Current Medical Science最新文献

{"title":"Electroacupuncture as Adjunctive Therapy for Organ Dysfunction Among Chinese ICU Patients with Sepsis: Study Protocol for a Randomized Clinical Trial.","authors":"Qi Meng, Ling-Ling Yu, Xiang-Hong Jing, Man Li, Qian-Rui Huang, Ting-Ting Xu, Yi Bian, Shu-Sheng Li","doi":"10.1007/s11596-026-00225-5","DOIUrl":"10.1007/s11596-026-00225-5","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a dysregulated response of the host to infection that can lead to life-threatening organ dysfunction and remains a leading cause of mortality. Early recovery of impaired organ function is crucial for the outcomes of sepsis. Electroacupuncture (EA) is a promising adjunctive therapy for sepsis, but no study has focused on the efficacy of EA for organ dysfunction. This study aimed to investigate the efficacy and safety of EA in improving organ dysfunction among intensive care unit (ICU) patients with sepsis.</p><p><strong>Methods: </strong>In this single-center, randomized, sham-controlled clinical trial, an adaptive sample size of 154-500 patients diagnosed with sepsis will be included. Eligible patients will be randomly assigned to receive EA or sham EA treatment at a 1:1 ratio using block randomization. Patients in the two groups will receive 6 consecutive sessions of 30-min EA or sham EA treatment, with the initial acupuncture treatment being completed within 24 h after randomization. The primary outcome is the change in the total score of the Sepsis-Related Sequential Organ Failure Assessment (SOFA) on day 7 after randomization compared with baseline. Secondary outcomes include changes in the SOFA score and related serological outcomes, mortality, ICU-free days, hospital-free days and organ support-free days from baseline to day 28. Statistical analyses will be performed on a full analysis set (FAS) and a per-protocol set (PPS).</p><p><strong>Discussion: </strong>We expect the findings of this trial to provide evidence that the use of EA as an adjunctive therapy to ICU treatment can promote the recovery of organ function and other outcomes in sepsis patients.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06666946. Registered on 28 October 2024.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1127-1136"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Memory B Cells in Major Depressive Disorder: Toward Mechanistic and Clinical Refinement.","authors":"Mei-Qi Yin, Kang-Xiang Xu","doi":"10.1007/s11596-026-00214-8","DOIUrl":"10.1007/s11596-026-00214-8","url":null,"abstract":"","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1137-1138"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Esmolol Is Associated with Early Opioid Sparing in Patients with Ischemic Heart Disease: Evidence from a Retrospective Cohort and an Incisional Pain Rat Model.","authors":"Yue-Yang Xin, Ning Yang, Hao Chen, Gao-Feng Zhan, Hui Xu","doi":"10.1007/s11596-026-00236-2","DOIUrl":"10.1007/s11596-026-00236-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Previous studies have confirmed the opioid-sparing and analgesic properties of perioperative esmolol, yet relevant clinical evidence specifically focusing on patients with ischemic heart disease (IHD) remains scarce, and the spinal nociceptive mechanism underlying esmolol-induced pain relief has not been fully elucidated. This study aimed to investigate the association between perioperative esmolol administration and early postoperative opioid demand in IHD patients undergoing elective non-cardiac surgery, and further explore the role of spinal 5-hydroxytryptamine (5-HT)/5-HT&lt;sub&gt;2B&lt;/sub&gt; signaling in incisional pain using a female rat plantar incision model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;For the clinical retrospective cohort, eligible IHD patients were divided into esmolol-exposed and non-exposed groups balanced via 1:1 propensity score matching. The primary outcome was cumulative 24-h postoperative opioid consumption converted to intravenous morphine equivalents (IME); secondary endpoints included early Numeric Rating Scale (NRS) pain scores, opioid-related adverse events and perioperative cardiovascular safety