Xing Wang

Access to oral healthcare is essential for general health and well-being. For autistic children, however, even routine dental attendance can be challenging. Sensory sensitivities, unfamiliar environments, and communication differences may make conventional dental visits particularly stressful (Stein et al. 2023). Yet the barriers to appropriate care are multifactorial. While the healthcare system's failure to make sufficient adjustments for neurodevelopmental differences is a central factor, oral health outcomes for autistic children also depend on interactions among the child's individual characteristics, family and social circumstances, and the dental care system's ability to provide reasonable accommodations, procedural preparation, and person-centred care. In China, the shortage of dentists trained in special care dentistry, together with the concentration of specialized pediatric services in tertiary hospitals in major cities, means that many families struggle to find appropriate care.China has made meaningful strides in disability policy in recent years, including the Healthy China 2030 framework (State Council 2016) and the Action Plan for Caring for Autistic Children (China Disabled Persons' Federation Citation 2024). However, current disability strategies remain largely focused on the disabilities themselves, while secondary health domains critically affected by disability receive less attention. This article examines the barriers autistic children encounter when seeking oral healthcare in China, while recognizing the progress that has been made, and considers how policy frameworks might be further adapted to address these inequities.Autism spectrum disorder affects approximately 0.70% of children aged 6 to 12 years in China, according to the first national prevalence study based on multi-center population data (Zhou et al. 2020). Oral health problems are common among autistic populations. Difficulties with tooth brushing due to sensory aversions, use of medications that cause dry mouth, and dietary preferences for soft or sweet foods may contribute to elevated oral health risks in autistic children. A Mendelian randomization study found that while pervasive developmental disorder showed a causal relationship with permanent tooth caries, autism spectrum disorder itself did not demonstrate a direct causal effect on either primary or permanent tooth caries. This suggests that atypical eating behaviors and dietary patterns, rather than ASD per se, may play a more significant role in the elevated caries risk observed in this population (Jin et al. 2025). A review of oral health research on autistic children in China confirms that this group experiences poorer oral hygiene, higher detection rates of dental calculus, and more frequent cases of gingivitis compared with neurotypical peers (Gao and Liu 2022). Another study of 117 children with autism and 121 neurotypical peers in China found that 74.36% of autistic children had dental caries and 52.14% had periodontal problems. Only 17.09% brushed their teeth twice or more per day, and 13.68% consistently used toothpaste. The study also found that 93.16% of autistic children were cared for full-time by a parent, and factors affecting oral health included brushing habits, primary caregivers, and parental education level (Tan et al. 2024). These findings suggest that the oral health challenges faced by autistic children are not merely clinical problems but have broader social and economic dimensions that affect entire families. Recognizing the magnitude of these needs is an important first step toward developing appropriate policy responses.Many dentists receive limited training in the management of autistic patients during their undergraduate education. A review of oral health research on autistic children notes that multiple adverse factors, including sensory sensitivities, communication barriers, and a shortage of dentists trained in special care dentistry, collectively contribute to poorer oral health outcomes in this population (Gao and Liu 2022). Consequently, newly qualified dentists may lack confidence in adapting their clinical approach for autistic children. Behavioral management techniques that are effective for neurotypical children, such as tell show do, may require modification for autistic patients who have communication differences or difficulty processing verbal instructions. Sensory adaptations to the clinical environment, such as dimming lights or minimizing unexpected noises, are straightforward to implement but are not routinely taught or practised in many dental education programmes. Without such adaptations, dental visits may become negative experiences for autistic children, reinforcing avoidance behaviors and making future care increasingly difficult. Continuing professional education in special care dentistry remains limited in China. In April 2025, the National Center for Mental Health and the Chinese Stomatological Disease Prevention Foundation jointly launched the Star Lighting Programme, a public welfare initiative aimed at improving oral healthcare for autistic children. The programme is structured as a pilot continuing professional education initiative. Its first phase covered 20 institutions across the country. The curriculum includes training for dental practitioners on communication strategies, environmental sensory adaptations, and behavioral management techniques, as well as oral health education for families and special education institutions (National Center for Mental Health and Chinese Stomatological Disease Prevention Foundation 2025). However, this initiative remains in its early stages, and detailed outcome data are not yet publicly available. Specific clinical guidance on environmental adaptations, communication strategies, and behavioural management techniques has not yet been developed into detailed, implementable protocols. The gap between the needs of this growing patient population and...

