Osteonecrosis of the jaw (ONJ) is one of the most challenging diseases in the field of oral and maxillofacial surgery, mainly including osteoradionecrosis of the jaw (ORNJ) and medication-related osteonecrosis of the jaw (MRONJ). With the continuous improvement in comprehensive treatment strategies for head and neck malignancies and the increasingly widespread clinical use of antiresorptive agents and antiangiogenic drugs, the incidence of ONJ has shown a gradual upward trend. Clinically, the disease is commonly characterized by exposed necrotic bone, chronic infection, progressive destruction of the jawbone, and functional impairment, which not only severely compromises patients' quality of life but also poses substantial challenges to clinical management. In recent years, significant progress has been achieved in the understanding of the pathogenesis of ONJ, the establishment of classification and staging systems, and the development of consensus guidelines for standardized diagnosis and treatment, leading to notable improvements in clinical management. Meanwhile, advances in precision medicine, digital surgery, and regenerative medicine have provided new perspectives and therapeutic strategies for the management of ONJ. Based on recent domestic and international research progress, this article discusses the clinical challenges, advances in diagnosis and treatment, and future development directions of ONJ, aiming to provide insights for further improving diagnostic and therapeutic strategies and promoting continued research in this field. 颌骨坏死（ONJ）是口腔颌面外科领域最具挑战性的疾病之一，主要包括放射性颌骨坏死（ORNJ）及药物相关性颌骨坏死（MRONJ）。随着头颈肿瘤综合治疗水平的不断提高，以及抗骨吸收药物、抗血管生成药物等临床应用的日益广泛，ONJ的临床发生率呈逐渐上升趋势。该疾病常表现为骨组织暴露、慢性感染、颌骨破坏及功能障碍，不仅严重影响患者生活质量，也给临床诊疗带来巨大挑战。近年来，随着对发病机制认识的不断深入、分类分期体系的逐步建立及规范化诊疗共识的发布，ONJ临床诊疗水平显著提升。同时，精准医学、数字化外科及再生医学等新技术的发展，为ONJ的治疗提供了新的思路和路径。本文结合近年来国内外研究进展，从临床挑战、诊疗突破及未来发展方向等方面进行探讨，旨在为推动ONJ诊疗理念的完善及相关研究的深入提供参考与思考。.
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。.
随着对间质性肺疾病（ILD）研究的不断深入，相关的分类、术语和定义持续更新。2025年欧洲呼吸学会和美国胸科学会对间质性肺炎分类术语进行了重大修订，费莱舍尔学会和美国胸科学会也分别对ILD相关术语和肺间质异常提出新标准。准确理解和应用这些术语，对规范儿童ILD的诊断、分型、治疗以及开展多中心研究具有重要意义。.
Since the implementation of GBZ 188-2014 "Technical Specifications for Occupational Health Surveillance", it has played a significant role in the determination of target diseases in occupational health examinations, effectively safeguarding the health of workers. However, in practical applications, various occupational health examination institutions have encountered difficulties in identifying "chronic kidney disease" as an occupational contraindication and have inconsistent determination standards. Given that the new version of GBZ 188-2025 "Technical Specifications for Occupational Health Surveillance" is about to be implemented, summarizing previous quality control experiences is particularly important. From the perspective of quality control, this paper discusses the connotation and examination contents of chronic kidney disease as an occupational contraindication in the technical specifications, providing a reference for the smooth implementation of the new standard and the continuous improvement of occupational health surveillance quality. GBZ 188-2014《职业健康监护技术规范》实施以来，在职业健康检查目标疾病的判定中发挥重要作用，有力保障了劳动者健康。但在实践过程中，各职业健康检查机构对"慢性肾脏病"这一职业禁忌证存在认定困难、判定标准不统一等问题。鉴于GBZ 188-2025《职业健康监护技术规范》即将实施，总结既往质量控制经验显得尤为重要。本文从质量控制角度出发，对技术规范中职业禁忌证慢性肾脏病的内涵和检查内容进行探讨，为新版标准的顺利实施及职业健康监护质量的持续提升提供参考。.
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。.
儿童射血分数保留的心力衰竭（HFpEF）病因谱复杂、表型高度异质，常与先天性心脏病、心肌病、遗传性综合征、肺动脉高压及肥胖代谢异常等因素相关，诊断和治疗均不能简单套用成人经验。近年来，年龄分层的心功能评估、心脏磁共振成像、新型生物标志物及机制导向治疗为儿童HFpEF的识别和干预提供了新思路。现围绕儿童HFpEF的诊断评估、分子病理机制及机制导向治疗进展进行综述，以期为分层诊疗和未来研究提供参考。.
