0.001). Similarly, for male inpatients, the threshold was identified at 17.288 g/dL; Exceeding this value resulted in a significant inverse correlation between hemoglobin and SpO₂ (β=-0.344, 95%CI: -0.550 to -0.138, P=0.001). Conclusion: This study establishes specific hemoglobin thresholds for oxygenation status in hospitalized patients at high altitude: 15.482 g/dL for females and 17.288 g/dL for males. Beyond these cut-off values, further increases in hemoglobin are associated with a deterioration in SpO₂, suggesting a transition from physiological adaptation to maladaptive hemoconcentration. These findings highlight the necessity of sex-stratified hemoglobin monitoring and potential preoperative optimization in high-altitude health management to prevent hypoxia-related complications.

Objective: To analyze the clinical features and virulence gene characteristics of Klebsiella pneumoniae multi-site infections in patients with hospital-acquired pneumonia, as well as the risk factors for death within 30 days in patients with multi-site infections, in order to provide help for clinical anti-infective treatment. Methods: The case data of hospital-acquired pneumonia patients with Klebsiella pneumoniae isolated in sputum culture from March 2018 to June 2023 in Peking University Third Hospital were selected for retrospective analysis, and a total of 128 consecutive patients were enrolled, of whom 35 were in the multi-site infection group and 93 were in the lung infection group, and the clinical data, strain sequence typing, and virulence-related genes of the patients in the two groups were analyzed and compared. Results: The differences in age, gender, proportion of the patients with length of hospital stay ≥30 days, antibiotic exposure rate within 90 days and 30-day mortality rate between the two groups were statistically significant (all P < 0.05); the differences in the proportions of combined interstitial lung disease, myocardial infarction, peripheral vascular disease, peptic ulcer, diabetes mellitus and hemiplegia between the two groups were statistically significant (all P < 0.05). The proportions of patients with Glasgow coma scale (GCS) scores < 8 points, the proportion of the patients who underwent peripherally inserted central catheter (PICC) and gastric tube invasive operation, the proportion of the presence of pleural effusion and infectious shock in the multi-site infection group were significantly higher than those of the pulmonary infection group (all P < 0.05). The blood procalcitonin (PCT) level in the multi-site infection group was significantly higher than that of the pulmonary infection group (P=0.004), and the red blood cell count and hemoglobin level were significantly lower than those of the pulmonary infection group (P < 0.001). The proportion of ST11 and the detection rates of virulence genes iroB, ybtA, irp1 and fyuA in Klebsiella pneumoniae strains in the multi-site infection group were significantly higher than those in the pulmonary infection group (P < 0.05). According to the occurrence of death within 30 days, the patients in the multi-site infection group were further divided into the multi-site infection survival group (n=21) and the non-survival group (n=14). Multivariate analysis showed that septic shock was an independent risk factor for death within 30 days of multi-site infection (P=0.045, OR=38.510). Conclusion: Patients with Klebsiella pneumoniae multi-site infection were mainly found in patients with advanced age, female, more comorbidities, performing invasive operation and having history of antimicrobial drug exposure within 90 days. They had lower erythrocyte counts, hemoglobin levels and higher PCT levels, and were prone to pleural effusion, infectious shock. Infectious shock was an independent risk factor for death within 30 days in patients with Klebsiella pneumoniae multi-site infection. ST11 type was the most prevalent type of multi-site infectious strains, and the virulence genes iroB, ybtA, irp1, fyuA were more prevalent.

