Objective: To assess the sulfur dioxide detection capabilities of occupational health laboratories through a comparative study of workplace air sulfur dioxide measurement proficiency, and to analyze the primary factors influencing measurement accuracy. Methods: From June to September 2024, sulfur dioxide comparison samples were prepared, undergoing homogeneity testing and stability evaluation, followed by collaborative calibration. The test results from participating laboratories were evaluated using the designated reference value range method. Analysis of non-compliant results was conducted by reviewing laboratory reports and records, with further investigation into measurement influencing factors. Results: The statistical F-value for homogeneity testing was below the critical threshold (P>0.05), indicating uniform sulfur dioxide distribution in the samples. The t-value for stability testing was also below the critical threshold (P>0.05), confirming sample stability under room temperature conditions for three months. The overall pass rate for laboratory comparisons was 85.0% (150/180). Non-compliance primarily stemmed from issues with reference standards, reagents, and testing conditions. Key influencing factors for sulfur dioxide determination by the formaldehyde method included the addition method of chromogenic reagents and precise control of reaction duration and temperature. Conclusion: The participating laboratories demonstrated generally high sulfur dioxide detection proficiency, though some institutions require further improvement in testing capabilities. Precise control of testing conditions and enhanced quality control measures are crucial for improving the accuracy of sulfur dioxide measurement results. 目的： 通过组织工作场所空气中二氧化硫检测能力比对，了解职业卫生检测实验室二氧化硫检测水平，并分析探讨主要的测定影响因素。 方法： 于2024年6月至9月，制备二氧化硫比对样品，对样品进行均匀性检验和稳定性评价并通过协作定值为样品赋值；采用指定参考值范围法评定各参加实验室的检测结果；通过查看各参加实验室提交的报告及记录分析结果不合格原因，结合试验探讨测定影响因素。 结果： 样品均匀性检验的统计量F小于临界值（P>0.05），即样品中的二氧化硫是均匀的；稳定性检验统计量t小于临界值（P>0.05），即样品在室温条件下保存3个月是稳定的。实验室比对结果总合格率为85.0%（153/180）；结果不合格的主要原因在于溯源标准、试剂及检测条件；显色剂加入方式、显色反应的时间和温度控制是甲醛法测定二氧化硫的主要影响因素。 结论： 参加比对的实验室二氧化硫检测水平总体较高，部分机构实验室检测能力有待提高；精准控制检测条件、加强质量控制措施对提高二氧化硫检测结果的准确性尤为重要。.
Objective: To establish a rapid and sensitive high performance liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) method for the simultaneous determination of 37 alkaloids in whole blood, in order to meet the needs of clinical alkaloid toxicity detection. Methods: From October 2024 to January 2025, whole blood samples were precipitated with acetonitrile and methanol (V∶V=1∶1) to remove proteins, followed by centrifugation, filtration and sample injection. A gradient elution was performed using a mobile phase containing 0.1% formic acid acetonitrile, 0.1% formic acid, and 5 mmol/L ammonium acetate aqueous solution. The injection volume was 1 μl at a flow rate of 0.4 ml/min. Separation was achieved on Waters XSelect(®)CSH(TM) C18 column. Mass spectrometry was operated in positive electrospray ionization with multiple reaction monitoring (MRM) mode, and quantification was performed using a matrix working curve external standard method. Results: The linear relationships between 37 alkaloids in whole blood were good within the corresponding concentration range, with correlation coefficients (r) all greater than 0.990. The detection limits (S/N) were 0.01-2.50 ng/ml, and the quantification limits were 0.03-7.50 ng/ml. The recovery rates were 81.1%-122.1%, and the intra and inter batch accuracies were 1.0%-13.9% and 2.3%-17.9%, respectively. Conclusion: This study establishes a rapid and sensitive LC-MS/MS for the simultaneous determination of 37 alkaloids in whole blood. The method is concise, rapid and sensitive, and can be used for the quantification of alkaloid poisoning toxins, monitoring of blood concentrations of medicinal alkaloids, and the detection of emergency response to sudden food poisoning incidents. 目的： 建立一种快速、灵敏的同时测定全血中37种生物碱的高效液相色谱-质谱/质谱方法，以满足临床生物碱中毒毒物检测的需求。 方法： 于2024年10月至2025年1月，全血样品经乙腈甲醇（V∶V=1∶1）沉淀去蛋白、离心、过滤后进样，以含0.1%甲酸乙腈、含0.1%甲酸和5 mmol/L乙酸铵水溶液作为流动相，进样量1 μl，流速0.4 ml/min，进行梯度洗脱，在Waters XSelect(®)CSH(TM) C18色谱柱上实现分离，质谱采用正离子-多反应离子监测模式，基质工作曲线外标法定量。 结果： 全血中37种生物碱在相应的浓度范围内线性关系良好，相关系数（r）均>0.990，检出限（S/N）为0.01~2.50 ng/ml，定量限为0.03~7.50 ng/ml，回收率为81.1%~122.1%，批内和批间精密度分别为1.0%~13.9%和2.3%~17.9%。 结论： 本次研究建立快速、灵敏的同时测定全血中37种生物碱的高效液相色谱-质谱/质谱方法，方法极简、快速、灵敏，可用于生物碱中毒毒物定量、药用生物碱血药浓度监测及突发性食品中毒事件的应急处置检测。.