患儿，女，8月龄，于7月龄时出现血糖持续升高，诊断为糖尿病，同时存在特殊面容，身材矮小，智力、运动发育落后，反复感染等表现，家系全外显子测序提示RNU4ATAC基因在n.18（exon1）G>A和n.13（exon1）C>T位点存在复合杂合变异，该变异导致次要剪接体的重要组分U4atac小核RNA功能异常，进而引发Roifman综合征。.
Objective: To investigate the risk factors of vascular function damage in children with primary hypertension and establish a risk prediction model. Methods: In this retrospective case-control study, a total of 117 children aged 6-17 years with primary hypertension, hospitalized at Capital Center for Children's Health, Capital Medical University, between February 2024 and October 2025 were included. Flow mediated dilation (FMD) and carotid-femoral pulse wave velocity (cfPWV) were used as indicators of vascular function impairment. The children were divided into a vascular function damage group and a normal vascular function group according to the presence or absence of vascular function damage. Independent samples t-test or Mann-Whitney U test was used for intergroup comparison of measurement data, χ2 test or Fisher's exact test was used for enumeration data. Differences in clinical, laboratory and vascular function-related indicators were compared between the two groups. Multivariate Logistic regression was employed to identify independent risk factors, based on which a nomogram was constructed. The predictive performance was verified by the receiver operating characteristic (ROC) curve. Results: Among 117 hypertensive children, there were 92 (78.6%) males and 25 (21.4%) females, with the age of (13.0±2.1) years at admission. There was 58 (49.6%) with vascular function damage. The body fat percentage, 24 h mean systolic blood pressure, daytime systolic blood pressure, nocturnal systolic blood pressure, low-density lipoprotein, total cholesterol, triglycerides, homocysteine, folic acid, fasting insulin, uric acid and cfPWV levels in the vascular function damage group (58 cases) were significantly higher than those in the normal group (59 cases), while the FMD level in the vascular function damage group was significantly lower than that in the normal group (all P<0.05). Multivariate Logistic regression identified that: nocturnal systolic blood pressure (SBP) (OR=1.06, 95%CI 1.01-1.10, P=0.019), serum low-density lipoprotein (LDL) (OR=5.51,95%CI 2.41-12.58,P<0.001), and homocysteine (OR=1.11,95%CI 1.03-1.19,P=0.005) were independent risk factors for vascular function damage. A nomogram prediction model was constructed accordingly, and the Logistic regression equation was: Logit(P)=-10.73+0.05×nocturnal systolic blood pressure+1.71×low-density lipoprotein+0.10×homocysteine. The ROC curve for the nomogram showed an area under curve of 0.82 (95%CI 0.74-0.89, P<0.001), with a sensitivity of 0.76 and a specificity of 0.71. Conclusion: Nocturnal systolic blood pressure, low-density lipoprotein and homocysteine are independent risk factors for vascular function damage in children with primary hypertension. 目的： 探讨原发性高血压患儿血管功能损伤的影响因素，构建风险预测模型。 方法： 病例对照研究。选取2024年2月至2025年10月在首都医科大学附属首都儿童医学中心住院的6~17岁原发性高血压患儿117例为研究对象，以血流介导的血管舒张功能（FMD）和颈-股动脉脉搏波传导速度（cfPWV）作为血管功能损伤的评估指标，根据患儿是否存在血管功能损伤分为血管功能损伤组与血管功能正常组，组间比较采用独立样本t检验、Mann-Whitney U检验、χ2检验或Fisher确切概率法，比较两组临床、实验室及血管功能相关指标的差异。采用多因素Logistic回归筛选独立危险因素并构建列线图模型，通过受试者工作特征（ROC）曲线评价预测效能。 结果： 117例患儿中男92例（78.6%），女25例（21.4%），就诊时年龄（13.0±2.1）岁。58例（49.6%）患儿存在血管功能损伤。血管功能损伤组（58例）患儿体脂率、24 h平均收缩压、日间收缩压、夜间收缩压、低密度脂蛋白胆固醇、总胆固醇、甘油三酯、同型半胱氨酸、叶酸、空腹胰岛素、尿酸以及cfPWV水平均高于血管功能正常组（59例），FMD水平低于血管功能正常组（均P<0.05）。多因素Logistic分析显示，夜间收缩压（OR=1.06，95%CI 1.01~1.10，P=0.019）、血清低密度脂蛋白胆固醇（OR=5.51，95%CI 2.41~12.58，P<0.001）和同型半胱氨酸（OR=1.11，95%CI 1.03~1.19，P=0.005）均为血管功能损伤独立危险因素。依此构建列线图预测模型，Logistic回归方程为：Logit（P）=-10.73+0.05×夜间收缩压+1.71×低密度脂蛋白胆固醇+0.10×同型半胱氨酸，ROC曲线显示曲线下面积0.82（95%CI 0.74~0.89，P<0.001），灵敏度和特异度分别为0.76和0.71。 结论： 夜间收缩压、低密度脂蛋白胆固醇、同型半胱氨酸是原发性高血压患儿血管功能损伤的独立危险因素。.
