Traditional Chinese medicine （TCM） therapy has unique clinical advantages in the treatment of atrial fibrillation， mainly reflected in five aspects， improving quality of life， enabling early diagnosis and treatment， promoting cardiac rehabilitation， making up for the limitations of Western medicine， and improving the success rate of catheter ablation. However， there is insufficient evidence in current clinical research. Based on the current status of TCM research in the treatment of atrial fibrillation， it is suggested that future studies should focus on standardized research on syndrome differentiation and classification. This can be achieved through clinical epidemiological surveys， expert consensus， and other methods to establish a unified syndrome differentiation and classification standard for atrial fibrillation. Clinical efficacy evaluation indicators should be standardized， and core outcome measures for clinical research on TCM treatment of atrial fibrillation should be developed through systematic reviews， patient interviews， and other methods. Additionally， clinical research design， implementation， and data management should be improved. By leveraging modern information technologies such as artificial intelligence， the scientific and standardized nature of TCM intervention research on atrial fibrillation can be enhanced， ultimately improving the quality of research.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Objective Studies on the expression and location of zinc finger protein A20 (A20) and connective tissue growth factor (CTGF) in liver tissues of patients with chronic hepatitis B were conducted, and the relationship between them and liver fibrosis was determined by FibroScan. Methods Studies on A20 and CTGF in liver tissues of 160 patients with chronic hepatitis B were conducted in accordance with the stage of pathological fibrosis and inflammation of the liver, and quantitative immunohistochemistry test was conducted, and statistical analysis was conducted by FibroScan. Results The expressions of A20 and CTGF in liver tissues increased with the aggravation of liver pathological fibrosis and inflammation, and there were significant differences between each stage and the control group (P<0.05), and there were significant differences between adjacent groups (P<0.05). Studies have shown that FibroScan increases along with pathological fibrosis and inflammation in the liver. There are significant differences between the stage and the control group (P<0.05), and no significant differences between the adjacent groups (P>0.05). There was positive correlation between liver A20 and CTGF, r=0.796 (P<0.05). Conclusions In patients with chronic hepatitis B, A20, CTGF and FibroScan are positively correlated with the degree of liver fibrosis, and A20 and CTGF are also positively correlated with the degree of liver inflammation, which can be used as indicators to evaluate the degree of liver inflammation and fibrosis, and further guide the anti-inflammatory and anti-fibrosis treatment of patients.

Purpose To investigate the expression of TRPS1 in synovial sarcoma(SS)and its significance.Methods Twenty-one cases of synovial sarcoma diagnosed by SS1 8(18q11)(SYT)fluorescence in situ hybridization(FISH)or SS18-SSX immunohistochemistry were collected.The expression of TRPS1 was detected by immunohistochemistry EnVision two-step staining,and the relevant literature was reviewed.Results There were 21 cases of synovial sarcoma,including 9 females and 12 males,aged 17-79 years,with a median age of 50 years and an average age of 47.1 years.The tumors occurred in the lung(3 cases),legs(3 cases),kidney(3 cases),feet(2 cases),psoas major muscle(2 cases),rectum(1 case),tho-racic cavity(1 case),ankle canal(1 case),inguinal area(1 case),knee(1 case),palm(1 case),nasal cavity(1 case),and forearm(1 case).The maximum diameter of the tumor was 1.2-13 cm.Grossly,the tumor section was grayish-white,grayish-yellowish solid,and the lesion with hemorrhage was dark red.Microscopically,there were monophasic fibrous SS(16/21,76.2％),poorly differential SS(small cell)(3/21,14.3％),and biphasic SS(2/21,9.5％).Immunophenotypi-cally,tumor cells expressed SS18-SSX(18/18,100％),TLE1(12/12,100％),BCL2(18/18,100％),partially expressed EMA(10/16,62.5％),CK(12/18,66.7％),CD99(4/10,40.0％),SMA(3/16,18.6％),S-100(3/19,15.8％),and desmin(0/21).The proliferation index of Ki67 ranged from 3％-80％,with an average of 39.9％.FISH test showed that all 11 cases were positive for SS18(18q11)split-ting.All 21 cases of SS expressed TRPS1 to varying degrees and intensities(21/21,100％),of which 19 cases(19/21,90.5％)had a positive range of＞50％.There were 19 cases(19/21,90.5％)with a positive intensity of 2+or above.All the 21 patients underwent surgical resection of the tumor,and 20 patients received follow-up visits.3 patients treated with postop-erative combination of radiotherapy and chemotherapy,18 pa-tients treated with postoperative chemotherapy,and 7 patients showed different degrees of recurrence or metastasis,and 9 pa-tients who received follow-up visits died(45％,9/20).Con-clusion Although TRPS1 is regarded as a highly sensitive and specific marker of breast tumor origin,it is also highly expressed in synovial sarcoma,and it is necessary to be vigilant at its pit-falls in the pathological diagnosis.

Severe asthma stands as a formidable contributor to both mortality and morbidity of pa-tients suffering asthma,casting substantial social and economic shadows on communities.As our un-derstanding of asthma's pathophysiology deepens,a beacon of hope emerges in the form of biological targeted therapies,offering a promising avenue for the management of this challenging condition.These therapies,by precisely inhibiting or modulat-ing pivotal molecules in the inflammatory cascade,offer potential benefits in symptom alleviation,lung function enhancement,and risk reduction of acute exacerbations.They signify a paradigm shift in severe asthma treatment.Within the confines of this article,we embark on a systematic exploration of the immunological underpinnings that define se-vere asthma.By delving into the intricacies of the immune system's role in exacerbating this condi-tion,we aim to offer a comprehensive assessment of both the current landscape and the future pros-pects of biological therapies.Our objective is to provide a scientifically robust and valuable refer-ence that can guide the individualized treatment of patients grappling with severe asthma.

The construction of National Regional Centers is a significant strategic deployment to promote the expansion of high-quality medical resources and a balanced regional layout.It introduces the performance of Peking University First Hospital in promoting the construction of National Regional Centre for women and children's hospital with the work mode of"geographical homogenization construction",summarizes effectiveness.It is believed that government support is the foundation,output hospital sinking is the key,and input hospital participation is the guarantee.

Severe asthma stands as a formidable contributor to both mortality and morbidity of pa-tients suffering asthma,casting substantial social and economic shadows on communities.As our un-derstanding of asthma's pathophysiology deepens,a beacon of hope emerges in the form of biological targeted therapies,offering a promising avenue for the management of this challenging condition.These therapies,by precisely inhibiting or modulat-ing pivotal molecules in the inflammatory cascade,offer potential benefits in symptom alleviation,lung function enhancement,and risk reduction of acute exacerbations.They signify a paradigm shift in severe asthma treatment.Within the confines of this article,we embark on a systematic exploration of the immunological underpinnings that define se-vere asthma.By delving into the intricacies of the immune system's role in exacerbating this condi-tion,we aim to offer a comprehensive assessment of both the current landscape and the future pros-pects of biological therapies.Our objective is to provide a scientifically robust and valuable refer-ence that can guide the individualized treatment of patients grappling with severe asthma.

The construction of National Regional Centers is a significant strategic deployment to promote the expansion of high-quality medical resources and a balanced regional layout.It introduces the performance of Peking University First Hospital in promoting the construction of National Regional Centre for women and children's hospital with the work mode of"geographical homogenization construction",summarizes effectiveness.It is believed that government support is the foundation,output hospital sinking is the key,and input hospital participation is the guarantee.