Objective: To investigate the changes in the balance between T helper 17 (Th17) cells and regulatory T (Treg) cells during the development and progression of pneumoconiosis. Methods: A cross-sectional study was conducted from June 2024 to May 2025. Pneumoconiosis patients admitted to Chongqing Prevention and Treatment Center for Occupational Diseases were enrolled using a total sampling method. A total of 56 patients were recruited, including 22 at Stage Ⅰ, 12 at Stage Ⅱ, and 22 at Stage Ⅲ. Bronchoalveolar lavage fluid (BALF) was collected from all participants. Flow cytometry was used to determine the percentages of T-lymphocyte subsets and macrophage phenotypes in BALF cell pellets. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was employed to measure the mRNA expression levels of Th17/Treg-related transcription factors and cytokines in BALF cell pellets. Enzyme-linked immunosorbent assay (ELISA) was used to quantify cytokine protein levels in BALF supernatant. Multi-group comparisons were performed using one-way analysis of variance or the Kruskal-Wallis H test.Results Changes in Treg cell number and function: Compared with Stage Ⅰ (16.05%±1.84%), the percentage of CD4(+)CD25(+)CD127(low) cells (Treg cells) in BALF was significantly higher in Stage Ⅲ (29.70%±5.64%), (F=6.31, P=0.007). The mRNA expression level of the Treg-specific transcription factor FOXP3 in BALF cell pellets was also significantly higher in Stage Ⅲ than in Stage Ⅰ (P=0.030). The protein levels of the Treg-secreted anti-inflammatory cytokines IL-10 and TGF-β in BALF supernatant were significantly lower in Stages Ⅱ and Ⅲ compared with Stage Ⅰ (all P<0.05). Changes in Th17 cells: No significant differences were observed across stages in the mRNA expression levels of the Th17-specific transcription factor RORγt or its related cytokine IL-23 in BALF cell pellets (all P>0.05). The level of the Th17-secreted cytokine IL-17 in BALF supernatant was significantly lower in Stage Ⅲ [ (27.97±2.60) pg/mg protein] than in Stage Ⅰ [ (38.47±3.60) pg/mg protein, P=0.009]. Changes in macrophages: No significant differences were observed across stages in the percentages of macrophages or their M1/M2 subtypes in BALF (all P>0.05) . Conclusion: A dissociation between Treg cell number and function occurs during the development and progression of pneumoconiosis. Immune imbalance mediated by Treg cell dysfunction may be involved in the pathogenesis of pneumoconiosis. 目的： 探索尘肺病发生发展过程中辅助性T细胞17（Th17）/调节性T细胞（Treg）平衡的变化。 方法： 于2024年6月至2025年5月，采用横断面研究设计，以整群抽样法选取重庆市职业病防治院收治的尘肺病患者为研究对象。共纳入56例，按尘肺病分期分为壹期22例、贰期12例和叁期22例。收集研究对象支气管肺泡灌洗液（BALF），采用流式细胞仪检测BALF沉淀细胞中T淋巴细胞及巨噬细胞亚群的百分比，实时定量逆转录聚合酶链式反应法检测BALF细胞沉淀中Th17/Treg转录因子及细胞因子的mRNA表达水平，酶联免疫吸附测定法检测BALF上清中细胞因子的蛋白含量。多组间比较采用单因素方差分析或Kruskal-Wallis H检验。 结果： 与壹期比较，叁期尘肺病患者BALF中CD4(+)CD25(+)CD127(low)细胞百分比更高，差异有统计学意义（F=6.31，P=0.007）。与壹期比较，叁期尘肺病患者BALF细胞沉淀中叉头框转录因子P3（FOXP3）的mRNA表达水平更高（P=0.030）。与壹期比较，贰期和叁期尘肺病患者BALF上清中Treg分泌的白细胞介素10（IL-10）和转化生长因子-β（TGF-β）的蛋白含量更低，差异均有统计学意义（P<0.05）。BALF细胞沉淀中视黄酸受体相关孤儿核受体γt（RORγt）及其相关细胞因子IL-23的mRNA表达水平在不同分期之间比较，差异均无统计学意义（均P>0.05）。与壹期[（38.47±2.65）pg/mg蛋白]比较，叁期尘肺病患者BALF上清中Th17分泌的IL-17含量更低[（27.97±2.60）pg/mg蛋白]，差异有统计学意义（P=0.009）。BALF中巨噬细胞及其M1/M2分型在不同分期间比较，差异均无统计学意义（均P>0.05）。 结论： 尘肺病发生发展过程中存在Treg数量与功能的解偶联现象，Treg功能耗竭介导的免疫失衡可能参与了尘肺病的发生发展。.
Medication-related osteonecrosis of the jaw (MRONJ), a serious adverse effect associated with antiresorptive agents or certain antiangiogenic drugs, has become an important complication of concern to the fields of oral medicine, oncology, and bone metabolism disorders. Its prevention, early identification, and standardized management are of significant clinical importance. To guide clinical practice, several academic organizations have issued relevant guidelines or position papers. Although these guidelines are generally consistent in their overall principles, notable differences remain on certain key issues. This article takes the American Association of Oral and Maxillofacial Surgeons (AAOMS) 2022 position paper as the central framework, and in conjunction with the Scottish Dental Clinical Effectiveness Programme (SDCEP) clinical guidance and other international consensus statements, reviews and analyzes the definition, risk factors, preventive measures, and treatment strategies for MRONJ. This approach aims to facilitate a more comprehensive understanding of the current evidence base and to provide clearer guidance for clinical practice. 药物相关性颌骨坏死（MRONJ）作为一种与抗骨吸收药物或某些抗血管生成药物相关的严重不良反应，已成为口腔医学、肿瘤学及骨代谢疾病领域共同关注的重要并发症，对其预防、早期识别和规范治疗具有重要意义。为了指导临床实践，多个学术组织陆续发布了相关指南或立场文件。尽管不同指南在总体原则上较一致，但在某些关键问题上仍存在明显的差异。本文以美国口腔颌面外科医师协会（AAOMS）2022立场文件为核心框架，结合英国苏格兰牙科临床有效性项目（SDCEP）临床指南及其他国际共识文件，对MRONJ的定义、危险因素、预防措施及治疗策略进行整合与分析，有助于更全面地理解当前证据基础，并为临床实践提供更清晰的参考依据。.
急性巨核细胞白血病（AMKL）是一种罕见的急性髓系白血病亚型，在儿童中相对多见，预后较差。AMKL发病机制复杂，具有高度的基因组异质性。本文梳理AMKL研究的最新进展，重点聚焦于其分子景观和基于分子机制的靶向治疗策略，旨在帮助理解其致病机制，推动个体化精准治疗体系的建立，以期最终改善患儿预后。.
患儿，女，3月龄，因“发育迟缓3个月”就诊深圳市儿童医院风湿免疫科，以生长发育迟缓、面容异常及反复喉鸣为主要临床表现，外周血常规提示白细胞及中性粒细胞减少。基因测序示ZNF699基因第2号外显子c.14-17delGAAA（p.Arg5fsTer14）和第6号外显子c.975-976delCA（p.His325fsTer8）复合杂合变异，分别遗传自其母亲和父亲。诊断为伴有胃肠道、心血管、泌尿生殖系统和骨骼畸形的发育迟缓综合征，随访至2岁5月龄，该患儿1年4~5次肺炎病史，仍存在生长发育迟缓。.