The expansion of China's early orthodontic market is increasingly driven by parental anxiety. This emotion can be deliberately created and used for profit in today's digital world. Social media has become a primary health information source for Chinese adults. A national survey reported that 71.9% obtain health education online (1). Yet misleading information is widespread on these platforms (2), and users often struggle to evaluate health content (3).Between 2018 and 2022, orthodontic related content on Chinese social media grew roughly fourfold. Orthodontics surpassed general dentistry as the fastest-growing oral health topic (4). Yet the quality of this information is deeply concerning. According to the same study, 79.4% of long-text dental posts were written by nonprofessionals. Using Spearman correlation analysis, the researchers found a significant negative correlation emerged between user engagement and content quality. On Weibo the correlation coefficient was -0.45 (P = 0.01). On WeChat it was -0.30 (P = 0.02). The most widely viewed content is often the least reliable (4). A separate analysis of paediatric orthodontic videos on TikTok confirmed this pattern. Orthodontist produced content scored significantly higher on reliability metrics with a P value below 0.01. Yet algorithm driven engagement consistently favoured lower-quality material. The most viewed videos offered limited guidance on treatment timing or indications (5).Importantly, the gap between parental concern and clinical necessity is not a new phenomenon. Early European studies found that parents' perceptions of their children's dentition often diverge from orthodontic expert assessments. Parental anxiety can exceed clinically indicated needs (6,7). These findings suggest that parental worry can operate independently of objective disease burden. In today's digital world, this vulnerability is amplified.Parental anxiety does not arise naturally. It is amplified within a digital environment where low-quality content receives the most attention. This trend risks undermining evidence-based care and may widen health inequalities.Malocclusion affects 45.50% of Chinese preschool children, a condition that without appropriate intervention can lead to severe dentofacial deformities (8). Paediatric malocclusion management is uniquely complex, shaped by individual craniofacial growth patterns (9). China has developed clinical consensus documents for early orthodontic intervention, including an expert consensus published in 2021 (10) and subsequent guidelines for specific conditions (11). However, a gap exists between these evidence-based recommendations and clinical practice. A recent analysis notes that some clinicians continue to perform excessive or premature interventions and exaggerate the role of early orthodontic treatment (12). This gap can create uncertainty for parents seeking guidance.Since the 2009 healthcare reforms, China's private dental sector has expanded to over 130,000 clinics nationwide, far outnumbering public facilities (13). While public hospitals, particularly tertiary stomatology hospitals, continue to handle a substantial proportion of patient volume, private clinics have come to dominate the direct-to-consumer marketing landscape. Facing intense competition and high customer acquisition costs (14), these clinics increasingly rely on social media platforms to attract patients. Recently, orthodontic topics have represented the fastest-growing category of oral health discussion, with a substantial proportion of high-engagement posts containing promotional material (4).Paediatric orthodontics, a high-margin service, has attracted considerable commercial attention in this digital space. Content often includes case demonstrations, warnings about risks of delayed treatment, and claims about optimal timing for intervention (4). Such promotional practices have contributed to misconceptions about early orthodontic care, including exaggerated claims and premature interventions (12).Unlike adult orthodontics, where treatment goals are relatively stable, paediatric intervention requires careful consideration of individual craniofacial growth patterns (9). Treatment decisions must balance the potential benefits of early intervention against the risks of unnecessary treatment. This complexity makes the specialty particularly vulnerable to inappropriate early intervention when commercial incentives override clinical judgment.A related concern is the potential blurring of professional boundaries in digital health communication. When clinicians use their institutional affiliations in commercial social media content, parents who trust the impartiality of public hospitals may find it hard to tell education from promotion. This issue has drawn regulatory attention, in part because hospital social media activity has grown substantially. A cross-sectional study of 721 officially verified hospital Weibo accounts found that promotional strategies significantly influence audience reach and engagement. The study identified hospital ownership, whether public or private, as a key factor shaping the effectiveness of social media promotional strategies (15). This suggests that public hospitals may face distinct challenges or incentives in managing their digital presence.The regulatory landscape has responded to these challenges. Since 2022, TikTok has prohibited medical professionals from engaging in live commerce. The Chinese National Health Commission has also announced strict monitoring of public hospital doctors' participation in pharmaceutical advertising and disguised medical promotions (16). Earlier position statements from professional associations noted the need to oppose excessive commercialization in dental practice (17).These patterns of commercial promotion raise questions about equity in paediatric dental care. Private clinics are predominantly concentrated in economically advanced urban areas (13). This means...