indicators. In animal experiments, intrathecal esmolol or selective 5-HT&lt;sub&gt;2B&lt;/sub&gt; antagonist RS127445 was delivered to the female rats with plantar incision, followed by detection of mechanical withdrawal thresholds and spinal 5-HT/5-HT&lt;sub&gt;2B&lt;/sub&gt; expression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After matching, 52 patients were included in each group. Perioperative esmolol was associated with a 3.0 mg reduction in 24 h IME (mean difference [MD] = -3.0, 95% CI [-4.9, -1.1], P = 0.002), alongside lower post-anesthesia care unit (PACU) opioid consumption (MD = -2.3, 95% CI [-4.2, - 0.3], P = 0.022) and decreased resting NRS scores in PACU (MD = -0.8, 95% CI [-1.3, -0.2], P = 0.006) and at postoperative 6 h (MD = -0.6, 95% CI [-1.1, -0.02], P = 0.043); no intergroup difference in NRS was observed at 24 h (P = 0.379). All opioid-related adverse events showed comparable incidence between groups (all P &gt; 0.05). Intraoperative heart rate was significantly lower in the esmolol group (MD = -4.4 beats/min, 95% CI [-7.8, -1.0], P = 0.012), while intraoperative mean arterial pressure (MAP) and major cardiovascular complications exhibited no between-group differences (all P &gt; 0.05). In rats, the results revealed transiently elevated paw withdrawal mechanical thresholds after intrathecal esmolol (P &lt; 0.05 at 5 and 10 min), accompanied by suppressed surgery-induced upregulation of spinal 5-HT and 5-HT&lt;sub&gt;2B&lt;/sub&gt; protein (P &lt; 0.05). Intrathecal RS127445 also significantly alleviated mechanical hypersensitivity at 1 h post-administration (P &lt; 0.01), with loss of efficacy at 2 h (P &gt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Perioperative esmolol is associated with early opioid-sparing and mild relief of acute postoperative pain in IHD patients receiving elective non-cardiac surgery, without increasing cardiovascular ri","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1058-1071"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Romiplostim in the Treatment of Aplastic Anemia: A Systematic Review and Single-Arm Meta-Analysis.","authors":"Zhi-Xuan Yang, Jia-Xin Zhang, Zi-Lu Guo, Chen-le Dong, Su-Ying Yuan, Xue Zhang, Dong-Hui Huang, Hu Zhao","doi":"10.1007/s11596-026-00216-6","DOIUrl":"10.1007/s11596-026-00216-6","url":null,"abstract":"<p><strong>Objective: </strong>Romiplostim, a second‑generation thrombopoietin receptor agonist (TPO‑RA), has been increasingly investigated for aplastic anemia (AA) across various populations and treatment settings; however, its overall efficacy, optimal dose, safety profile, and sources of heterogeneity across studies have not been systematically quantified and validated. This study aims to perform an up‑to‑date systematic review and single‑arm meta‑analysis to comprehensively assess the overall efficacy and safety of romiplostim in AA patients.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, Web of Science, Cochrane Library, and CNKI from inception to March 3, 2026, without language restrictions. Two independent reviewers screened literature, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale (NOS) and Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was applied in Stata 15.1 to pool overall response rate (ORR) and complete response rate (CRR); subgroup, sensitivity, and publication bias analyses were performed to explore heterogeneity and robustness.</p><p><strong>Results: </strong>Nineteen studies with 382 patients were included. The pooled ORR was 72.4% (95% CI: 61.9%-81.9%), and CRR was 25.5% (95% CI: 18.4%-33.1%). Patients receiving 20 μg/kg romiplostim achieved higher ORR (77.6% vs. 51.7%) and CRR (29.3% vs. 17.0%) than those receiving 10 μg/kg (P = 0.081). Patients aged <60 years showed higher ORR (74.9% vs. 49.3%) than those ≥60 years (P = 0.298). Tolerability was favorable, with low discontinuation rate (2.1%) and no treatment-related deaths.</p><p><strong>Conclusion: </strong>Romiplostim demonstrates promising efficacy and safety in AA, with enhanced outcomes at 20 μg/kg and in younger patients. Further high-quality trials are warranted.