Objective: To investigate the clinical manifestations, muscle imaging features, and muscle pathological characteristics of juvenile idiopathic inflammatory myopathies (IIM). Methods: A retrospective cohort study was conducted including 76 children with IIM admitted to Children's Medical Center, Peking University First Hospital from January 2012 to January 2024. Clinical manifestations, laboratory findings, muscle imaging features, and muscle pathological characteristics were compared between the major subtypes of dermatomyositis and immune-mediated necrotizing myopathy (IMNM). Independent sample t-test or Mann-Whitney U test, and χ2 test or Fisher's exact test were used to compare differences in characteristics between groups. Results: Among 76 children with IIM, 30 were males and 46 were females, with the age of onset at 5.0 (3.0, 8.0) years. Of these 76 children, 57 children were diagnosed with dermatomyositis, 15 children with immune-mediated necrotizing myopathy (IMNM) and 4 children with overlap myositis. The proportion of heliotrope rash, Gottron's sign, and antinuclear antibody positivity were all higher in the dermatomyositis group than those in the IMNM group (63% (36/57) vs.1/15, 47% (27/57) vs. 0/15, and 68% (32/47) vs. 5/14, respectively, all P<0.05), whereas serum creatine kinase (CK), alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase levels were all lower (all P<0.05). The proportion of myositis specific autoantibody positivity was also lower in the dermatomyositis group than in the IMNM group (52% (24/46) vs. 13/14, P=0.006). Muscle MRI showed that subcutaneous soft tissue edema was more frequently observed in the dermatomyositis group than in the IMNM group (28% (14/50) vs. 0/14, P=0.005), whereas muscle fatty infiltration was less common in the dermatomyositis group (16% (8/50) vs. 9/14, P<0.001). On muscle pathology, perifascicular muscle fiber atrophy and perivascular inflammatory cell infiltration, as well as sarcoplasmic myxovirus resistance protein A expression on perifascicular myofibers, were more common in the dermatomyositis group (78% (28/36) vs. 1/7, 89% (32/36) vs.1/7 and 10/14 vs. 0/4, respectively, all P<0.05), while muscle fiber necrosis, perimysial hyperplasia, and endomysial hyperplasia were more common in the IMNM group (7/7 vs. 33% (12/36), 2/7 vs. 0/36 and 4/7 vs. 3% (1/36), respectively, all P<0.05). Conclusions: There are differences between the 2 major juvenile IIM subtypes in terms of clinical manifestations, muscle MRI findings, and muscle pathological features. Dermatomyositis is more likely to present with characteristic skin rashes and perifascicular muscle fiber pathological changes, whereas IMNM is characterized by markedly elevated serum CK levels and prominent muscle fiber necrosis, and is more frequently associated with muscle fatty infiltration. 目的： 探讨儿童特发性炎症性肌病（IIM）患儿的临床表现、肌肉影像学及肌肉病理特征。 方法： 回顾性队列研究，纳入2012年1月至2024年1月北京大学第一医院儿童医学中心就诊的76例IIM患儿。比较IIM两种主要亚型即皮肌炎和免疫介导性坏死性肌病（IMNM）的临床表现、实验室检查结果、肌肉影像学及肌肉病理学特征。采用独立样本t检验或Mann-Whitney U检验、χ2检验或Fisher确切概率法进行组间比较。 结果： 76例IIM患儿中男30例、女46例，发病年龄为5.0（3.0，8.0）岁，其中皮肌炎57例、IMNM15例、重叠性肌炎4例。皮肌炎组患儿向阳疹、Gottron征发生率和抗核抗体阳性比例均高于IMNM组［63%（36/57）比1/15、47%（27/57）比0/15、68%（32/47）比5/14，均P<0.05］，血清肌酸激酶、丙氨酸转氨酶、天冬氨酸转氨酶、乳酸脱氢酶水平均低于IMNM组（均P<0.05），肌炎特异性抗体阳性率亦低于IMNM组［52%（24/46）比13/14，P=0.006］。在肌肉MRI中，皮肌炎组患儿皮下软组织水肿发生率高于IMNM组［28%（14/50）比0/14，P=0.005］，肌肉脂肪化发生率低于IMNM组［16%（8/50）比9/14，P<0.001］。在肌肉病理学检查中，皮肌炎组患儿束周肌纤维萎缩及血管周围炎症细胞浸润、束周肌纤维肌浆黏液病毒抵抗蛋白阳性表达更常见［78%（28/36）比1/7、89%（32/36）比1/7、10/14比0/4，均P<0.05］，IMNM组患儿肌纤维坏死、肌束衣增生和肌内衣增生更常见［7/7比33%（12/36）、2/7比0/36、4/7比3%（1/36），均P<0.05］。 结论： 儿童IIM两个主要亚型在临床表现、肌肉MRI及肌肉病理特征方面存在明显差异。皮肌炎更易表现为特征性皮疹及肌纤维束周为主病理改变；而IMNM则以血清肌酸激酶显著升高、肌纤维坏死为特征，更易合并肌肉脂肪化。.
Objective: To analyze the distribution characteristics of body mass index (BMI) and its associated factors among pneumoconiosis patients in China. Methods: A cross-sectional survey was conducted among 12210 pneumoconiosis patients from 27 provinces, autonomous regions, and municipalities directly under the central government of China from March 2017 to December 2021 using stratified sampling combined with purposive sampling. Data were collected on sociodemographic characteristics, dust exposure history, disease severity, complications, economic and employment status, dietary pattern, and social insurance coverage. BMI was calculated and classified (underweight, normal weight, overweight, obesity) according to WS/T 428-2013 Criteria of weight for adults. Comparisons among different BMI groups were conducted using Pearson's χ(2) test. Binary logistic regression (forward method) was used to analyze factors associated with underweight, with underweight as the dependent variable (underweight=1, normal weight=0) . Results: The mean BMI of pneumoconiosis patients was (23.3±3.6) kg/m(2). The proportions of underweight, normal weight, overweight, and obesity were 6.9% (844/12210), 52.6% (6425/12210), 32.7% (3997/12210), and 7.7% (944/12210), respectively. Among respondents with valid data, underweight patients were predominantly distributed in western regions[44.3% (374/844) ] and rural areas [71.9% (605/841) ], and had higher proportions of silicosis [60.5% (506/836) ], stage Ⅲ pneumoconiosis [44.8% (376/839) ], and pulmonary complications (pulmonary tuberculosis 17.1%, pulmonary infection 29.9%, cor pulmonale 23.6%, chronic obstructive pulmonary disease 41.6%, pulmonary bullae or pneumothorax 26.1%). They also had lower personal income (47.5% earning ≤5000 yuan per year), lower coverage of urban employee medical insurance (26.1%), and lower daily egg intake (35.3%). Overweight and obese patients were mostly coal workers' pneumoconiosis and stage I, and had higher proportions of hypertension and diabetes (P<0.05). Multivariate logistic regression analysis showed that stage Ⅲ pneumoconiosis (OR=2.41, 95%CI: 1.94-2.99), silicosis (OR=1.27, 95%CI: 1.07-1.50), pulmonary complications (OR=1.36-1.55), and socioeconomic factors (lack of work-related injury insurance, lack of urban employee medical insurance, low income) were factors associated with underweight (P<0.05) . Conclusion: BMI level of pneumoconiosis patients in China is correlated with geographic region, disease severity, and social security. Individualized intervention strategies are recommended for different BMI strata. 目的： 分析我国尘肺病患者体质指数（BMI）的分布特征及关联因素。 方法： 采用分层抽样与典型调查相结合的方法，于2017年3月至2021年12月，在我国27个省、自治区、直辖市纳入12 210例尘肺病患者开展横断面调查。调查内容包括人口社会学特征、接尘史、疾病严重程度、并发症、经济与就业状况、饮食结构及社会保障等。依据WS/T 428-2013《成人体重判定标准》计算并判定体质指数（BMI）分类（低体重、正常、超重、肥胖）。不同BMI组间比较采用Pearson χ(2)检验；以低体重为因变量（低体重=1，正常体重=0），采用二分类logistic回归（向前法）分析低体重的关联因素。 结果： 尘肺病患者平均BMI为（23.3±3.6）kg/m(2)，低体重率6.9%（844/12 210），正常体重率52.6%（6 425/12 210），超重率32.7%（3 997/12 210），肥胖率7.7%（944/12 210）。有效应答人群中，低体重者多分布于西部地区[44.3%（374/844）]和农村[71.9%（605/841）]，具有较高的矽肺比例[60.5%（506/836）]、叁期尘肺比例[44.8%（376/839）]及肺部并发症发生率（肺结核17.1%、肺部感染29.9%、肺心病23.6%、慢性阻塞性肺疾病41.6%、肺大泡或气胸26.1%）；同时表现为较低的个人收入（≤5 000元，占47.5%）、城镇职工医保覆盖率（26.1%）及每日鸡蛋摄入率（35.3%）。超重和肥胖患者多为煤工尘肺和壹期尘肺，合并高血压、糖尿病的比例更高（P<0.05）。多因素logistic回归分析显示，叁期尘肺（OR=2.41，95%CI：1.94~2.99）、矽肺（OR=1.27，95%CI：1.07~1.50）、肺部并发症（OR=1.36~1.55）及社会经济因素（无工伤保险、无城镇职工医保、低收入、待业或失业等）是低体重的关联因素（P<0.05）。 结论： 我国尘肺病患者BMI水平与地域、疾病严重程度及社会保障相关，建议针对不同BMI分层制定个性化干预策略。.
