Background: Drug-related problems (DRPs) might lead to adverse drug events, and medication errors have received extensive attention among the public and health care system worldwide. The purpose of this study was to identify common drug-related problems (DRPs) during pharmacy consultation in outpatient pharmacies by implementing a counseling model. Method: We conducted a prospective study in the outpatient pharmacy of a tertiary academic hospital for 16 months. A counseling model was implemented by a pharmacy team, and data were collected during pharmacy consultation. Data analysis was performed on identified DRPs, causes and their relationships. Problem-level descriptive analysis and network analysis were conducted using R 3.6.3. Result: Pharmacists identified 504 DRPs during pharmacy consultation with primarily adverse drug events (ADEs, 26.98%) and untreated symptoms or indications (16.67%). The most frequent drug classes correlated with DRPs were ‘cardiovascular system’ drugs (13.39%), followed by ‘traditional Chinese medicine’ (12.71%) and ‘alimentary tract and metabolism’ drugs (12.54%). Most DRPs were due to necessary information not provided in dispensing and drug selection. More than 98.25% of advice given by the pharmacist was accepted or taken into consideration, and 97% of patients reported that their medication problems were totally or partially solved. Conclusion: Implementation of the counseling model appears to be a means to improve drug use by serving as an important tool to increase the identification and resolution of DRPs, resulting in positive experiences in both pharmacy practitioners and patients.

INTRODUCTION AND AIMS:Periodontal ligament stem cells (PDLSCs) from deciduous teeth (DePDLSCs) can perceive and respond to mechanical signals upon exposure to various environments. The effects of mechanical stress on the biological characteristics and metabolism of DePDLSCs were investigated using in vitro stress loading. METHODS:DePDLSCs were subjected to mechanical stresses of different strengths. Cell proliferation, expression of osteogenic/osteoclastic factors, apoptosis, and oxidative stress levels were evaluated using CCK-8 assays, alkaline phosphatase staining, real-time PCR, flow cytometry, and malondialdehyde and superoxide dismutase assays. Liquid chromatography-mass spectrometry was used to perform nontargeted metabolomic detection and analysis. RESULTS:Under stresses of 75 and 150 kPa, the expression of osteogenesis-related factors OPG, ALP, and RUNX2 decreased, and the ratio of RANKL/OPG significantly increased. A pressure of 150 kPa induced oxidative stress and caused a significant increase in cell apoptosis. Among the differential metabolites screened from the 150 kPa group, spermine, spermidine, ceramide, phosphatidylethanolamine, lysophosphatidylethanolamine, linoleic acid, and docosatrienoic acid were the most significantly upregulated. The metabolites screened from the 75 kPa group were mainly related to glycerophospholipid and sphingolipid metabolism, oxidative phosphorylation, and mineral absorption, which were common pathways affected in both experimental groups. CONCLUSION:A certain degree of mechanical stress can inhibit the proliferative activity and osteogenic differentiation of DePDLSCs, enhance their osteoclast-inducing ability, and cause elevated levels of cell apoptosis and oxidative stress. The metabolic expression profile of DePDLSCs changed significantly under stress. Understanding changes in cellular activity and metabolic reactions may provide an experimental basis for elucidating the role of mechanical stress in root resorption and periodontal tissue remodelling of deciduous teeth. CLINICAL RELEVANCE:Mechanical stress may affect periodontal tissue remodeling and root resorption of DePDLSc.

Introduction: To evaluate the long-term efficacy of in situ tooth fragment reattachment combined with pulpotomy for treating complicated crown-root fractures in young permanent anterior teeth. Case description: A case of a complicated crown-root fracture (Andreasen Class II) in the maxillary right central incisor (tooth 11) of a 10-year-old patient was reported. The fracture line extended obliquely from approximately 2 mm above the gingival margin on the labial surface to the subgingival area on the palatal side, with pulp exposure and an open apex. A two-step protocol was performed: Pulpotomy (palatal access, removal of coronal pulp 3 mm below the fracture line, iRoot BP Plus pulp capping, and glass ionomer base placement); In situ fragment reattachment (preservation of the palatal fragment and natural periodontal seal, labial bevel preparation at the fracture line, and dual-cure resin bonding for both supragingival and intrapulpal fracture surfaces). Five-year follow-up assessed reattached fragment stability, pulp vitality, and root development. Discussion: At 5-year follow-up, the reattached fragment remained intact without displacement, with slight discoloration and healthy gingiva. Radiographs revealed dentinal bridge formation and completed root development in tooth 11. Normal occlusal function and high patient satisfaction were achieved. Conclusion/clinical significance: In situ fragment reattachment combined with pulp preservation enables biological reconstruction of young permanent teeth with complicated crown-root fractures through minimally invasive procedures. This approach promotes root development, restores partial function, and provides a transitional solution until definitive adult restoration, offering a conservative and pulp-preserving strategy for pediatric patients.