Local electrical stimulation (LES) is a widely used clinical method to treat peripheral nerve injury. However, existing plate electrodes (PE) usually suffer from low electronic transport efficiency, whereas acupuncture electrical stimulation may cause damage to normal tissues. There is an urgent need to develop an innovative LES technique with efficient electronic transport, minimal tissue injury and enhanced biosafety. Here, we present a new stretchable transcutaneous electrical stimulation system (STESS) that integrates dissolvable conductive microneedles (DCMN) for optimal skin penetration and electronic transport, along with snake-like electrodes that offer superior flexibility, which can effectively penetrate the stratum corneum, enabling deep tissue electrostimulation with minimal injury. In vitro studies and 3D finite-element analysis demonstrate that the DCMN-based electrotherapy significantly enhances subcutaneous nerve stimulation compared to the conventional PE-based technique. By diminishing the electrical resistance of the stratum corneum, the DCMN-based electrotherapy has shown remarkable in vivo therapeutic efficacy in a rat facial nerve crush injury model. This will pave the way for innovative physiotherapeutic methodologies in the realm of neurological rehabilitation.

Lycopene (LY) is a major active natural product isolated from red fruits, which has been shown to have good antioxidant, antitumor, and antifibrosis activities. Previous studies have shown that LY has an antioral cancer effect, but its molecular mechanism of action is still unknown. Here, we found 56 interaction genes between LY and oral cancer using bioinformatic data analysis methods. The gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis found that genes were enriched primarily in the positive regulation of cell proliferation and associated with sequence-specific DNA binding. These were mainly enriched in pathways in cancer, chemical carcinogenesis - receptor activation, proteoglycans in cancer, as well as other pathways. The protein with the highest degree in the protein–protein interaction (PPI) network is the epidermal growth factor receptor (EGFR). Our previous study found that aminolevulinic acid photodynamic therapy (ALA-PDT) could negatively regulate EGFR expression in oral cancer. Consequently, we address for the first time the potential combinations of ALA-PDT and LY in the treatment of oral cancer. This treatment regimen could synergistically reduce the growth and induced apoptosis of CAL-27 cells in vitro and significantly down-regulate EGFR gene expression, meanwhile, suppress the growth of oral cancer xenograft in nude mice. The antioxidant capacity as measured in vivo by the ferric reducing ability plasma (FRAP) assay was also significantly higher in the combined intervention group than in the ALA-PDT or LY groups alone. Taken together, these findings reaffirm the role of LY with ALA-PDT as a putative combination treatment scheme through their direct killing effect on tumor cells and their capacity to suppress EGFR activity. Clinical trial number Not applicable.

Background Colon adenocarcinoma (COAD) is a leading cause of cancer-related mortality worldwide. Transient receptor potential vanilloid 4 (TRPV4), a calcium-permeable non-selective cation channel, has been implicated in various cancers, including COAD. This study investigates the role of TRPV4 in colon adenocarcinoma and elucidates its potential mechanism via the ferroptosis pathway. Materials and Methods Gene expression profiles and clinical data were obtained from The Cancer Genome Atlas (TCGA), encompassing 647 colon adenocarcinoma tissue samples and 51 normal colorectal tissue samples. Ferroptosis-related genes were retrieved from the FerrDb database. Differential expression analysis, survival analysis, and Cox proportional hazards regression were performed to assess the prognostic significance of TRPV4. Protein–protein interaction networks and gene enrichment analyses (GO and KEGG) were conducted to explore functional associations. In vitro experiments were carried out using HT-29 and SW480 colon cancer cell lines. TRPV4 was knocked down using siRNA, and cell viability was assessed via hematoxylin and eosin (HE) staining. Immunofluorescence assays evaluated the expression of ferroptosis-related proteins (SLC3A2, GPX4) and proliferation markers (KI67, SRC, CTNNB1, COL1). Results TRPV4 expression was significantly elevated in colon adenocarcinoma tissues compared to normal tissues (p < 0.05), demonstrating high diagnostic accuracy (AUC = 0.848). High TRPV4 expression correlated with poorer overall survival (OS) and disease-specific survival (DSS), particularly in patients over 65 years old and those in clinical stage II. Cox regression analysis confirmed TRPV4 as an independent prognostic factor (HR = 1.395, p = 0.074). Bioinformatics analyses revealed that TRPV4 is closely associated with ferroptosis-related genes, participating in key biological processes such as responses to external stimuli, oxidative stress, and cell adhesion. In vitro, TRPV4 knockdown significantly reduced cell viability (p < 0.05) and decreased expression levels of SLC3A2, GPX4, KI67, SRC, and COL1 (p < 0.05). The addition of the ferroptosis inhibitor FER-1 did not restore cell viability in TRPV4 knockdown cells, suggesting that TRPV4 modulates cell survival through the ferroptosis pathway. Discussion The bioinformation and in vitro experiments inTRPV4 and ferroptosis-related genes support the hypothesis that TRPV4 influences tumor cell survival via the ferroptosis pathway. The inability of FER-1 to rescue viability in TRPV4-deficient cells further confirms this mechanism. These findings provide novel insights into the molecular mechanisms of COAD and highlight TRPV4 as a potential therapeutic target. Conclusion TRPV4 is significantly upregulated in COAD and is associated with unfavorable patient outcomes. It appears to promote tumor progression by regulating the ferroptosis pathway, affecting the expression of key ferroptosis-related genes and proliferation markers. Targeting TRPV4 may offer a new therapeutic approach for COAD, and further research is warranted to explore its role in other cancers and to develop TRPV4-based therapies.