Objective: To summarize the key surgical techniques of the modified submental artery island flap for repairing tissue defects following surgery for mandibular medication-related osteonecrosis of the jaw (MRONJ), and to retrospectively evaluate the therapeutic outcomes. Methods: A total of 116 patients with mandibular MRONJ who underwent surgical treatment at the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology, Peking University International Hospital, and Baoding Second Hospital from June 2021 to September 2025 were included. All patients underwent saucer-like osteotomy preserving mandibular continuity, combined with a modified submental artery island flap for bone defect cavity filling and wound closure. Baseline data (age, sex), clinical data (primary disease, medication strategy, AAOMS stage), and surgical intervention factors (fluorescence guidance, reconstruction plate placement, flap transfer method) were retrospectively analyzed. Regular follow-up was conducted postoperatively via clinical (3 weeks, 6 weeks, and 12 weeks) and imaging examinations (12 weeks) to assess soft tissue and bone wound healing, and to evaluate the overall cure rate. Results: The modified submental artery island flap was utilized to reconstruct tissue defects and achieve wound closure in a series of 116 mandibular MRONJ patients. Among them, 52 were male and 64 were female, with a mean age of 64.9 years. Lung cancer, breast cancer, and prostate cancer were the most common primary diseases. There were 29 patients with AAOMS stage Ⅱ and 87 with stage Ⅲ MRONJ. Seventy-six received antiresorptive agents alone, and the remqining 40 patients received a combination of antiresorptive and antiangiogenic agents. All 116 patients underwent saucer-like osteotomy preserving mandibular continuity, with 66 patients receiving reconstruction plates to enhance the strength of residual mandibular bone. Necrotic bone resection was performed based on clinical judgement in 94 patients, whereas autofluorescence-guided resection was used in 22 patients. Of the 116 cases, 105 were successful and 11 failed, translating to an overall cure rate of 90.5%. Univariate and multivariate statistical analyses revealed that none of the variables examined had a statistically significant effect on treatment outcome. Conclusions: The modified submental artery island flap provides an effective approach for reconstructing mandibular MRONJ defects, enabling reliable soft tissue coverage and favorable clinical outcomes. This technique shows considerable potential for widespread application in preserving mandibular continuity and function, presenting a safe and effective option in the surgical management of MRONJ. 目的： 回顾分析改良颏下动脉岛状瓣用于下颌骨药物相关性颌骨坏死（MRONJ）术后组织缺损修复的手术技术要点和疗效。 方法： 纳入2021年6月至2025年9月就诊接受手术治疗的下颌骨MRONJ患者116例（男性52例，女性64例），均采用保留下颌骨连续性的碟形截骨术，同时应用改良颏下动脉岛状瓣填充骨缺损腔。回顾分析患者基线资料、临床资料及手术干预因素，通过临床及影像学检查定期随访观察患者术后软组织及骨创面愈合情况，评估总体治愈率。 结果： 本研究共纳入116例下颌MRONJ患者，恶性肿瘤为最常见原发疾病；AAOMS Ⅱ期29例，Ⅲ期87例；应用抗骨吸收药物76例，联合应用抗骨吸收药物与抗血管生成药物40例。116例患者中，66例患者植入重建板增强颌骨强度；94例患者术中依据术者经验行坏死骨切除，22例患者在自体荧光引导下行坏死骨切除。全部采用改良颏下动脉岛状瓣进行术后组织缺损腔修复及创面关闭，手术成功105例，失败11例，总体治愈率达90.5%。 结论： 改良颏下动脉岛状瓣可有效修复下颌骨MRONJ碟形截骨后的组织缺损并严密关闭创面，在下颌骨连续性功能保留中具有良好的临床疗效。.
Objective: To analyze the distribution characteristics of blood lead levels and their influencing factors among lead-exposed workers in Tianjin City in 2022 through active monitoring, and to provide a scientific basis for the prevention and control of occupational lead poisoning. Methods: In January 2022, 141 workers who were exposed to lead and its inorganic compounds in four lead related enterprises in Binhai New Area, Dongli District, and Wuqing District of Tianjin City in 2022 were selected as the research subjects for active monitoring of occupational health and collection of relevant data. Mann Whitney U test was used for inter group comparison of non normally distributed quantitative data, while Kruskal Wallis H test was used for inter group comparison of multiple data; The influencing factors of elevated blood lead were analyzed using multiple unconditional logistic regression. Results: 141 lead workers had an average age of (36.9±7.0) years and an average lead exposure length of (5.4±5.1) years; The median and quartiles of blood lead concentration [M (Q(1), Q(3)) ] were 23.73 (12.04, 39.73) μg/L, with a geometric mean of 22.27 μg/L; 129 individuals (91.49%) had blood lead levels below 100 μg/L, 12 individuals (8.51%) had blood lead levels between 100-400 μg/L, and no individuals had blood lead levels above 400 μg/L. Univariate analysis showed that there were statistically significant differences in blood lead concentrations among workers from different regions, genders, ages, lead exposure years, industry categories, and enterprise sizes (P<0.05). Multivariate logistic regression analysis showed that gender, age, and industry category were independent risk factors for elevated blood lead levels in workers (OR=9.66, 4.87, 2.30, P<0.05) . Conclusion: The blood lead concentrations of lead workers in Tianjin City are influenced by factors such as gender, age, and industry category. Strengthened supervision and management should be implemented for key populations and industries. 目的： 分析2022年天津市铅作业工人主动监测血铅水平分布特征及其影响因素，为职业性铅中毒防控提供科学依据。 方法： 于2022年1月，以2022年天津市滨海新区、东丽区、武清区4家涉铅企业中所有接触铅及其无机化合物的141名劳动者为研究对象，开展职业健康主动监测并收集相关资料。非正态分布计量资料组间比较用Mann-Whitney U检验，多组间比较用Kruskal-Wallis H检验；血铅升高的影响因素用多因素非条件logistic回归分析。 结果： 141名铅作业工人平均年龄（36.9±7.0）岁，平均接铅工龄（5.4±5.1）年；血铅浓度中位数及四分位数[M（Q(1)，Q(3)）]为23.73（12.04，39.73）μg/L，几何均数为22.27 μg/L；血铅<100 μg/L者129人（占91.49%）、100~400 μg/L者12人（占8.51%）、无血铅> 400 μg/L者。单因素分析显示，不同地区、性别、年龄、接铅工龄、行业类别、企业规模的工人血铅浓度差异有统计学意义（P<0.05）；多因素logistic回归分析显示，性别、年龄、行业类别是工人血铅升高的独立危险因素（OR=9.66、4.87、2.30，P<0.05）。 结论： 天津市铅作业工人血铅浓度受性别、年龄、行业类别等因素影响。应加强对重点人群和重点行业的监督管理。.