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"914-925"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Commentary: Memory B Cells in Major Depressive Disorder: Toward Mechanistic and Clinical Refinement.","authors":"Shao-Meng Si, Yue-Yang Xin, Shao-di Guan, Jie Dong, Pei Lu, Hao Chen, Wei Xia, Hui Xu","doi":"10.1007/s11596-026-00220-w","DOIUrl":"10.1007/s11596-026-00220-w","url":null,"abstract":"","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1139-1140"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular Alterations in Vaginal Wall Tissues Associated with Post-Hysterectomy Pelvic Organ Prolapse.","authors":"Ya-Qian Li, Yi-Wei Zhang, Yang Ye, Ru-Sha Yin, Jin-Bo-Wen Yan, Shuo Liang, Lan Zhu","doi":"10.1007/s11596-026-00234-4","DOIUrl":"10.1007/s11596-026-00234-4","url":null,"abstract":"<p><strong>Objective: </strong>Hysterectomy significantly increases the risk of pelvic organ prolapse (POP). However, the underlying molecular changes remain unclear. The aim of this study was to elucidate potential molecular associations by comparing single-cell transcriptomic profiles of vaginal tissues from postmenopausal women across three groups: normal controls, POP patients with an intact uterus, and post-hysterectomy POP patients.</p><p><strong>Methods: </strong>A single-cell transcriptomic dataset of prolapsed vaginal tissues was used to analyze genes that were differentially expressed between fibroblasts and macrophages in the two prolapse types. Key transcriptional regulators of myofibroblast differentiation were identified. Cell subtypes were identified, and macrophage polarization states were assessed to evaluate immune responses in different POP subtypes.</p><p><strong>Results: </strong>Post-hysterectomy POP patients exhibited impaired myofibroblast differentiation, downregulated expression of wound-healing genes, and disrupted extracellular matrix (ECM) remodeling. In contrast, uterus-intact POP patients showed stronger immune activation, enhanced fibroblast‒macrophage crosstalk, and upregulated expression of genes related to leukocyte-mediated immunity. Key transcriptional regulators were linked to myofibroblast differentiation. Macrophage profiling revealed predominant M2 polarization in post-hysterectomy patients, indicating a potential compensatory response to biomechanical instability, whereas uterus-intact POP patients maintained more active immune responses.</p><p><strong>Conclusion: </strong>This study revealed that hysterectomy alters vaginal homeostasis through ECM disorganization, impaired wound healing, and macrophage reprogramming. Our findings highlight distinct molecular changes in fibroblasts and macrophages between uterus-intact POP patients and post-hysterectomy POP patients, advancing the understanding of POP pathogenesis.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"993-1003"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic Classification of Anterior Talofibular Ligament Based on 2D Convolutional Neural Network.","authors":"Feng Li, Xiao-Shan Wang, Ting Li, Gang Wu","doi":"10.1007/s11596-026-00241-5","DOIUrl":"10.1007/s11596-026-00241-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility of 2D convolutional neural networks (CNNs) in the automatic classification of anterior talofibular ligaments (ATFLs) on MR images.</p><p><strong>Methods: </strong>A total of 560 transverse T2-weighted MR images of the ATFL were collected from Center A, and 96 from Center B; manual segmentation of the ATFL was performed. The ATFL segmentation model was trained on YOLO11 and was validated on images from Center B. The dice similarity coefficient (DSC) between manual and automatic segmentation was calculated. A total of 1,103 T2-weighted MR images of the ATFL were further collected from Center C and divided into three groups: normal, partial, and total tear, and ATFL was automatically segmented for all the images. The 2D ResNet model was then trained for ATFL classification. Finally, the segmentation model and classification model were applied to 420 images from Center D.