Occlusion refers to the contact relationship between the upper and lower teeth.Its biomechanical properties influence motor function,most often in the orofacial and cervical regions,and the patient's psychological well-being as well.In this review,we summarized age-related changes in occlusion and the corresponding clinical management and preventive strategies from three perspectives—the functional characteristics of normal occlusion and their age-related changes,the effects of abnormal occlusion on health and the potential neurophysiological mechanisms involved,and age-related changes in occlusion and the corresponding preventive and therapeutic approaches.Abnormal wear of the occlusal surfaces alters the biomechanical relationship of occlusion.Animal studies have shown that abnormal biomechanical occlusion may result in the following problems:1)periodontal trauma;2)dysfunction of the orofacial and cervical muscles and vagus nerve-related visceral motor dysfunction through synaptic connections between neurons in the mesencephalic trigeminal nucleus and motor neurons in the trigeminal motor,facial,accessory,hypoglossal,and dorsal vagal nuclei;and 3)psychological responses such as anxiety,mediated via effects on neuronal activity in the lateral habenular nucleus.The wear coefficients of dental restorative prostheses differ from those of natural teeth.Long-term use of dental prostheses increases the risk of wear mismatch between natural and artificial teeth,which may lead to increased risk of occlusal interference.Tooth wear is the most common manifestation of age-related changes in occlusion.In addition to malocclusion,missing teeth,and pre-existing prostheses,many older patients also present with periodontal disease.Prolonged failure to replace missing teeth may lead to progressive occlusal disturbances,characterized by tilting of adjacent teeth and elongation of opposing teeth.When age-related wear is superimposed on malocclusion,periodontal disease,and missing teeth,it not only exacerbates the adverse health effects of abnormal occlusion but also substantially complicates treatment.Therefore,early diagnosis and treatment of malocclusion and periodontal diseases are essential to the prevention of situations where orthodontic intervention becomes extremely challenging in old age.Missing teeth should be restored promptly to prevent secondary occlusal disorders.For dental prostheses,careful attention should be paid to material selection and biomechanical design.Excessively hard materials should be avoided to prevent the development of interfering occlusal contacts.In addition,prostheses should be replaced regularly to reduce occlusal problems arising from uneven physiological wear and the associated secondary health consequences.
With the high-quality development of China's medical and health care industry,the outsourcing of laboratory examinations by health care institutions has become an important supplementary approach to alleviate the shortage of medical resources and provide precise medical services.Drawing on management practices for outsourced laboratory examinations,this article systematically identifies legal,ethical,and management risks in outsourced laboratory testing,deeply analyzes the root causes of these risks,and in combination with the relevant regulatory requirements of health and wellness administrative departments,proposes targeted prevention and control strategies,The goal is to standardize the outsourcing of laboratory testing by health care institutions,prevent medical safety and integrity risks,protect patients'legitimate rights and interests,and maintain the public welfare and credibility of the medical industry.
Objective To investigate the effect of Shashen Maidong Decoction(SMD)on inflammaging in a mouse model of chronic obstructive pulmonary disease(COPD),and to determine whether its efficacy is mediated by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase(cGAS)-stimulator of interferon genes(STING)-nuclear factor-kappa B(NF-κB)signaling pathway.Methods Female and male C57BL/6JNifdc mice(half male and half female)aged 18-20 months were selected to establish a COPD model was subsequently established via cigarette smoke exposure combined with intranasal lipopolysaccharide instillation.The mice were randomly assigned to 6 groups,including a normal control group,a model group,low-,medium-,and high-dose SMD groups(receiving 8.3,16.5,and 33.0 g/kg,respectively),and a dexamethasone group(3 mg/kg),with 8 mice in each group(4 males and 4 females).Starting on the day after modelling,the mice received daily intragastric administration for 12 weeks(normal control and model groups received sodium carboxymethyl cellulose at 0.15 mL/10 g).Pulmonary function parameters,including resistance of the respiratory system(Rrs),elastance of the respiratory system(Ers),the ratio of forced expiratory volume in 0.2 seconds to forced vital capacity(FEV0.2/FVC),and forced expiratory flow at 50%of vital capacity(FEF50%),were measured.Lung histopathology was evaluated by hematoxylin and eosin(HE)and Masson's trichrome stains.Serum inflammatory factors,including interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),and tumor necrosis factor α(TNF-α),as well as oxidative stress markers,including superoxide dismutase(SOD)and malondialdehyde(MDA),were assessed.In addition,the mRNA and protein expression levels of senescence-associated proteins(p16 and p21)and the cGAS-STING-NF-κB pathway molecules in lung tissues were determined.Results Compared with the normal control group,mice in the model group exhibited impaired pulmonary function,characterized by increased Rrs and decreased Ers,FEV0.2/FVC,and FEF50%.Histopathologic examination demonstrated massive inflammatory cell infiltration,bronchiolar wall thickening,and destruction of alveolar structures.The levels of serum inflammatory factors and MDA were increased,whereas SOD activity was decreased,demonstrating statistically significant differences(all P<0.01).Furthermore,the mRNA and protein expression levels of senescence-associated proteins and cGAS-STING-NF-κB pathway molecules were significantly elevated in lung tissues(all P<0.01).Compared with the model group,the medium-and high-dose SMD groups showed significantly improved lung function parameters,decreased serum inflammatory factors and MDA levels,and increased SOD activity(all P<0.05).In addition,the expression levels of senescence-associated proteins and cGAS-STING-NF-κB pathway molecules in lung tissues were significantly downregulated(all P<0.05).Conclusion SMD ameliorates lung function impairment,particularly FEV0.2/FVC,in COPD mice.The underlying mechanism may have involved the inhibition of inflammaging mediated by the cGAS-STING-NF-κB signaling pathway.SMD can protect against lung function impairment,particularly centered on FEV0.2/FVC,in COPD mice.The potential mechanism may involve the inhibition of inflammaging mediated by the cGAS-STING-NF-κB signaling pathway.