Objective: To evaluate the scientificity, transparency and applicability of the guidelines and consensus in the field of stomatology published by Chinese experts between 2023 to 2024. Method: Systematic searches were conducted in 8 databases including China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, China Biomedical Literature Service System, Chinese Medical Journal Full-text Database, Wanfang Medical Network, PubMed, Web of Science, and Scopus. Guidelines and consensus led by Chinese scholars in the field of stomatology from 2023 to 2024 were included. The comprehensive evaluation of the included guidelines and consensus was conducted based on the scientific, transparent and applicable rankings (STAR) tool, followed by analyzation of the results. Results: Total of 4 guidelines and 33 expert consensuses were included. Calculated based on the total score of 100 points, the highest score was 32.15 while the lowest was 8.10, as well as the average score was 18.02 and the median score was 17.35. The top 3 STAR domains with the highest score rate were recommendations (48.0%), fundings (31.5%), and guideline development groups (31.5%), while the bottom 3 domains with the lowest score rate were registries (0), protocols (1.4%), and clinical questions (6.8%). Conclusions: The overall quality of guidelines and consensus in the field of stomatology in China needs to be improved. It is necessary to strengthen the planning of guideline and consensus formulation, standardize the formulation process. We emphasize that the guideline development group should include experts from multiple disciplines including evidence-based medicine or guideline methodology. 目的： 评价2023—2024年度期刊发表的中国口腔医学领域指南和共识的科学性、透明性和适用性。 方法： 系统检索中国知网、万方数据知识服务平台、中国生物医学文献服务系统、中华医学期刊全文数据库、万方医学网、PubMed、Web of Science、Scopus共8个中英文数据库，纳入2023—2024年度中国学者牵头发表的口腔医学领域指南及共识。基于指南科学性、透明性和适用性（STAR）评级工具对纳入的指南及共识进行综合评价，并对结果进行分析。 结果： 共纳入4部指南和33部专家共识。以100分为总分计算，纳入的指南和共识中，最高得分32.15分，最低8.10分，平均18.02分，中位得分17.35分。得分率最高的3个STAR领域为推荐意见（48.0%）、资助（31.5%）和工作组（31.5%），得分率最低的3个领域为注册（0）、计划书（1.4%）和临床问题（6.8%）。 结论： 中国口腔医学领域的指南和共识总体质量有待提升，需加强指南和共识制订的计划性、规范制订流程，强调制订工作组应包含循证医学或指南方法学在内的多学科专家共同参与。.
Objective: To analyze the pathogen distribution and antimicrobial resistance profiles of severe community-acquired bacterial pneumonia (SCABP) in children admitted to the pediatric intensive care unit (PICU). Methods: This retrospective cohort study included 308 children with SCABP treated at the PICU of Children's Hospital of Shanghai Jiao Tong University between January 2018 and December 2024. A total of 426 non-duplicate pathogenic bacteria were isolated from bronchoalveolar lavage fluid and sputum specimens. Antimicrobial susceptibility testing was performed for all isolates. Patients were stratified by admission year and the trends in isolation rates were tested using the Cochran-Armitage trend test. Results: A total of 426 non-duplicate pathogens were isolated from the 308 pediatric patients (178 males, 130 females), comprising 330 strains (77.5%) Gram-negative and 96 strains (22.5%) Gram-positive bacteria. The 5 most common organisms were: Acinetobacter baumannii (AB, 84 strains, 19.7%), Haemophilus influenzae (HI, 76 strains, 17.8%), Streptococcus pneumoniae (SP, 49 strains, 11.5%), Staphylococcus aureus (SA, 47 strains, 11.0%), and Pseudomonas aeruginosa (PA, 39 strains, 9.2%). Over the study period, HI emerged as the leading pathogen in 2024, with its isolation rate rising significantly from 8.3% (6/72) in 2018 to 36.1% (22/61) in 2024. In contrast, the isolation rates of AB and SP declined significantly from 33.3% (24/72) and 16.7% (12/72) in 2018 to 4.9% (3/61) and 1.6% (1/61) in 2024, respectively (χ2 for trend=18.75, 27.50, 9.50, all P<0.05). The overall resistance rates of HI to ampicillin, trimethoprim-sulfamethoxazole (TMP-SMZ), azithromycin, and cefuroxime were 72.4% (55/76), 71.1% (54/76), 63.2% (48/76), and 60.5% (46/76), respectively, while it remained fully susceptible to ceftriaxone. No PA isolates exhibited resistance to amikacin or piperacillin-tazobactam throughout the study. SP was universally resistant to erythromycin and clindamycin, with 71.4% (35/49) resistance to TMP-SMZ, while remaining fully susceptible to amoxicillin-clavulanate. SA had an 85.1% (40/47) resistance rate to penicillin, but retained complete susceptibility to vancomycin, linezolid, minocycline, tigecycline, TMP-SMZ, and rifampicin. Conclusions: Gram-negative bacteria predominate in SCABP among PICU patients. The pathogen spectrum has shifted significantly over time, with HI emerging as the predominant causative agent and exhibiting high resistance to multiple antibiotics. Ongoing surveillance and susceptibility-guided antibiotics selection are essential in clinical management. 目的： 分析儿童重症社区获得细菌性肺炎（SCABP）病原菌分布特征及耐药性。 方法： 回顾性队列研究。收集2018年1月至2024年12月上海交通大学医学院附属儿童医院重症监护病房（PICU）收治的308例SCABP患儿的人口学特征、实验室指标等临床资料，对患儿支气管肺泡灌洗液和痰液标本中分离出的426株非重复病原菌进行菌种分布与药物敏感性分析。根据入院年份分组，线性变化趋势采用Cochran-Armitage趋势检验。 结果： 308例SCABP患儿（男178例、女130例）共分离非重复菌426株，其中革兰阴性菌330株（77.5%），革兰阳性菌96株（22.5%）。排名前5位的细菌依次为鲍曼不动杆菌（AB）84株（19.7%）、流感嗜血杆菌（HI）76株（17.8%）、肺炎链球菌（SP）49株（11.5%）、金黄色葡萄球菌（SA）47株（11.0%）和铜绿假单胞菌（PA）39株（9.2%）。HI于2024年成为SCABP首位致病菌，分离率由2018年的8.3%（6/72）升至2024年的36.1%（22/61），AB与SP的分离率分别由2018年的33.3%（24/72）和16.7%（12/72）降至2024年的4.9%（3/61）和1.6%（1/61），差异均有统计学意义（χ2趋势=18.75、27.50、9.50，均P<0.05）。HI对氨苄西林、甲氧苄啶磺胺甲噁唑（TMP-SMZ）、阿奇霉素及头孢呋辛的总耐药率高达72.4%（55/76）、71.1%（54/76）、63.2%（48/76）、60.5%（46/76），对头孢曲松则保持全敏感。在整个研究周期内未分离出PA对阿米卡星及哌拉西林他唑巴坦的耐药菌株。SP对红霉素、克林霉素全耐药，对TMP-SMZ总耐药率为71.4%（35/49），对阿莫西林克拉维酸全敏感。SA对青霉素的总耐药率高达85.1%（40/47），对万古霉素、利奈唑胺、米诺环素、替加环素、TMP-SMZ及利福平全敏感。 结论： SCABP以革兰阴性菌感染为主。病原菌谱发生动态变化，HI已成为SCABP主要致病菌且对多种抗菌药物保持高耐药率，临床应结合药敏结果合理选用抗菌药物。.