Objective: To explore the key technical points and value of cell transfer technology in the diagnosis of micro-volume cell fluid. Methods: In the study, 32 micro-volume cell fluid samples with the diagnosis of tumor or atypical cells in the Department of Pathology, Peking University First Hospital were collected from September 2024 to June 2025. The cells on the ThinPrep cytology test (TCT) slides were divided into several sections and transferred to corresponding slides for immunocytochemistry (ICC) and special staining. Hematoxylin-eosin (HE) staining slides before and after transfer were compared to evaluate the performance of cell transfer technology in maintaining the consistency of cell morphology. The re-diagnosis referring to the results of ICC and special staining of transfer slides were made. The diagnosis before and after cell transfer was compared to evaluate the value of technology in improving the differential diagnostic accuracy. Results: A total of 140 cell transfer slides were prepared from the 32 samples. Among them, 32 HE-stained slides were consistent with the original TCT slides in terms of staining quality, cell morphology and arrangement, with a success rate of 100%; 99 transfer slides were immuno-stained, of which 91 had accurate color and position of positivity and clear background of negativity, with a success rate of 91.91%; 9 special-stained slides had sharp color contrast and clear background, with a success rate of 100%. With the help of ICC and special staining results of transfer slides, 26 of the 32 samples were accurately diagnosed, including 18 cases of malignant tumors and 8 cases of non-neoplastic lesions; 6 cases remained undiagnosed, including four due to ICC staining failure and two due to too few cells. Compared with the original cytological diagnosis, a definitive differential diagnosis was obtained in 81.25% of cases after cell transfer. Conclusion: The application of cell transfer technology in TCT samples is feasible in clinical practice and is suitable for cases requiring ICC and special staining for auxiliary diagnosis. It can significantly improve the differential diagnostic accuracy for the micro-volume cell fluid samples, which is invaluable for the special cases which pathological diagnosis can only be made based on the micro-volume cell fluid samples because no more tissue sample is available.

This case report describes the micro-endodontic retreatment and comprehensive management of a complex left maxillary second molar presenting with multiple complications. The patient, a 41-year-old female, presented with recurrent gingival swelling associated with the tooth for more than six months. The tooth had a history of root canal treatment, fiber post placement, and full crown restoration two years earlier. Cone-beam CT (CBCT) revealed a separated metallic instrument approximately 5 mm in length in the apical region of the mesiobuccal root, a fiber post in the palatal root, underfilled root canal obturation, and periapical radiolucency involving the mesiobuccal, distobuccal and palatal roots. A diagnosis of chronic periapical periodontitis (post-endodontic treatment) was established. The primary challenges included the limited access to the left maxillary second molar, the deeply embedded apical instrument segment, and the high risk for complications, such as root fracture or secondary perforation during retrieval attempts. The treatment strategy involved removal of the separated instrument and retreatment under a dental operating microscope. With ultrasonic assistance, the palatal fiber post and the coronal segment (2.5 mm) of the separated instrument from the mesiobuccal canal were successfully removed. An iatrogenic lateral perforation occurred in the mesiobuccal canal near the furcation area during the instrument retrieval procedure. Given the depth and high risk of further damage from retrieving the remaining apical segment (2 mm), a conservative and flexible approach was adopted using the bypass technique. After successful bypassing, thorough chemo-mechanical debridement was performed, followed by obturation using the warm vertical compaction technique. The iatrogenic perforation on the distal wall of the mesiobuccal canal was immediately repaired with a bioceramic material (iRoot BP) for its superior sealing and bioactivity. The tooth was then restored with a full crown. A 10-month follow-up showed that the patient was asymptomatic with complete fistula healing and radiographic examination revealed favorable healing of the periapical lesion. This case demonstrates that, in complex root canal retreatment cases involving retained instruments and iatrogenic perforations, the integration of advanced diagnostic tools (e. g. CBCT), microsurgical techniques (e. g. microscope and ultrasound), and modern restorative materials (e. g. bioceramics), along with a dynamic strategy combining instrument retrieval and bypassing, is essential for achieving predictable long-term success.

