Objective To discuss the etiology and clinical characteristics of human rhinovirus (HRV) as pathogen of central nervous system infection .Methods Two hundred and five cerebrospinal fluid (CSF) specimens were collected from children with fever and convulsions who were admitted to the pediatric intensive care unit with suspicion of central nervous system infection from June 2011 to December 2012 .Genome Lab Genetic Analysis System (GeXP) was applied to detect HRV from CSF .Specimens with positive results were amplified by nested reverse transcription‐polymerase chain reaction and followed by gene sequencing . Clinical data of HRV positive cases were analyzed . Results Of the 205 CSF specimens ,7 samples were positive for HRV ,which were composed of 2 HRV‐A ,1 HRV‐B and 4 HRV‐C (including 1 HRV‐Ca) .There were 6 boys and 1 girl among the 7 positive cases for HRV .Six children were less than 3 years old ,except one was 9 years old .The onset time was mainly concentrated between September and October . The main clinical manifestations were fever and convulsions . The clinical diagnosis before the pathogen confirmation included viral encephalitis ,epilepsy ,febrile convulsion ,benign infantile convulsions with mild gastroenteritis (CwG ) and hand‐foot‐and‐mouth disease ( HFMD ) . Although the disease severity of the 7 cases varied ,all ended with favorable prognosis .Conclusions HRV is one of pathogens of viral central nervous system infection .All types of HRV can cause central nervous system infection ,among which HRV‐C accounts for the majority .The clinical manifestations of HRV central nervous system infection could mimic febrile convulsion ,CwG and HFMD .

Objective To compare the clinical efficacy of anatomic locking compression plate augmented with anchor nail versus calvicular hook plate in the treatmeut of Neer type Ⅱb distal calvicular fractures.Methods The data of 65 patients were retrospectively analyzed who had undergone surgery in our hospital from January 2012 to January 2015 for Neer type Ⅱb distal calvicular fractures.They were 39 men and 26 women,aged from 18 to 58 years(average,42.6 years).Open reduction plus anatonical locking compression plating augmented with anchor nailing was performed in 33 patients (group A) and open reduction plus calvicular hook plating was conducted in 32 (group B).The internal fixation was removed oue year after surgery in all.Constant Scale was used to evaluate shoulder function at 1,3 and 6 months postoperatively.X-ray examination on the shoulder was also conducted to observe fracture healing.Complications and percentage of the patients who resumed their job 3 months postoperatively were documented.Results The 2 groups were comparable because they showed no significant differences in general clinical information preoperatively (P ＞ 0.05).All the 65 patients were followed up tor 12 to 18 months (average,15.2 months).The fracture clinical healing time in group A (23.9 ± 2.3 weeks) was significantly shorter than in group B (26.1 ± 3.0 weeks) (P ＜ 0.05).The mean Constant-Murley scores at 1,3,6 months and the last follow-up postoperatively in group A (91.2 ±3.6,95.2 ±2.4,96.1 ±5.1 and 97.3 ± 1.6) were significantly higher thau those in group B (89.2 ± 6.1,91.1 ± 1.1,91.2 ± 6.2 and 92.1 ± 3.1) (P ＜ 0.05).The rate of total complications in group A (6.1％,2/33) was significantly lower than in group B (25.0％,8/32) (P ＜ 0.05).At postoperative 3 months,31 patients (93.9％) in group A resumed their job while 23 (71.9％) ones did in group B,showing a significant difference (P ＜ 0.05).Conclusions For Neer lⅡb distal calvicular fractures,anatomical locking compression plate augmented with anchor nail is obviously superior to calvicular hook plate,because the former can avoid damage to the soft tissue surrounding the acromion,leading to satisfactory functional recovery of the affected shoulder.

Objective: This study aimed to investigate the correlation between brain gray matter volume(GMV) and MPD based on voxel-based morphometry(VBM) method. Methods: By using principle of random sampling method, 566 students were recruited from 5 different majors in a certain university. An electronic questionnaire was used to collect the general situation and MPD. Moreover, 266 students were obtained high-resolution 3-dimensional T1 structure images by 3.0 T MRI based on voluntary principle. A multiple regression model with VBM8 was performed to detect GMV associated with MPD scores. Results: Among the 266 participants, 81 students(30.5%) reported MPD. There were no statistical differences of MPD scores between different characteristics, such as gender, residential area, sibling and perceived family income, as well as academic performance(t/F=-1.04,0.40,-1.30,0.23,1.48,P>0.05). An inverse correlation was found between GMV of the anterior cingulate gyrus(ACC) and right fusiform gyrus(FFG) with MPD scores(FDR corrected, P<0.05), and no positive associations were found. Conclusion College students with higher severity of MPD have lower GMV of ACC and right FFG, and these results suggested that MPD was correlated with brain reward, executive control and emotional related GMV.

Objective:To investigate the curative efficacy and application value of convalescent plasma (CP)in severe and critical coronavirus disease 2019 (COVID-19) caused by Delta variant.Methods:The treatment process and results of CP therapy for a patient with critical COVID-19 caused by Delta variant were reported. The clinical application value of CP for COVID-19 caused by Delta variant was analyzed along with the literature review.Results:Our case was a 50-year-old male, who was imported from abroad and had not been vaccinated against COVID-19. The novel coronavirus nucleic acid test was negative before entry. On the second day after entry, fever occurred, novel coronavirus nucleic acid test was positive. Chest CT images showed bilateral multiple mottling and ground-glass opacity with symptoms of nausea, headache, loss of appetite, diarrhea, but no running nose, nasal obstruction, dyspnea, abnormal smell and taste. The infection rapidly developed from medium to critical. On the basis of standard treatment, Delta variant CP was intravenous dripped on the 10th day of hospital admission (the 6th day after becoming severe). The patient's condition improved rapidly.Conclusion:The curative efficacy evaluation of this patient proved that CP therapy is of great value in the treatment of severe and critical COVID-19.

