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Objective To investigate the incidence and severity of enamel demineralization during clear aligner treatment and provide reference for clinical medical nursing work. Methods A total of 151 patients(3 507 teeth)undergoing clear aligner treatment in our hospital from 2015 to 2022 were collected. The enamel demineralization before and after treatment was compared, and the enamel demineralization index(EDI) was calculated to evaluate the severity of demineralization. The incidence and severity of enamel demineralization were analyzed statistically, and the differences among different genders, ages and dental positions were compared. Results Enamel demineralization occurred in 84 patients during treatment, with an incidence rate of 55.63%. Gender and treatment time had no effect on the incidence, and the incidence of adolescent patients was higher than that of adult patients. Among the investigated 3 507 teeth, 601 teeth had enamel demineralization, and the incidence rate was 17.14%. The incidence of maxillary anterior teeth and mandibular posterior teeth was higher; the incidence of right teeth was significantly higher than that of left teeth, and the incidence of teeth with adhesive attachments was also significantly increased. 88% of the enamel demineralization lesions were 1-2 degrees, and the degree of enamel demineralization was similar in male and female patients. But the degree in adolescents was significantly higher than that in adult patients. The average EDI value of maxillary anterior teeth was significantly higher than that of mandible, but that of maxillary posterior teeth was significantly lower than that of mandible. The average EDI value of right teeth was significantly higher than that of left. Conclusion The incidence of enamel demineralization is high in the process of clear aligner treatment, and teenagers are susceptible to it. The demineralization of teeth is significantly different among different tooth positions, and adhesive attachments will increase the risk of enamel demineralization. Therefore, medical staff should take active and effective measures in the prevention and treatment of enamel demineralization.

The TRPA1 ion channel is activated by electrophilic compounds through the covalent modification of intracellular cysteine residues. How non-covalent agonists activate the channel and whether covalent and non-covalent agonists elicit the same physiological responses are not understood. Here, we report the discovery of a non-covalent agonist, GNE551, and determine a cryo-EM structure of the TRPA1-GNE551 complex, revealing a distinct binding pocket and ligand-interaction mechanism. Unlike the covalent agonist allyl isothiocyanate, which elicits channel desensitization, tachyphylaxis, and transient pain, GNE551 activates TRPA1 into a distinct conducting state without desensitization and induces persistent pain. Furthermore, GNE551-evoked pain is relatively insensitive to antagonist treatment. Thus, we demonstrate the biased agonism of TRPA1, a finding that has important implications for the discovery of effective drugs tailored to different disease etiologies.

Antibiotic resistance in bacteria has become a great threat to global public health. Tigecycline is a next-generation tetracycline that is the final line of defense against severe infections by carbapenem-resistant Gram-negative bacteria. Unfortunately, this last-resort antibiotic has been challenged by the recent emergence of the mobile tet(X) orthologs that can confer high-level tigecycline resistance. This review will systematically introduce the latest progress in the type, distribution and dissemination, and genetic environment of this orthologs. At present, orthologs of tet(X) mainly include tet(X1), tet(X2), tet(X3), tet(X3.2), tet(X4), tet(X5), tet(X6) and tet(X7). The resistance gene has already been reported in a variety of bacterial hosts and spread to hospital-associated patients and environment in multiple countries/regions. The bacteria carrying tet(X3) and tet(X4) shows the highest resistance level. The insertion sequence ISCR2 is closely related to the horizontal spread of tet(X3), tet(X4) and tet(X5). In particular, the genetic environment of tet(X4) on plasmids is complex, that can be located on various mobile elements, which accelerates the spread of the drug resistance gene. The plasmid-mediated tigecycline resistance may further spread into a variety of ecological niches and into clinical high-risk pathogens and collective efforts are in urgent need to further strengthen the surveillance and research on tigecycline resistance.