The Sixth Conference of the Parties (COP-6) to the Minamata Convention on Mercury-a treaty administered by the United Nations Environment Programme adopted a decision to phase out the manufacture, import, or export of dental amalgam by 2034. This article reviews the background of the Minamata Convention and China's implementation process, with a focus on analyzing the policy measures taken by China to phase down dental amalgam, the promotion and application of clinical alternative materials (such as composite resins), and the corresponding adjustments in dental education. At present, the usage rate of dental amalgam in oral clinical practice of China has dropped significantly, and composite resin has become the mainstream restorative material. China has provided practical references for global mercury pollution control through multi-departmental collaboration, scientific research support and professional training. 联合国环境规划署在2025年11月召开的《关于汞的水俣公约》第六次缔约国大会上讨论产生了关于牙科汞合金管控的最新决议，会议确定淘汰牙科汞合金生产及进出口贸易的时限为2034年。本文回顾了公约的出台背景及中国履约进程，重点分析了我国在逐步减少牙科汞合金使用方面的政策和举措、口腔医学领域中对临床替代材料复合树脂和牙科粘接系统的科学研究和临床推广应用，以及口腔医学教育内容的相应调整。目前，我国在口腔临床实践中银汞合金的使用率已大幅下降，复合树脂成为主流和首选牙体缺损修复材料。中国一直致力于通过多部门协同、科研支持与专业培训，为全球汞污染治理提供了实践参考。.
Objective: To summarize the clinical characteristics, molecular genetic features, diagnosis and treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL) with myocyte enhancer factor 2D (MEF2D) gene rearrangement. Methods: In this case series study, clinical data of 9 children newly diagnosed B-ALL with MEF2D gene rearranged, admitted to the First Affiliated Hospital of Zhengzhou University from May 2020 to June 2025 were collected. The clinical characteristics, laboratory findings, treatment regimens, and outcomes of these patients were systematically analyzed. Results: A total of 9 chlidren were enrolled (3 boys and 6 girls), with the diagnostic age of 12.0 (11.0, 13.8) years. Five children initially presented with fever accompanied by arthralgia. Immunophenotyping revealed that 1 child was early precursor B-ALL and the remaining 8 children were common B-ALL. Uniformly high expression of CD38 and absence of cytoplasmic immunoglobulin M (cIgM) expression in all 9 children. Bone marrow smear examination demonstrated cytoplasmic vacuolization in 5 children. RNA sequencing detected 5 types of MEF2D gene fusion partners, including BCL9 gene in 4 children, FOXJ2 gene in 2 children, and 1 child each of DAZAP1 gene, SS18 gene, and ARNT gene. Heterozygous deletions of CDKN2A or CDKN2B gene were detected in 6 children, and 8 children exhibited concurrent gene variations. Induction therapy with the vincristine+daunorubicin+L-asparaginase+prednisone (VDLP) regimen was administered to all 9 children in accordance with＂the Clinical Practice Guideline for Childhood Acute Lymphoblastic Leukemia (2018)＂. At the end of induction remission therapy, minimal residual disease (MRD) assessed by flow cytometry were all negative (<0.01%) in all cases. One child was lost to follow-up during the maintenance phase. Three children experienced relapse and succumbed. The remaining 5 children were followed up until October 10, 2025, with 2 in disease-free survival and 3 still receiving regular treatment. Conclusions: B-ALL with MEF2D gene rearrangement predominantly affects older children, typically presenting with fever accompanied by arthralgia. This subtype exhibits high CD38 expression and absence of cIgM expression, with a frequent incidence of CDKN2A or CDKN2B gene deletions. Although the initial treatment response was good, the risk of recurrence was high and the efficacy of salvage treatment was limited. For this high-risk sub-type, the use of next-generation sequencing for MRD monitoring could be explored to more accurately assess the risk of relapse. 目的： 总结伴有肌细胞增强因子2D（MEF2D）基因重排的儿童急性B淋巴细胞白血病（B-ALL）的临床特点、分子遗传学特征及诊治要点。 方法： 病例系列研究。收集2020年5月至2025年6月郑州大学第一附属医院收治的9例伴有MEF2D基因重排的初诊B-ALL患儿的资料，分析其临床特征、实验室检查、治疗及转归情况。 结果： 9例患儿男3例、女6例，诊断年龄12.0（11.0，13.8）岁，5例以发热伴关节疼痛起病。免疫分型提示1例为早期前B-ALL，其余8例为普通B-ALL；9例均高表达CD38，不表达胞质免疫球蛋白M（cIgM）。5例骨髓涂片可见细胞伴有空泡。RNA测序检测到5种MEF2D基因融合伙伴，分别为BCL9基因4例，FOXJ2基因2例，DAZAP1基因、SS18基因及ARNT基因各1例。6例检出CDKN2A或CDKN2B基因杂合缺失，8例合并基因变异。9例患儿均按照2018儿童急性淋巴细胞白血病诊疗规范给予VDLP（长春新碱、柔红霉素、培门冬酶、泼尼松）方案诱导治疗，诱导缓解治疗结束时经流式细胞术检测微小残留病均阴性（<0.01%）。1例患儿维持治疗阶段失访，3例复发后死亡，随访至2025年10月10日2例无病生存，3例规律治疗中。 结论： 伴有MEF2D基因重排的B-ALL多见于大龄儿童，常以发热伴关节疼痛起病，高表达CD38，不表达cIgM，CDKN2A或CDKN2B基因缺失发生率高。尽管初始治疗反应良好，但复发风险高且挽救治疗疗效有限，采用二代测序进行微小残留病监测或许可更准确评估复发风险。.