Objective: To explore the effects of occupational stress and job burnout on productivity loss among enterprise workers, and to provide evidence for workplace mental health intervention. Methods: From April to May 2024, five enterprises in a district of Shanghai were selected by stratified purposive sampling. A cross sectional survey was conducted to collect data on occupational stress, job burnout and productivity loss. Binary logistic regression was used to analyze influencing factors and the effects of occupational stress and job burnout on productivity loss. Results: A total of 1032 valid questionnaires were collected. The prevalence of occupational stress was 55.1% (569/1032). The prevalence of job burnout was 78.9% (814/1032), including 67.8% (700/1032) mild-to-moderate and 11.0% (114/1032) severe burnout. Productivity loss was reported by 60.9% (629/1032) of workers. Significant differences in productivity loss were observed across education level, enterprise types, and monthly income (all P<0.05). After adjusting for confounders, employees with occupational stress (OR=1.88, 95%CI: 1.43-2.48, P<0.001) and severe job burnout (OR=1.81, 95%CI: 1.01-3.25, P=0.046) were more likely to have productivity loss. Conclusion: The prevalence of occupational stress and job burnout is relatively high in this occupational population and is positively associated with productivity loss. Enterprises should pay attention to occupational stress and job burnout to promote employee well-being and reduce productivity loss. 目的： 探究企业职工职业应激和职业倦怠对生产力的影响，为职业场所心理健康干预提供依据。 方法： 于2024年4至5月，采用分层目的抽样选取上海市某区5家企业，通过横断面调查收集职工职业应激、职业倦怠和生产力受损情况。用二元logistic回归分析影响因素及职业应激、职业倦怠对生产力的影响。 结果： 回收有效问卷1 032份。职业应激检出率55.1%（569/1 032）；职业倦怠检出率78.9%（814/1 032），其中轻中度67.8%（700/1 032）、重度11.0%（114/1 032）；60.9%（629/1 032）的职工存在生产力受损。不同教育程度、企业类型、月收入职工的生产力受损差异有统计学意义（P<0.05）。经控制混杂因素后，存在职业应激（OR=1.88，95%CI：1.43~2.48，P<0.001）及重度职业倦怠（OR=1.81，95%CI：1.01~3.25，P=0.046）的员工更易发生生产力受损。 结论： 该区域职业人群的职业应激和倦怠情况较为严重，且与生产力受损正向相关；企业应关注员工职业应激与职业倦怠情况，以促进员工福祉、降低生产力受损。.
Occupational health technical service institutions are no longer included in the China Inspection Body and Laboratory Mandatory Approval (CMA). RB/T 214-2017 "General Requirements for Evaluation of Qualification Accreditation Capability of Inspection and Testing Institutions" has also been officially abolished, and the original quality management system is facing the challenge of restructuring. This study proposes to combine the basic principles of quality management and specific requirements for the management of occupational health technical service institutions in China. It proposes to combine the core principles of ISO 9000 and ISO 9001 with regulatory standards such as the "Technical Review Criteria for Qualification Accreditation of Occupational Health Technical Service Institutions" and the actual situation of the institution, in order to construct a quality management system that meets the requirements of qualification review, quality supervision, and adapts to the operation of the institution. 目前，职业卫生技术服务机构已不再纳入检验检测机构资质认定（CMA）范围，RB/T 214-2017《检验检测机构资质认定能力评价　检验检测机构通用要求》亦正式废止，原有质量管理体系面临重构挑战。本研究通过梳理质量管理基本原理和我国职业卫生技术服务机构管理具体要求，提出将ISO 9000、ISO 9001核心原理与《职业卫生技术服务机构资质认可技术评审准则》等法规标准及机构实际相结合，构建符合资质评审、质量监督且适配机构运行的质量管理体系。.