Objective To investigate the effect of long-term exposure to PM2.5 and its chemical components on frailty risk among middle-aged and older adults in China.Methods A prospective cohort study was conducted using data from the China Health and Retirement Longitudinal Study(CHARLS)collected between 2011 and 2020 and the Tracking Air Pollution(TAP)dataset.The frailty status of the participants was assessed using the frailty index.A time-dependent Cox proportional hazards model was applied to examine the associations between frailty risk and long-term exposure to PM2.5 and its chemical components,including black carbon,organic matter,sulfate,nitrate,and ammonium.Results A total of 9 603 participants were included in the analysis.After adjusting for potential confounders,each interquartile range increase in the average PM2.5 concentration during the preceding year was associated with a 10.0%higher risk of frailty(hazard ratio[HR]=1.100,95%CI:1.015-1.193).For individual chemical components,each interquartile range increase in the one-year average concentrations of organic matter,black carbon,ammonium,sulfate,and nitrate,the participants were exposed to was associated with a 14.2%(HR=1.142,95%CI:1.055-1.236),13.1%(HR=1.131,95%CI:1.041-1.229),9.8%(HR=1.098,95%CI:1.010-1.194),8.8%(HR=1.088,95%CI:0.996-1.187),and 8.1%(HR=1.081,95%CI:0.996-1.172)higher risk of frailty,respectively.Conclusion Long-term exposures to PM2.5 and its chemical components,particularly black carbon,organic matter,and ammonium,were associated with a higher risk of frailty among middle-aged and older adults in China.Priority should be given to strengthening emission control of black carbon and organic aerosols to mitigate the public health burden of air pollution in the context of an aging society.
Objective To evaluate the clinical efficacy of body scan mindfulness training as an intervention for patients with burning mouth syndrome(BMS).Methods This randomized,controlled,single-blind clinical trial enrolled patients with BMS who met the inclusion and exclusion criteria.Participants were assigned to a control group or an intervention group using a random number table.The control group received pharmacological treatment and routine psychological care,while the intervention group additionally received two weeks of body scan mindfulness training.The Visual Analog Scale(VAS),Insomnia Severity Index(ISI),Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),and Oral Health Impact Profile(OHIP-14)were used to assess pain intensity,sleep quality,anxiety,depression,and oral health-related quality of life,respectively,at baseline,immediately after the intervention,and 3 months after the intervention.The efficacy of body scan mindfulness training for patients with BMS was evaluated by comparing changes in the primary outcome measure(VAS)and secondary outcome measures(ISI,GAD-7,PHQ-9,and OHIP-14)between the two groups before and after the intervention.Results A total of 80 patients were enrolled in this study;3 were lost to follow-up,and 77 patients(38 in the control group and 39 in the intervention group)were included in the analysis.The median changes(P25,P75)in VAS,ISI,GAD-7,and PHQ-9 scores after the intervention in the experimental group were 2.00(1.00,3.00),3.00(0.00,8.00),3.00(1.00,6.75),and 2.00(0.00,5.00),respectively.These were all greater than the corresponding changes in the control group(0.95[0.00,2.50],0.00[0.00,3.00],1.00[0.00,3.25],and 1.00[0.00,2.00]),with statistically significant differences.(P<0.05).No significant difference was observed in the reduction of OHIP-14 scores between the two groups(P>0.05).Both immediately after the intervention and at 3 months post-intervention,the VAS score remained significantly lower in the intervention group than in the control group(P<0.05).Conclusion For patients with BMS,implementing body scan mindfulness training alongside conventional drug treatment has proven effective in alleviating the intensity of oral burning pain,improving sleep quality,and reducing anxiety and depression.These findings suggest that body scan mindfulness training is a promising adjuvant therapy for patients with BMS receiving conventional drug treatment,and warrants broader clinical adoption.