</p><p><strong>Results: </strong>The median DSC for the YOLO11 segmentation model was 0.95. For Center D data, the automatic workflow achieved an accuracy of 92.6% (389/420). It showed 95.0% (190/200) sensitivity and 93.6% (206/220) specificity for abnormal ATFL detection, slightly below the junior radiologist's 97.0% (194/200) sensitivity and 95.5% (210/220) specificity, but the difference did not reach statistical significance (P = 0.22). Automatic classification of the Center D dataset took 3 minutes, compared with manual 14 minutes for the junior radiologist.</p><p><strong>Conclusion: </strong>Automatic segmentation and classification of ATFL on MR images based on CNNs are feasible for evaluating ATFL.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1121-1126"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peptide Loading Complex in Cancer: From Peptide Translocation, Editing, and Loading into MHC-I to a Potential Therapeutic Target.","authors":"Omer Qutaiba B Allela, Abdulkareem Shareef, Hayder Naji Sameer, Ahmed Yaseen, Zainab H Athab, Mohaned Adil","doi":"10.1007/s11596-026-00227-3","DOIUrl":"10.1007/s11596-026-00227-3","url":null,"abstract":"<p><p>The peptide-loading complex (PLC) is a pivotal endoplasmic reticulum (ER) protein machinery that facilitates peptide translocation, editing, and loading onto major histocompatibility complex class I (MHC-I) to allow recognition of infected or transformed cells by CD8⁺ cytotoxic T lymphocytes (CTLs). PLC comprises the peptide transporter complex formed of transporters associated with antigen processing (TAP1/2), the adapter protein tapasin, chaperones such as calreticulin (CRT) and ERp57, and β2-microglobulin (β2M), ensuring the proper assembly of MHC-I/peptide complexes for subsequent antigen presentation on the cell surface. In cancer, tumorigenesis often involves structural malfunctions and transcriptional, post-transcriptional, and epigenetic modifications that impair the functioning of PLC proteins. This eventually causes loss of MHC-I cell-surface expression, failure of antigen presentation, and escape from CTL-mediated immunosurveillance. Although malfunctions in antigen-processing machineries are well known, herein we provide an overview of the PLC as a major determinant of tumor immune escape and a potential therapy target. In this regard, recent evidence indicates that individual PLC components not only affect MHC-I/antigen presentation but also influence tumor development and progression, immune evasion, and treatment resistance. Furthermore, we explore existing or evolving therapeutic approaches to recover/reprogram PLC functions such as IFN-γ-induced PLC activation, TAP1 and tapasin gene therapy, epigenetics-based treatments such as DNA methyltransferase inhibitors (DNMTi) and histone deacetylase inhibitors (HDACi), and microRNA targeting strategy.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"926-945"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Peptic Ulcer Disease (1990-2021) and Projections to 2050: A Comprehensive Analysis of Age, Sex, and Socioeconomic Disparities.","authors":"Jing Gong, Ke Zhang, Jun-Wei Yan, Xiao-Xia Zhang, Jing Liu","doi":"10.1007/s11596-026-00215-7","DOIUrl":"10.1007/s11596-026-00215-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Peptic ulcer disease (PUD) represents an ongoing global public health concern and is responsible for significant illness and mortality. Despite considerable advancements in medical therapy, the distribution and overall burden of PUD vary substantially across different regions and population segments worldwide. This research provides a comprehensive analysis of the global PUD burden, examining trends from 1990 to 2021 and forecasting patterns until 2050. The findings of this research, which use the most up-to-date epidemiological data available, are significant for epidemiology and disease management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We leveraged data from the Global Burden of Disease (GBD) 2021 study, which covers 195 countries and territories. Our analysis assessed key metrics of disease impact, including disability-adjusted life years (DALYs), mortality rates, incidence and prevalence data, years lived with disability (YLDs), and years of life lost (YLLs). We calculated age-standardized rates (ASRs) to