The pathogenesis of medication-related osteonecrosis of the jaw (MRONJ) is complex, and the traditional bone remodeling inhibition theory cannot fully explain its pathological evolution. From a microenvironmental perspective, this review systematically reviews the critical role of "immune-vascular coupling" dysfunction in MRONJ. Long-term exposure to anti-resorptive drugs induces phenotypic polarization imbalance, metabolic disorders, and impaired efferocytosis in local macrophages, triggering persistent inflammation. Simultaneously, these drugs not only exert direct toxicity on endothelial cells but also disrupt vascular regeneration and drainage through abnormal intercellular communication. The combination of immune dysregulation and vascular degeneration ultimately leads to the failure of coordinated soft and hard tissue repair. This article aims to provide a systematic reference for the mechanistic understanding and targeted prevention and treatment of MRONJ. 药物相关性颌骨坏死（MRONJ）发病机制复杂，传统单一的骨重建抑制理论难以全面解释其病理演进。本文从微环境视角出发，系统梳理了“免疫-血管耦联”障碍在MRONJ中的关键作用。长期抗骨吸收药物暴露可能诱发局部巨噬细胞极化失衡、代谢障碍及胞葬功能受抑，引发持续性炎症。药物不仅对内皮细胞产生直接毒性，还通过异常的跨细胞通讯干扰脉管生成与引流。免疫失调与脉管退化的叠加，最终导致软硬组织协同修复失败。本文旨在为MRONJ的机制解析与靶向防治提供系统参考。.
骨性Ⅲ类错(牙合)伴牙龈退缩不仅影响牙周健康和口腔美观，也可增加正畸治疗中及治疗后的牙周并发症风险。本文展示1例骨性Ⅲ类错(牙合)伴牙龈退缩的病例，正畸治疗前采用牙周表型改善疗法，即前庭沟切口骨膜下隧道技术联合去上皮结缔组织进行软组织增量，旨在为正畸治疗创造稳定的牙周环境。治疗后牙龈退缩区实现完全根面覆盖，牙龈厚度与角化龈宽度增加且唇侧骨板保持稳定。经5年牙周-正畸联合治疗随访观察，患者牙周健康并对美学效果满意，可为临床多学科联合治疗提供参考。.
Three-dimensional (3D) tooth shape completion refers to the process of predicting and reconstructing the intact tooth morphology based on defective 3D inputs obtained from intraoral or laboratory scanner. The generated result serves as a digital diagnostic wax-up, offering clinicians a visualized treatment target and outcome preview, thereby aiding in clinical diagnosis and treatment planning. This review summarizes the current applications of artificial intelligence in 3D tooth shape completion, focusing on major research progress in commonly used algorithmic models, datasets, ground truth acquisition, control model configuration, and evaluation metrics. It aims to provide guidance for future related studies. 牙齿三维形状补全是基于口内扫描或仓式扫描获得的缺损牙齿三维模型，预测并重建完整牙齿形状的过程。该过程的最终目标是生成数字化诊断模型，从而为临床提供可视化的治疗目标和效果预览，以辅助临床诊疗。本文综述人工智能技术在牙齿三维形状补全中的应用现状，重点介绍常用的算法模型、数据集、参考标准、对照模型和评价指标等方面的进展，以期为后续研究提供参考。.
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。.