OBJECTIVES:This study aimed to evaluate the clinical application value of in-situ crown reattachment technique combined with pulpotomy in the treatment of complicated crown-root fractures in young permanent anterior teeth. METHODS:A prospective study was conducted on 50 children with complicated crown-root fractures in young permanent anterior teeth, who were treated at the Pediatric Dentistry Department, Hospital of Stomatology, Xi'an Jiaotong University from June 2023 to June 2024. All patients underwent in-situ crown reattachment technique combined with pulpotomy. Clinical examinations, radiographic evaluations, and subjective satisfaction surveys (using a Likert scale of 1-10) were conducted at 1, 6, and 12 months postoperatively. Data were analyzed using SPSS 23.0. RESULTS:The loss-to-follow-up rate was 12% (6/50), with 44 cases completing the 12 months of evaluation. The clinical success rate was 93.18% (41/44), and the radiographic success rate was 97.73% (43/44). The subjective satisfaction scores showed a significant improvement in masticatory function from 7.03±0.52 at 1 month to 8.07±0.92 at 12 months postoperatively (P<0.05), whereas the scores for aesthetics, comfort, and quality-of-life impact showed no statistically significant differences (P>0.05). CONCLUSIONS:In-situ crown reattachment technique combined with pulpotomy effectively treats complicated crown-root fractures in young permanent anterior teeth, demonstrating a high short-term clinical success rate, significantly improved masticatory function, and minimally invasive preservation of pulp vitality and root development potential. This technique provides an optimized treatment option for dental trauma in children, although its long-term efficacy requires further validation.

Introduction: A 3-year-old child with severe early childhood caries (S-ECC) was treated under general anesthesia, with all 20 primary teeth requiring therapeutic intervention. Due to the patient’s young age, extensive carious involvement, and inability to cooperate with routine dental procedures in an outpatient setting, general anesthesia proved to be an ideal approach. Case description: The patient presented to the hospital with the chief complaint of ''multiple cavities in the entire mouth over six months.'' Following a comprehensive oral examination and radiographic evaluation, the diagnoses included: Moderate caries in teeth 55 and 65; Deep caries in teeth 53, 54, 63, 64, 71, 72, 73, 81, 82, and 83; Pulpitis in teeth 74, 75, 84, and 85; Chronic pulpitis in teeth 51, 52, and 62; Chronic apical periodontitis in tooth 61; Interventions included composite fillings, indirect pulp capping, pulpotomy, stainless steel crowns for posterior teeth, and esthetic strip crowns for anterior teeth, achieving favorable clinical outcomes. Discussion: The management of S-ECC with coexisting crowded primary dentition requires meticulous planning. In this case, the anatomical complexity impeded plaque control, exacerbating caries progression. The single-visit comprehensive rehabilitation under general anesthesia not only addressed acute pathologies but also mitigated long-term risks through preventive restorations (e.g., stainless steel crowns). Crowding-induced challenges underscore the need for interdisciplinary collaboration between pediatric dentists and orthodontists. Conclusion/clinical significance: This case highlights the importance of addressing both behavioral factors (e.g., oral hygiene practices) and anatomical risk factors (e.g., dental crowding) in pediatric caries prevention strategies.