allow for consistent comparisons across populations. Temporal changes were quantified using estimated annual percentage changes (EAPCs) derived from linear regression. Furthermore, we applied hierarchical cluster analysis to investigate regional patterns in the PUD burden. These methods were chosen because of their robustness and ability to provide a comprehensive understanding of the global burden of PUD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PUD was responsible for an estimated 6.06 million DALYs in 2021 (ASR: 71.56 per 100,000). This burden increased substantially with advancing age, peaking among individuals aged 80 and above. Compared with females, males had higher DALY rates (ASR: 87.02 vs 57.05 per 100,000) and considerably higher mortality rates. Regions with low and low-middle sociodemographic index (SDI) presented the highest ASRs (e.g., 178.38 per 100,000 in low-SDI areas). The highest DALY rates were observed in South Asia and parts of sub-Saharan Africa. Between 1990 and 2021, the global DALY ASR decreased markedly (EAPC: -2.96), though absolute DALY numbers remained elevated in populous, low- to middle-SDI regions. Model-based projections (exponential smoothing and ARIMA), assuming the continuation of recent trends, suggest that ASRs may continue to decline through 2050.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Over the past three decades, the global age-standardized burden of PUD has markedly decreased. However, significant challenges remain, particularly for older adults, males, and individuals in low-SDI areas, such as South Asia and sub-Saharan Africa. Although forecasts suggest further reductions in ASRs, the overall burden, influenced by population changes, underscores the crucial need for ongoing, targeted prevention and control efforts. This should prioritize Helicobacter pylori detection and eradication, safer NSAID use with gastroprotection in high-risk patients, and improved access to timely diagnosis ","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1023-1037"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming the Viscosity-Strength Trade-Off in 3D-Printable Dental Resins by Hydrogen Bond Engineering.","authors":"Yu-Lin Hou, Fei-Long Wang, Hui-Yu Shang, Dong Xiang, Yu-Fei Wang, Li Gao, Fei-Yan Yu, Yong-Xiang Xu","doi":"10.1007/s11596-026-00221-9","DOIUrl":"10.1007/s11596-026-00221-9","url":null,"abstract":"<p><strong>Objective: </strong>To overcome the trade-off between the low viscosity required for printability and the high mechanical strength required for functionality in dental resins for vat photopolymerization 3D printing by developing a hydrogen-bond engineering strategy.</p><p><strong>Methods: </strong>Three dental oligomers (Bis-GMA, UDMA, and Bis-EMA) were blended with four diluents differing in hydrogen-bonding ability. Fourier transform infrared (FTIR) spectroscopy, rheometry, three-point bending tests and 3D printing performance tests were carried out to evaluate hydrogen bond formation, viscosity, mechanical properties, printability and accuracy.</p><p><strong>Results: </strong>FTIR and rheological tests confirmed strong hydrogen bonding between MAA and matrix oligomers. The optimized formulation, n(MAA): n(UDMA) = 2:1, achieved flexural strengths of 228 MPa (mold-filled) and 178 MPa (3D-printed) and elastic modulus of 5.3 GPa and 4.0 GPa, respectively, whereas the viscosity was only 307 mPa·s-a dramatic improvement over that of neat UDMA (viscosity 9689 mPa·s, mold-filled mechanical strength 174 MPa and 3.8 GPa). The hydrogen-bonding diluents also demonstrated significant advantages in composite resin formulations.</p><p><strong>Conclusions: </strong>Hydrogen bond engineering decouples viscosity from mechanical strength, enabling the fabrication of low-viscosity, high-strength dental resins for 3D printing. This scalable platform overcomes the longstanding viscosity-strength trade-off, offering promising potential for dentistry and other fields of photocurable additive manufacturing.</p>","PeriodicalId":10820,"journal":{"name":"Current Medical Science","volume":" ","pages":"1072-1088"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}