Objective: To define the causal time-series link between blood pressure and the body mass index (BMI) using cross-logged pathway analysis. And to determine the moderating role of blood lipids in the relationship between BMI and blood pressure. Methods: In January 2022, a study was conducted involving 19, 959 oil workers in Xinjiang who participated in the study in 2022 and completed their follow-up in 2023. The BMI, total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and blood pressure of the research subjects were measured repeatedly during the follow-up period. The correlations between BMI, TG, HDL and blood pressure at baseline time point and follow-up time point were analyzed by Spearman rank correlation. A cross-lagged pathway analysis model was used to analyze the causal time-series link between BMI, TG, HDL and increased blood pressure in temporal fluctuation. And bootstrap method was adopted to further understand the mediating role of TC and TG in the association between BMI and blood pressure. Results: The results of the correlation analysis showed that the baseline BMI, TG of the Xinjiang oil workers were positively correlated with the follow-up systolic blood pressure (SBP) and diastolic blood pressure (DBP) (r(s)=0.020, 0.017, 0.015, 0.016, P<0.05), while the baseline HDL was negatively correlated with the follow-up SBP and DBP (r(s)=-0.015, -0.017, P<0.05). The cross-lagged pathway analysis results showed that the baseline BMI of Xinjiang oil workers was positively correlated with the follow-up SBP and DBP levels (ρ=0.085, 0.047, P<0.05), the baseline TG was positively correlated with the follow-up SBP and DBP levels (ρ=0.133, 0.094, P<0.05), and the baseline HDL was negatively correlated with the follow-up SBP and DBP levels (ρ=-0.651, -0.505, P<0.05). The mediating analysis results showed that the levels of TC and TG played a partial mediating role in the relationship between BMI and SBP, DBP among Xinjiang oil workers, and the results were statistically significant (P<0.05) . Conclusion: The BMI rises occur before the changes in blood pressure among oil workers. In addition, the lipid changes that emerged after the increase of BMI play a partial mediating role in the causal link between BMI and blood pressure. 目的： 采用交叉滞后路径分析探索体质指数（BMI）和血压之间的因果时序关系，了解血脂在BMI和血压关系间的中介作用。 方法： 于2022年1月，将2022年参与研究同时在2023年完成随访的19 959名新疆石油工人作为研究对象，随访期间重复测量研究对象的BMI、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、血压等数据，通过Spearman秩相关分析基线时间点和随访时间点BMI、TG和HDL与血压之间的相关性，采用交叉滞后路径分析模型分析BMI、TG、HDL在时间变化中和血压升高的因果时序关系，使用bootstrap方法进一步了解TC、TG在BMI和血压之间的中介作用。 结果： 相关性分析结果显示，新疆石油工人基线BMI、TG与随访收缩压（SBP）、舒张压（DBP）之间均呈正相关（r(s)=0.020、0.017、0.015、0.016，P<0.05），基线HDL与随访SBP、DBP之间呈负相关（r(s)=-0.015、-0.017，P<0.05）。交叉滞后路径分析结果显示，新疆石油工人基线BMI与随访SBP和DBP水平呈正相关（ρ=0.085、0.047，P<0.05），基线TG与随访SBP和DBP水平呈正相关（ρ=0.133、0.094，P<0.05），基线HDL和随访SBP和DBP水平呈负相关（ρ=-0.651、-0.505，P<0.05）。中介分析结果发现，TC和TG水平在新疆石油工人BMI与SBP和DBP的关系中起部分中介作用，结果具有统计学意义（P<0.05）。 结论： 石油工人的BMI增加先于血压变化，并且在BMI增加后出现的血脂变化在BMI和血压的因果关系中起部分中介作用。.
Objective: To understand the current status of chronic disease multimorbidity among steel workers, and to further explore the correlation between occupational hazardous factor exposure with chronic disease multimorbidity among steel workers. Methods: From March to June 2017, 6560 steel workers who participated in the 2017-2018 occupational health examinations at a steel company in Tangshan City were selected as study subjects from the Health Effects Cohort of the Beijing-Tianjin-Hebei Region were sellected as the research subjects. Data on their demographic characteristics, work-related factors, lifestyle behaviors, and prevalence of chronic diseases were collected. Their height and weight were measured, biochemical indicators were tested, and the occupational hazardous factor exposure of research subjects was assessed. The