Objective:To investigate the association between serum levels of thyroglobulin (Tg), thyroid stimulating hormone (TSH) and antibodies and lymph node metastasis (LNM) in papillary thyroid cancer (PTC) .Methods:A total of 1 502 patients with PTC who were admitted to the Department of Breast and Thyroid Surgery of the First Affiliated Hospital of Chongqing Medical University from Jan. 2019 to Jan. 2022 were retrospectively enrolled, including males ( n=431), females ( n=1 071), aged < 55 years ( n=1 271), and ≥ 55 years old ( n=231). All patients were pathologically confirmed to have PTC after surgery. Univariate analysis was performed on the general data of patients and the indexes in the postoperative pathology report and the LNM group, and the data of P<0.05 in the analysis were included in the regression analysis to determine the independent risk factors of cervical LNM in PTC patients. Patients were divided into 8 subgroups according to the different statuses of the three thyroid antibodies (TGAb, TPOAb, TRAb) : [ (+) indicates positive; (-) indicates negative]. According to the order of TGAb, TPOAb, and TRAb, there are the following 8 states, 1 (+++) ; 2 (---) ; 3 (++-) ; 4 (+--) ; 5 (+-+) ; 6 (-+-) ; 7 (-++) ; 8 (--+). The differences in general clinical information, Tg and TSH between the two groups were compared, and the receiver operating characteristic curve (ROC) curve of Tg in the diagnosis of PTC lymph node metastasis was constructed, and regression analysis was used to explore the diagnostic value of serological indicators in the diagnosis of cervical LNM in PTC. Results:In this study, compared with the non-metastasis group, there were 308 males (33.2%) and 225 patients (24.3%) with bilateral PTC in metastasis group. The mean serum Tg value was (25.5±2.1) ng/mL and the TSH level was significantly increased ( P<0.05), and the results of binary logistic regression analysis showed that males ( OR=1.57, P<0.001), bilateral PTC ( OR=1.448, P<0.001), non-papillary carcinoma (>10 mm) ( OR=1.745, P<0.001) and increased Tg level ( OR=1.007, P=0.002) were independent risk factors for cervical lymph node metastasis in PTC patients, and the area under the ROC curve of Tg in the evaluation of cervical lymph node metastasis was 0.634 [95% CI (0.636, 0.691), P<0.05], while the TSH status was 0.56-1.39 ( OR=0.375, P=0.013). 1.40-2.29 ( OR=0.422, P=0.003) ; 2.30-5.91 ( OR=0.466, P=0.004) ; ≥5.91 ( OR=0.41, P=0.001) was not a risk factor. Conclusion:Male sex, bilateral thyroid cancer, non-papillary carcinoma (>10 mm), and preoperative serum Tg>29.8 ng/mL are the influencing factors of LNM in PTC patients.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Dental and craniofacial bone development is a highly coordinated process that is tightly controlled by genetics and influenced by complex environments. The abnormal regulation of many development-related signaling molecules may lead to abnormal tooth development, severe craniofacial bone formation disorders, and developmental deformities. Transforming growth factor-β (TGF-β) is widely expressed in vivo and participates in many cellular biological processes, showing complex regulatory roles in mammalian craniofacial bone growth and tooth development. In tooth development, abnormal TGF-β signaling can lead to the failure of tooth germ formation, and its deletion mutation can directly affect odontoblast differentiation and enamel formation defects. However, the current research on TGF-β mainly focuses on the early stage of tooth development, and a comprehensive and systematic study of TGF-β-related tooth development is lacking. TGF-β signal transduction mainly controls the development of teeth and craniofacial bone by regulating the expression of development-related molecules via the classical Smad-dependent signaling pathway. In addition, the nonclassical mitogen-activated protein kinase (MAPK) pathway also participates in this process. Abnormal TGF-β signaling may cause jaw development disorders, temporomandibular joint dysplasia and inflammation, and cleft palate. Because the specific regulatory mechanism of TGF-β in craniofacial bone development has not been fully elucidated, its specific application in the treatment of related diseases is also greatly limited. This paper describes the new research progress of TGF-β in the development of teeth, jaws, temporomandibular joints and palate as well as related diseases.

Fibroblast growth factor 8 (FGF8) is a kind of secretory polypeptide that has crucial roles in the development of various tissues and organs. Current studies have found that FGF8 can regulate the differentiation of cranial neural crest cells by activating the mitogen-activated protein kinase (MAPK) signaling pathway and affect the establishment of mandibular arch polarity and the development of craniofacial symmetry by regulating the expression of target genes. Cleft lip with or without cleft palate, ciliopathies, macrostomia and agnathia are four developmental malformations involving the craniofacial region that seriously affect the quality of life of patients. The abnormal FGF8 signal caused by gene mutation, abnormal protein conformation or expression is closely related to the occurrence of craniofacial malformations, but the molecular mechanism and signaling pathway underlying these malformations have not been fully elucidated. Craniofacial development is a complex process mediated by a variety of signaling molecules. In the future, the role of various signaling molecules in craniofacial development and malformations need to be explored to provide a new perspective and vision for the prevention and treatment of these craniofacial malformations.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.