目的:系统评价奥希替尼治疗晚期非小细胞肺癌(NSCLC)的经济性,为临床应用及卫生和医保决策者提供参考.方法:计算机检索PubMed、Embase、Cochrane图书馆、Health Technology Assessment、中国知网、万方数据、维普网和中国生物医学文献数据库等数据库,查询自建库至2020年4月公开发表的有关奥希替尼治疗晚期NSCLC的相关药物经济学研究,经筛选并提取相关资料后,采用健康经济学研究质量评估工具(QHES)评估纳入研究的质量,采用描述性分析方法系统评价纳入文献的经济学研究结果.结果 与结论:共纳入10项研究,来自7个不同的国家;纳入文献的QHES评分为73～93分,平均86.8分,研究质量总体较高.10项研究均为成本-效果分析,其中一线治疗6项、二线治疗4项;6项研究报告了成本贴现率;仅有1项研究采用奥希替尼降价后的价格进行评估分析.奥希替尼作为一线治疗方案与其他表皮生长因子受体-络氨酸激酶抑制剂(EGFR-TKI)类药物相比,来自不同国家的6项研究结果均显示奥希替尼不具有成本-效果优势;奥希替尼二线治疗对比化疗方案的成本-效果则存在一定争议.对于晚期NSCLC患者,经国家集中谈判降价后的奥希替尼二线治疗相比于化疗方案在我国医疗服务体系下更具有成本-效果优势,而降价前的奥希替尼一线治疗相比于其他EGFR-TKI类药物则不具备成本-效果优势.

目的:体外比较单支锉ProTaper Sx和不锈钢K锉预备乳牙根管的时间和根尖推出物量.方法:门诊收集离体乳牙,经截冠、分根后,按远中根管、近中根管、前牙根管、腭根管、近颊根管及远颊根管六种根管类型各收集16个,共96个.将每种类型根管随机均匀分配至Sx组(n=48)和K锉组(n=48).分别用ProTaper Sx和不锈钢K锉进行根管预备,各根管均用10 mL 0.2％氯己定溶液冲洗,记录预备时间、测定根尖推出碎屑量和根尖渗出冲洗液量,进行统计学分析.结果:K锉组(328.8s)的预备时间是Sx组(180.9 s)的近1.8倍,差异有统计学意义(P<0.05).两种器械均会造成一定的根尖推出物,但推出物的量不同.Sx组的根尖推出碎屑量和根尖渗出冲洗液量(0.00128±0.00056)g;(0.00614±0.00183)g均低于K锉组(0.00345±0.00124)g;(0.02930±0.01879)g,差异均有统计学意义(P<0.05).结论:与不锈钢K锉相比,单支锉ProTaper Sx预备乳牙根管具有预备时间短、根尖推出物量少的特点.

ObjectiveThis article reviewed research conducted on economic evaluations of clinical pharmacy services (CPS) in China. We aimed to identify the types of CPS and the possible economic effects of these services and to hopefully provide some suggestions for designing future economic evaluations of pharmacy interventions in the region.DesignSystematic review.Data sourcesSeveral English databases (PubMed, Embase, The Cochrane Library, National Health Service Economic Evaluation Database), Chinese databases (China National Knowledge Infrastructure, VIP, Chinese Biomedical Literature Database and WanFang Data) and search engines (Google Scholar and BaiDu Scholar) were searched through December 2017.Eligibility criteria for selecting studiesStudies with an economic assessment of CPSs in China were included.Data extraction and synthesisTwo reviewers independently screened the studies, extracted the data, assessed the quality of the included studies and then qualitatively analysed the results.ResultsForty articles were included in the final analysis. Most studies were performed in hospitals and the intervention populations mainly included adults. The types of pharmaceutical services included antimicrobial management, chronic disease state management and multidimensional clinical pharmaceutical services. A positive economic benefit associated with CPS was noted in 80% (n=32) of these articles, showing that CPS were associated with cost savings and improved patient outcomes. However, only three studies were full economic evaluations, using the method of cost-effectiveness analysis.ConclusionCPS was associated with cost savings and generated positive economic value. With the expanding role of pharmacists in the healthcare sector, it is suggested that new pharmaceutical services be used in future studies and that high-quality full economic evaluations capturing both expenses and cost savings be conducted.