prevalence of chronic disease multimorbidity among steel workers with different characteristics were compared, and logistic regression analysis was used to at analyze the relationship between the occupational hazardous factor exposure and the prevalence of chronic disease multimorbidity among steel workers. Results: Among the 6560 study subjects, the prevalence of chronic disease multimorbidity was 62.1% in men (3729/6001) and 24.7% in women (138/559). There were statistically significant differences in the prevalence of chronic disease multimorbidity among steel workers in different age, sex, educational attainment, monthly per capita household income, marital status, smoking status, alcohol consumption, family history of multiple diseases, body mass index (BMI), and dietary approaches to stop hypertension (DASH) group (P<0.05). After adjusting for age, sex, educational attainment, monthly per capita household income, marital status, DASH group, smoking status, alcohol consumption, family history of multiple diseases and BMI, multivariable logistic regression showed that, compared with their respective control groups, cumulative night shift exposure ≥2601 d, cumulative high-temperature exposure ≥776 °C·years, cumulative noise exposure ≥1721 dB (A) ·years, and cumulative dust exposure ≥40.47 mg/m(3)·years were all associated with increased odds of chronic disease multimorbidity among steel workers (OR=3.34, 95%CI: 2.29-4.85; OR=2.63, 95%CI: 1.74-3.97; OR=2.75, 95%CI: 1.95-3.88; OR=2.28, 95%CI: 1.62-3.23; P<0.001) . Conclusion: The prevalence of chronic disease multimorbidity in male steel workers is higher than that in females. Night shift, high temperature, noise and dust exposure are all risk factors for chronic disease multimorbidity in steel workers. 目的： 了解钢铁工人慢性病共病患病现状，并进一步探讨职业性有害因素暴露与钢铁工人慢性病共病患病的关联性。 方法： 于2017年3月至6月，以京津冀地区职业人群健康效应队列中参加唐山市某钢铁公司2017至2018年职业健康体检的6 560名钢铁工人为研究对象，收集其人口学资料、工作有关特征、行为生活方式和慢性病患病情况等资料；测量其身高、体重，检测血生化等指标，评估研究对象职业性有害因素暴露情况；比较不同特征钢铁工人慢性病共病患病率的差异，并采用logistic回归分析职业性有害因素暴露与钢铁工人慢性病共病患病间的关联。 结果： 6 560名研究对象中，男性慢性病共病患病率为62.1%（3 729/6 001），女性为24.7%（138/559）；不同年龄、性别、文化教育程度、家庭人均月收入、婚姻状况、吸烟情况、饮酒情况、多重疾病家族史情况、体重指数（BMI）、高血压防控饮食模式（DASH）分组的钢铁工人慢性病共病患病率差异有统计学意义（P<0.05）。调整年龄、性别、文化教育程度、家庭人均月收入、婚姻状况、DASH分组、吸烟情况、饮酒情况、多重疾病家族史、BMI等因素后，多因素logistic回归结果显示，与相应对照组比较，夜班累积暴露天数≥2 601 d、高温累积暴露量≥776 ℃·年、噪声累积暴露量≥1 721 dB（A）·年及粉尘累积暴露量≥40.47 mg/m(3)·年的钢铁工人慢性病共病患病风险均增加（OR=3.34，95%CI：2.29~4.85；OR=2.63，95%CI：1.74~3.97；OR=2.75，95%CI：1.95~3.88；OR=2.28，95%CI：1.62~3.23；P<0.001）。 结论： 男性钢铁工人慢性病共病患病率高于女性；夜班、高温、噪声和粉尘暴露与钢铁工人慢性病共病的患病风险增加相关。.
以罕见危重感染患儿千里救治案例为切入点，叙事团队精准诊疗、精细化护理、溯源治本的全过程，展现科室精湛的医疗技术与人文医者的爱心温度。科室始终坚守儿童健康守护初心，深耕临床、精修医术、勇担公卫使命，代代赓续医者仁心与责任担当，为儿童传染感染性疾病和肝病防治、公共卫生安全筑牢屏障，生动诠释了新时代儿科人的医者使命与家国情怀。.
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。.
In 2024, the Board of Trustees of the American Association of Orthodontists (AAO) established a special task force consisting of AAO members, academics, and clinicians deeply engaged in the field of dental sleep medicine to evaluate and update the content of the 2019 White Paper entitled Obstructive Sleep Apnea (OSA) and Orthodontics. This paper presents a professional interpretation of the updated white paper. By integrating the national contextual differences in orthodontic clinical practice between China and other countries, it clarifies the core positioning and professional boundaries of orthodontists in the management of sleep-disordered breathing (SDB). Meanwhile, based on the actual clinical situation in China, it provides practical guidance for orthodontists to implement the concepts of the white paper and standardize clinical practices. 2024年，美国正畸医师协会理事会组建专项工作组，成员包括正畸学会会员以及深耕睡眠医学领域的口腔学者与临床医师，评估并更新2019年版《阻塞性睡眠呼吸暂停与正畸学白皮书》内容，发布《睡眠呼吸障碍与口腔正畸：美国正畸医师协会白皮书2026年更新》。本文针对此次更新的白皮书展开专业解读，结合中外正畸临床国情差异，明晰正畸医师在睡眠呼吸障碍诊疗中的核心定位，同时立足我国临床实际，为正畸医师践行白皮书理念、规范临床操作提供实践指引。.