Solid fundamental skills in periodontal diagnosis and treatment constitute the cornerstone of professional development and clinical competence for every dentist, particularly for periodontists. This article highlights the practical significance and urgency of strengthening such fundamental training within the current landscape of oral healthcare. These essential competencies, mandatory for both periodontists and general dentists, include periodontal examination, manual supragingival scaling, subgingival scaling and root planning, ultrasonic instrumentation, as well as basic periodontal surgical procedures such as gingivectomy and periodontal flap surgery. Proficiency in these skills is crucial for preventing periodontal diseases, arresting disease progression, and achieving long-term clinical stability. Furthermore, this article identifies seven common cognitive and operational misconceptions in current periodontal practice and proposes corresponding strategies. Neglecting fundamental skills while blindly pursuing advanced devices, complex procedures, or techniques absence of scientific evidence equates to abandoning the foundation of periodontal therapy. Therefore, continuous enhancement and innovating fundamental skills training in undergraduate, postgraduate, and dental continuing education hold strategic importance for improving the overall standard of periodontal disease prevention and treatment in China. 扎实的牙周病诊治基本功是每一位口腔医师，尤其是牙周专科医师专业发展与临床实践的基石。本文旨在探讨在当前口腔医疗环境下，加强牙周病诊治基本功训练的现实意义与紧迫性。牙周诊治基本功是牙周专科及口腔全科医师必须掌握的操作技能，涵盖牙周检查、手工龈上洁治术、龈下刮治与根面平整术、超声技术等基础治疗操作，以及牙龈切除术和牙周翻瓣术等基础性手术。熟练掌握并运用这些技能，是预防牙周疾病发生、控制其进展并获得长期稳定疗效的关键路径。本文进一步指出了当前牙周临床实践中存在的七大认知与操作误区，并提出相应对策。若忽视基本功而盲目追求高端器械、复杂操作或缺乏科学依据的新技术，无异于舍本逐末。因此，在院校教育、毕业后教育以及继续教育中持续强化并创新基本功训练模式，对全面提升我国牙周病防治水平具有重要的战略意义。.
Toluene is one of the most widely used organic solvents in industry today and is also a commonly abused inhalant among the population. Prolonged exposure to toluene causes multi-system health damage, significantly affecting public quality of life and resulting in substantial socioeconomic costs. Toluene entering the human body primarily damages the nervous system, genetic and reproductive development, as well as liver and kidney metabolic functions, while also affecting the respiratory, circulatory, and hematological systems, and may even increase the risk of cancer. This paper systematically reviews recent studies on toluene exposure levels and their associated health hazards, comprehensively presents research advances in the field, and provides insights and theoretical support for health risk assessment, prevention strategies, and future scientific research on toluene exposure. 甲苯是当前工业领域使用最广泛的有机溶剂之一，亦是人群中较为常见的滥用性吸入剂，其持续暴露引发的多系统健康损害，对公众生命质量造成严重影响，同时带来巨大的社会经济损失。进入人体的甲苯主要损害神经系统、遗传和生殖发育及肝肾代谢功能，同时伴随着对呼吸系统、循环系统和血液系统的影响，甚至增加患癌的风险。本文系统梳理近年来甲苯暴露水平及所致健康危害的研究，全面阐述领域内研究进展，为甲苯暴露的健康风险评估、防控策略制定及后续科学研究提供思路与理论支撑。.
Diffuse sclerosing osteomyelitis of the jaw (DSO) is a rare non-suppurative inflammatory bone disease of unknown etiology, characterized by a chronic course, recurrent pain, and diffuse jawbone sclerosis. Diagnosis is challenging, and conventional surgical and anti-infective therapies have limited efficacy with high recurrence. Recent studies reveal that DSO is closely associated with synovitis-acne-pustulosis-hyperostosis-osteitis syndrome. The core mechanisms involves autoinflammatory bone-immune imbalance, particularly dysregulation of the RANKL/RANK/OPG signaling pathway. Consequently, the treatment strategy for DSO has fundamentally shifted from surgery and anti-infective drugs to a precision medicine approach with bisphosphonates, as the cornerstone,and expanded to include denosumab, tumor necrosis factor-α inhibitors, and JAK inhibitors. This article systematically reviews the etiology, diagnosis, key differential diagnoses, and recent advances in pharmacotherapy, and proposes a stepped treatment algorithm. 颌骨弥漫性硬化性骨髓炎（DSO）是一种病因未明的罕见非化脓性炎性骨病，以慢性病程、反复发作性疼痛和颌骨弥漫性硬化为主要特征。该病诊断困难，传统手术治疗与抗感染治疗效果有限，且易复发。近年研究发现，DSO与滑膜炎-痤疮-脓疱病-骨肥厚-骨髓炎综合征（SAPHO综合征）密切相关，核心机制涉及自身炎症性骨免疫失衡，尤其是RANKL/RANK/OPG信号通路异常。基于上述认识，DSO的治疗策略已发生根本性转变：从以手术和抗感染为主，发展为以双膦酸盐为核心、拓展至地舒单抗、肿瘤坏死因子-α抑制剂及JAK抑制剂等生物与靶向治疗的精准管理模式。本文系统综述DSO的病因学、诊断与鉴别诊断要点，重点阐述药物治疗最新进展，并提出阶梯化治疗流程。.
Osteonecrosis of the jaw (ONJ) is an inflammatory and necrotic disease affecting the jawbones. The most prevalent forms include osteoradionecrosis of the jaws (ORNJ) following radiotherapy for head and neck malignancies, and medication-related osteonecrosis of the jaw (MRONJ) triggered by long-term use of antiresorptive, antiangiogenic, or corticosteroid agents. Although clinicians have explored diverse modalities, including pharmacotherapy, hyperbaric oxygen, and surgical intervention and several international guidelines have been published, a universal "gold standard" for ONJ management remains elusive. Significant challenges persist regarding the selection of treatment modalities for different disease stages, the timing of surgical intervention, and the restoration of jaw function. This review focuses on these clinical dilemmas, summarizes recent therapeutic advances to provide a refined reference for clinical decision-making. 颌骨坏死是颌骨组织的炎症坏死性疾病，其中口腔颌面-头颈部恶性肿瘤放疗后继发的放射性颌骨坏死（ORNJ），以及长期应用抗骨吸收、抗血管生成或激素类药物引发的药物性颌骨坏死（MRONJ）较常见。目前，针对颌骨坏死的“金标准”治疗策略仍未达成广泛共识。在疾病不同分期的治疗模式选择、手术干预的把控、颌骨功能恢复等关键问题上，仍面临诸多挑战。本文旨在聚焦临床治疗难点，对ORNJ和MRONJ的治疗方案进行比较，以期为临床决策提供参考。.