Compared with mesenchymal stem cells (MSCs) obtained from other tissue sources, those derived from umbilical cord (UC) tissue exhibit numerous advantages and vast potential for therapeutic applications. However, MSCs from different tissue sources are heterogeneous, and therefore, the therapeutic efficacy of UC-derived MSCs as a replacement for other tissue-derived MSCs needs to be studied. To better understand the distinctions between UC-derived MSCs and MSCs derived from other tissues, we conducted a transcriptome analysis of MSCs obtained from UC and three other tissues. Correlation analysis revealed the strongest correlation between UC-MSCs (UC-MSCs) and bone marrow-MSCs (BM-MSCs). Compared with UC-MSCs, the lower differentially expressed genes of BM-MSCs, dental pulp-MSCs (DP-MSCs), and adipose tissue-MSCs (AP-MSCs) were predominantly enriched in actin-related terms, while higher differentially expressed genes were predominantly enriched in immunological processes. We also analyzed the distribution of 34 frequently or highly expressed cell characterization molecules in BM-MSCs, DP-MSCs, AP-MSCs, and UC-MSCs. CD200 (FPKM >10) was only detected in UC-MSCs, while CD106 was detected in AD-MSCs and DP-MSCs (FPKM >10). The reliability of transcriptomic data analysis was verified by quantitative real-time PCR. Finally, we recommend the use of CD200, CD106, and other similar markers with unstable expression as benchmark molecules to monitor the proliferation and differentiation potential of MSCs. This study provides comprehensive insights into the heterogeneity between UC-MSCs and MSCs derived from other tissues, which can guide the therapeutic application of UC-MSCs.

Backround Early treatment of oral precancerous lesions is considered as a key strategy for in oral carcinogenesis prevention. Increasing evidence has suggested that the transforming growth factor beta (TGF-β) signaling pathway is tightly involved in the process of oral-carcinogenesis. In this study, we investigated the inhibition effect and potential mechanism of 5-aminolaevulinic acid photodynamic therapy (ALA-PDT) in human oral precancerous cells via TGF-β pathway. Materials and methods Here, the dysplastic oral keratinocyte (DOK) cells were incubated with ALA concentration of 1 mM/mL for 4 h and then irradiated with a Helium–Neon (He–Ne) ion laser at 633 nm (200 mW/cm²). The control cells were cultured in Dulbecco’s modified Eagle’s medium (DMEM) medium. We analyzed the differentially expressed genes and correlated pathways in oral precancerous cells following ALA-PDT using Affymetrix microarrays. TGF-β pathway was analyzed by quantitative real-time polymerase chain reaction (RT-qPCR) and western blotting. Bioinformatics analysis was performed to evaluate the expression of TGF-β1 in human oral cancer samples and adjacent normal samples. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT), flow cytometry, 2′-7′-dichlorodihydrofluorescein diacetate (DCFH-DA), and wound healing assay were used to assess the effects of ALA-PDT plus TGF-β receptor inhibitor (LY2109761) in DOK cells. Results The TGF-β signaling could exert in suppressive effects on DOK cells after ALA-PDT. The cell proliferation and migration rate of DOK cells was significantly reduced and apoptosis and ROS generation induced more effectively by ALA-PDT combined with LY2109761. Furthermore, cell cycle analysis revealed that the combined treatment resulted in G0/G1 phase arrest. Conclusions ALA-PDT suppresses the growth of oral precancerous cells by regulating the TGF-β signaling pathway, and its suppressive effect was enhanced using LY2109761. These results indicate that it could be a promising alternative treatment against oral precancerous lesions.