Recent individual studies have indicated that ultra-processed food (UPF) consumption may be associated with the incidence of chronic kidney disease (CKD). We conducted a systematic review and meta-analysis based on those longitudinal studies evaluating the relationship between UPF consumption and the risk of incident CKD, and synthesizing the results. PubMed, Embase, The Cochrane Library, Web of Science, and Scopus were searched from inception through 22 March 2023. Any longitudinal studies evaluating the relationship between UPF consumption and the risk of incident CKD were included. Two researchers independently conducted the literature screening and data extraction. RR and its 95% CI were regarded as the effect size. The Newcastle–Ottawa Scale (NOS) was applied to assess the quality of the studies included, and the effect of UPF consumption on the risk of incident CKD was analyzed with STATA version 15.1. This study's protocol was registered in PROSPERO (CRD42023411951). Four cohort studies with a total of 219,132 participants were included after screening. The results of the meta-analysis suggested that the highest UPF intake was associated with an increased risk of incident CKD (RR = 1.25; 95% CI: 1.18–1.33). High-dose UPF intake was associated with an increased risk of incident CKD. However, the underlying mechanisms remain unknown. Thus, more standardized clinical studies and further exploration of the mechanisms are needed in the future. [ABSTRACT FROM AUTHOR]

Background: The development of the human vermiform appendix at the cellular level, as well as its function, is not well understood. Appendicitis in preschool children, although uncommon, is associated with a high perforation rate and increased morbidity. Methods: We performed single-cell RNA sequencing (scRNA-seq) on the human appendix during fetal and pediatric stages as well as preschool-age inflammatory appendices. Transcriptional features of each cell compartment were discussed in the developing appendix. Cellular interactions and differentiation trajectories were also investigated. We compared scRNA-seq profiles from preschool appendicitis to those of matched healthy controls to reveal disease-associated changes. Bulk transcriptomic data, immunohistochemistry, and real-time quantitative PCR were used to validate the findings. Results: Our analysis identified 76 cell types in total and described the cellular atlas of the developing appendix. We discovered the potential role of the BMP signaling pathway in appendiceal epithelium development and identified HOXC8 and PITX2 as the specific regulons of appendix goblet cells. Higher pericyte coverage, endothelial angiogenesis, and goblet mucus scores together with lower epithelial and endothelial tight junction scores were found in the preschool appendix, which possibly contribute to the clinical features of preschool appendicitis. Preschool appendicitis scRNA-seq profiles revealed that the interleukin-17 signaling pathway may participate in the inflammation process. Conclusions: Our study provides new insights into the development of the appendix and deepens the understanding of appendicitis in preschool children. [ABSTRACT FROM AUTHOR]

Objective: To analyze the results of irregular antibody detection in early and late pregnancy and to study its clinical significance and safety strategy. Methods: A total of 14 770 pregnant women visited Shanghai First Maternity and Infant Hospital from July 2018 to September 2019 were enrolled and detected for irregular antibodies in the first trimester (≤16 weeks) and late pregnancy (≥32 weeks). In pregnant women with positive irregular antibody, umbilical cord blood or venous blood of newborn infant were collected for the testing of hemolytic disease of fetus and newborn HDFN. Results: Of the 14 770 case of pregnant women, 63 cases had irregular antibodies detected in the early pregnancy, with a positive rate of 0.43%, while 97 cases had irregular antibodies detected in late pregnancy, with a positive rate of 0.66%( χ2=7.264, P< 0.05). The number of cases with irregular antibody detected increased by 34cases in late pregnancy, accounting for 35.05% of the total positive irregular antibody cases. Majority of irregular antibody detected were anti-M antibodies, accounting for 33.33% and 34.02% in early and late pregnancy, respectively. Anti-E antibodies accounted for 12.69% and 16.49%, respectively, while proportion of anti-D antibodies were 7.94% and 8.25%, respectively. The distribution of antibody types between early and late pregnancy was similar( χ2=2.269, P>0.05). Of the 63 cases with irregular antibodies detected in early pregnancy, the titration of antibody increased by 2 gradients in 11 cases at late pregnancy, and 7 of them reached ≥ 64. The 34 cases with irregular antibody newly detected in late pregnancy generally had lower titration of antibodies, with only 1 case with titration≥64. Amongthe fetus delivered by 97 pregnant women with irregular antibodies, 12 were confirmed having non-ABO-HDFN; 8 were delivered by pregnant women with irregular antibody detected at early pregnancy, and 6 of the 8 were of the RH system (anti-D5, anti-Ec1), with more severe symptoms requiring blood transfusion or exchange transfusion. The 4 fetuses with non-ABO-HDFN delivered by women with irregular antibody newly detected at late pregnancy had mild symptoms. Conclusions: The detection rate of irregular antibody in late stage of pregnancy in Shanghai is obviously higher than that in early stage of pregnancy. Higher titer of antibody in early stage of pregnancy may result in serious HDFN. Retesting of irregular antibody in late pregnancy has some significance for ensu-ring the safety of mother and child.