Objective: To investigate the ameliorative effect of alveolar ridge preservation (ARP) on maxillary sinus mucosal thickening caused by severe periodontitis, as well as its positive significance in preventing the occurrence of pathological maxillary sinus pneumatization. Methods: This retrospective study included 49 patients with severe periodontitis who underwent unilateral ARP of maxillary molar at the Department of Periodontology, School and Hospital of Stomatology, China Medical University, between April 2020 and April 2025. A total of 98 sites were analyzed, including 49 ARP sites and 49 contralateral control sites. According to the completeness of follow-up cone beam CT (CBCT) data and the study objectives, the analysis was divided into two parts: ①Longitudinal study: 31 patients with complete preoperative and 6-month postoperative CBCT records were included (31 ARP sites) to evaluate changes in residual alveolar bone height and maxillary sinus vertical height before and after surgery. Among these, 18 sites with odontogenic maxillary sinusitis (OMS) at baseline were further analyzed for changes in Schneiderian membrane thickness. ②Cross-sectional study: 40 patients with complete 6-month postoperative CBCT records were included (80 sites in total). The maxillary sinus vertical height at ARP sites was compared with that at contralateral naturally healed post-extraction sites (12 pairs) or contralateral healthy natural tooth sites (28 pairs). Results: In the longitudinal analysis, the vertical alveolar bone height at ARP sites significantly increased from 3.60(1.77, 5.82) mm at baseline to 6.84(4.96, 9.46) mm at 6 months postoperatively (n=31, Z=4.74, P<0.05), whereas no significant change was observed in maxillary sinus vertical height (P>0.05). At sites with OMS, Schneiderian membrane thickness significantly decreased from 5.13 (3.17, 10.90) mm preoperatively to 1.19 (0.57, 2.09) mm at 6 months postoperatively (n=18, Z=-3.62, P<0.05). In the cross-sectional analysis, the maxillary sinus vertical height at ARP sites [33.69 (28.97, 36.70) mm] was significantly lower than that at contralateral naturally healed post-extraction sites [36.45(32.76, 39.08) mm] (n=12, Z=2.98, P<0.01), while with no significant difference compared to contralateral healthy natural tooth sites (P>0.05). After adjustment for age and sex, maxillary sinus vertical height was negatively correlated with residual alveolar bone height (rpartial=-0.448, P<0.001). Conclusions: ARP may help reduce Schneiderian membrane thickening associated with severe periodontitis and may have potential clinical value in limiting post-extraction maxillary sinus pneumatization. 目的： 探究牙槽嵴保存术（ARP）对重度牙周炎所致上颌窦黏膜增厚的改善效果，以及对预防病理性上颌窦气化发生的积极意义。 方法： 回顾性纳入2020年4月至2025年4月于中国医科大学口腔医学院·附属口腔医院牙周病科因重度牙周炎行单侧上颌磨牙ARP的患者49例，共获取98个位点（含49个ARP患牙位点及49个对侧对照位点）。根据随访锥形束CT（CBCT）资料的完整性与研究目的，研究分为两部分：①纵向研究，纳入具备完整术前及术后6个月CBCT资料的31例患者（31个ARP位点），观察术前、术后剩余牙槽骨高度及上颌窦垂直高度变化；并选取其中基线伴发牙源性上颌窦炎（OMS）的18个位点，分析上颌窦底黏膜厚度的变化；②横向研究，纳入具备完整术后6个月CBCT资料的40例患者（共80个位点），比较ARP侧与对侧拔牙后自然愈合位点（12对）或对侧健康天然牙（28对）的上颌窦垂直高度差异。 结果： 纵向研究结果显示，相较于术前基线水平，ARP术后6个月31例患者（31个位点）牙槽骨垂直高度由［3.60（1.77，5.82）mm］显著提升至［6.84（4.96，9.46）mm］（Z=4.74，P<0.05），上颌窦垂直向高度与术前相比差异无统计学意义（P>0.05）；存在OMS的位点，术前18例患者（18个位点）上颌窦底黏膜厚度值［5.13（3.17，10.90）mm］在术后6个月显著降低至［1.19（0.57，2.09）mm］（Z=-3.62，P<0.05）。横向研究结果显示，12例患者（12个位点）ARP术后位点的上颌窦垂直高度［33.69（28.97，36.70）mm］显著低于对侧拔牙后自然愈合位点［36.45（32.76，39.08）mm］（Z=2.98，P<0.01），与对侧健康天然牙的上颌窦垂直高度相比差异无统计学意义（P>0.05）。在校正年龄与性别因素后，上颌窦垂直高度与剩余牙槽骨高度呈负相关关系（偏相关系数rpartial=-0.448，P<0.001）。 结论： ARP有助于改善重度牙周炎引起的上颌窦底黏膜炎性增厚，并可能在减少拔牙后上颌窦气化方面具有潜在临床价值。.
Infectious oral diseases represent the most prevalent categories of oral conditions, including dental caries, periodontitis, periapical lesions, and pericoronitis. Their bidirectional relationship with mental health has emerged as a critical interdisciplinary research frontier. This paper integrates epidemiological findings and molecular mechanism evidence to analyze the significant comorbidity and correlation characteristics between infectious oral diseases such as caries and periodontitis, and psychological disorders including depression and anxiety. Oral diseases not only directly impair mental well-being through pain, functional impairment, and social anxiety, but also induce systemic inflammatory responses that disrupt the blood-brain barrier, activate microglia, and alter neurotransmitter metabolism, thereby contributing to functional dysregulation within emotional regulatory centers. The dysbiosis of the oral microbiota caused by infectious oral diseases plays a central role in the vicious cycle of "oral infection-mental health disorders" through the"oral-gut-brain axis", inflammation-mediated neuroimmune cascades, and hypothalamic-pituitary-adrenal axis dysregulation. Meanwhile, mental disorders exacerbate oral microbial imbalance and tissue destruction through poor oral hygiene behaviors, xerostomia induced by psychotropic medications, and stress-related neuroendocrine alterations. This paper advocates for synergistically integrate oral clinical interventions with mental health improvement strategies, and for the development of microbiome-targeted precision modulation approaches. It further proposes an integrated health management paradigm that bridges dentistry and psychiatry, providing both theoretical foundations and practical pathways to transcend traditional disciplinary boundaries and achieve holistic oral-mental co-management. 口腔感染性疾病是发病率较高的一类口腔疾病，以龋病、牙周病、根尖周病、冠周炎为代表，其与心理疾病的双向关联已成为跨学科研究的重要前沿。本文整合了流行病学与分子机制研究证据，分析龋病、牙周炎等口腔感染性疾病与抑郁、焦虑障碍等心理健康问题之间存在的显著共病关系与相关性。口腔疾病不仅通过疼痛、功能障碍与社交焦虑直接损害心理健康，还可能诱发系统性炎症反应，通过破坏血脑屏障、激活小胶质细胞及改变神经递质代谢直接参与情绪调节中枢的功能紊乱。口腔感染性疾病所致的口腔菌群稳态失衡，可通过“口腔-肠-脑轴”、炎症介质驱动的神经免疫炎症级联反应以及下丘脑-垂体-肾上腺轴功能紊乱等在“口腔感染性疾病-心理健康障碍”恶性循环中起到核心作用。同时，心理疾病可通过口腔卫生行为退化、精神类药物所致口干症及应激相关神经内分泌改变，显著加剧口腔菌群失调与组织破坏。本文提出应推动口腔临床干预与心理健康改善的协同，发展以微生物组为靶点的精准调控策略，构建融合口腔医学与精神医学的综合健康管理范式，为突破传统单科诊疗局限、实现口-心共治提供理论依据与实践路径。.