Cemento-osseous dysplasia (COD) is an uncommon, non-neoplastic benign fibro-osseous lesion of the jaws, characterized by cementum-like tissue deposition. It primarily affects middle-aged women of African and East Asian descent. Generally asymptomatic, this condition is frequently identified incidentally through radiographs showing radiopacities with radiolucent rims. This report presented a case of florid cemento-osseous dysplasia (FLCOD) in a 45-year-old Asian female. The patient exhibited secondary caries extending to the pulp chamber on the left mandibular first molar, showed no signs of pulpitis or periapical pathosis. Adjacent tooth (the left mandibular third molar) and contralateral molars (the right mandibular molars) responded normally to pulp vitality testing, with no swelling, sinus tracts, or mobility observed. Cone beam computed tomography (CBCT) revealed multifocal lesions with amorphous radiopacities and thin radiolucent rims without root resorption or cortical perforation in the periapical regions of bilateral mandibular molars. These findings reflected characteristic radiographic features of FLCOD, aligning with the World Health Organization (WHO) 2022 classification criteria. Significantly, three radiographic stages of COD were concurrently demonstrated through multifocal lesions involving six mandibular molars, providing a representative model of its natural progression. The initial osteolytic stage in teeth 38, 46, and 48 manifested as well-defined periapical radiolucencies with sclerotic borders; the intermediate stage in 36 and 37 featured punctate or nodular radiopacities within periapical radiolucency; while the mature terminal stage in 47 presented a homogeneous radiopaque mass bordered by a thin radiolucent rim. The diagnostic process prioritized exclusion of chronic apical periodontitis through confirmed pulp vitality and absence of infection. Cemento-ossifying fibroma (COsF) was dismissed based on solitary presentation and cortical expansion. Familial gigantiform cementoma (FGC) was differentiated by early diffuse jaw expansion and extensive involvement beyond COD. Cementoblastoma exclusion relied on pathognomonic features, specifically root resorption or compromised pulp vitality. Given the asymptomatic, non-progressive behavior of the FLCOD lesions, annual surveillance was implemented, with intervention limited to the restorative failure in tooth 36. At 12-month follow-up, the FLCOD lesions showed clinical-radiographic stability without secondary infection or progression. This case reflected the classic presentation of FLCOD as incidental, multifocal mandibular posterior radiopacities bordered by radiolucent rims. CBCT proved instrumental in delineating the lesions, providing diagnostic evidence. Long-term surveillance remains the cornerstone of management for COD. Invasive procedures are not recommended in cases with asymptomatic non-progressive behavior to prevent surgical complications.

Kennedy disease is a rare X-linked recessive genetic disease with a low incidence rate. The main manifestations of motor neuron involvement include limb weakness, muscle atrophy, dysarthria, difficulty swallowing, and coughing after drinking water. The patient may die from pulmonary infection and respiratory failure, and there is currently no effective treatment available. There are few reports on anesthesia for such patients and no guidelines or expert consensus. This article reports on perioperative anesthesia management for a 69 years old patient who underwent lumbar spine surgery before with coronary heart disease. The patient was diagnosed with Kennedy disease through electromyography and genetic testing before surgery and underwent knee replacement surgery. After sufficient preoperative consultation and evaluation, femoral nerve block was performed with 0.25% ropivacaine under guidance with ultrasound and nerve stimulator, followed by induction of general anesthesia with sufentanil, propofol, and etomidate. A laryngeal mask was inserted without the use of muscle relaxants and breathing was controlled by machine. During the operation, propofol and remifentanil were used for total intravenous anesthesia. The patient had stable vital signs, well tolerated, and the surgical process was smooth. The time of recovery from anesthesia was short, and no anesthesia related complications, such as nausea, vomiting, aspiration, or suffocation was observed after the operation. Postoperative muscle strength recovery was good. After closely monitoring in the ICU for a day, the patient returned to the regular ward. A postoperative analgesia combination of nerve block and oral nonsteroidal analgesics was performed, and emergency pain rescue with pethidine was administered if necessary. The analgesic effect was satisfactory. The patient was safely discharged in the end and recovered well.