富血小板纤维蛋白(PRF)源于自体,主要成分包括纤维蛋白、血小板生长因子和白细胞等,具有制备简单、应用安全、无伦理学应用限制等优势,其中各种成分的共同作用在炎症调节、血管生成以及软硬组织修复再生等生理过程中发挥着重要功能,在年轻恒牙治疗中具有很大的应用潜力.目前,PRF作为一种新型医学材料,已逐步应用于年轻恒牙牙髓再生、根尖屏障、延迟再植和活髓保存等治疗,且疗效良好.随着PRF在年轻恒牙治疗中的应用,其具体作用机制和临床优势逐渐显现.

目的:通过曲面体层片(PR)描述非异位萌出的第一恒磨牙萌出过程中在影像片中的变化特点.方法:纳入5～10岁青少年及儿童所拍摄的573张PR,测量计算第一恒磨牙倾斜角度、水平垂直距离比值.将所得数据进行统计分析绘制随年龄变化折线图.结果:上颌第一恒磨牙倾斜角度随年龄增加而降低,变化范围为115°～97°,水平向距离比值逐渐降低,从0.45～0.42,男性变化范围稍小于女性;下颌第一恒磨牙倾斜角度随年龄增加而逐渐增加,范围为66°～73°,水平向距离比值均随年龄增加而逐渐降低,下颌变化范围为0.65～0.55,且下降速度快于上颌.结论:5～10岁儿童上颌第一恒磨牙萌出过程中牙体倾斜角度随年龄增加而减小,下颌第一恒磨牙倾斜角度随年龄增加而逐渐增大;第一恒磨牙牙胚在萌出过程中逐渐向方及近中移动.

OBJECTIVE:The prevalence rate, distribution, and reasons of immature permanent-tooth trauma in Xi'an were investigated and described, and a scientific basis was provided for the decision-making of health-administration departments.METHODS:Through cluster and simple random sampling survey, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled. All pupils and their parents were requested to complete a questionnaire. Oral examinations were conducted for children who had immature permanent teeth trauma. The number of trauma teeth and teeth were recorded. Survey data were analyzed statistically.RESULTS:The prevalence rate of immature permanent dental trauma was 10.5% in Xi'an. No significant differences were observed between districts and counties (P>0.05). The peak age of permanent dental trauma was at 7-9 years old, and the most was at 8 years old (31.5%). The first reason of trauma was falling down (50.9%), and the second reason was crash (36.0%). The most common trauma teeth were maxillary incisors (75.4%).CONCLUSIONS:The prevalence rate of immature permanent teeth trauma in Xi'an was in the middle of all international levels. Children, who are vulnerable to dental trauma at their age, should be provided with appropriate prevention measures to reduce the incidence of dental trauma.

OBJECTIVE:This study aims to investigate the clinical visiting and prognosis of schoolchildren in Xi'an after immature permanent tooth trauma and explore the prognostic factors associated with this type of trauma.METHODS:Through cluster and simple random sampling surveys, 4 013 pupils in schools from nine districts and four counties in Xi'an were sampled, respectively. All pupils and their parents were requested to complete a questionnaire, and children who had immature permanent tooth trauma answered a separate questionnaire and underwent oral examinations. The data of the survey were analyzed statistically.RESULTS:The amount of valid questionnaire was 3 641. Clinical visiting rate related to immature permanent tooth trauma of Xi'an schoolchildren was low (38.2%). Gender and trauma type were the factors related to clinical visiting for dental trauma concerns. The incidence of poor prognosis was 29.7%. The incidence of poor prognosis of patients with clinical visiting (35.4%) was higher than that of patients without clinical visiting (20.6%).CONCLUSIONS:Clinical visiting rate related to immature permanent tooth trauma in Xi'an schoolchildren is extremely low, and incidence of poor prognosis is high.

AIM:To investigate the degree of schoolchildren parents' knowledge of dental trauma in Xi'an.METHODS:With the cluster and simple random sampling survey,4 013 pupils in schools in 9 districts and 4 counties in Xi'an were sampled respectively.All pupils' parents were requested to complete a questionnaire.The data of survey were analyzed statistically.RESULTS:The percent of parents who support a clinical visit after dental trauma was in an increasing trend with the increase of education level.However,only 10.1％ parents had the sense that an avulsed permanent tooth should be replanted;48.2％ parents selected the unsuitable storage medium.CONCLUSION:The parents' knowledge of dental trauma for schoolchildren in Xi'an is poor and should be improved.