With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

Objective:To explore the dosimetric characteristics of proton radiotherapy plan and photon radiotherapy plan for esophageal cancer.Methods:Four patients who were admitted to Shandong Cancer Hospital and Institute from January 2024 to April 2024 with esophageal cancer (cervical, middle thoracic and total esophageal tube, as well as the lymphatic drainage areas involved) and required radiotherapy were selected as the research subjects. Intensity modulated proton therapy (IMPT) and intensity modulated radiation therapy (IMRT) plans were designed respectively based on the clinical target volume and the dose constraints for organs at risk (OARs). Dosimetric parameters, including conformity index (CI), homogeneity index (HI), gradient index (GI) for target coverage, as well as OARs dosimetric parameters were evaluated. The volume of additional dose deposition in the body was compared by assessing regions receiving 10%, 30%, and 50% of the prescription dose.Results:For all four cases, IMPT plans yielded lower HI values (0.12, 0.10, 0.06, and 0.08) than IMRT plans (0.15, 0.13, 0.10, and 0.11), and the GI values of IMPT plans (3.11, 3.21, 2.43, and 2.72) was lower than IMRT plans (4.52, 5.14, 3.09, and 3.92). Moreover, the CI of the IMPT plans (0.59, 0.60, 0.77, and 0.72) was inferior to IMRT plans (0.81, 0.77, 0.91, and 0.85). Compared with the IMRT plans, in the whole lung dose indicators of the IMPT plans for the 4 patients, V 5 decreased by 34.1%, 55.0%, 79.7% and 60.3%, respectively; V 20 decreased by 48.3%, 43.9%, 65.8% and 40.8%, respectively, and D mean decreased by 43.4%, 57.2%, 76.2% and 45.4%, respectively. V 30 of the heart decreased by 36.2%, 45.3%, 40.1% and 52.4%, respectively, and D mean of heart decreased by 96.6%, 57.9%, 58.5% and 55.3%, respectively. For the middle and lower thoracic target area, the liver was significantly protected in the IMPT plan (D mean decreased by 76.0% compared with the IMRT plan). In terms of the additional dose deposition in the patient's body, IMPT plans reduced the volumes receiving 10%, 30% and 50% of the prescription dose by 45.0%-61.4%, 41.2%- 61.8% and 34.8%-61.6%, respectively, compared with the IMRT plans. Conclusions:By comparing the dosimetric parameters of IMPT and IMRT plans for 4 cases of esophageal cancer, the IMPT plans have advantages in reducing the doses to lung tissue, heart, and liver, and can also reduce additional dose deposition in the patient's body.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

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*

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective To investigate the short-term efficacy of 3D-printed artificial vertebral body combined with PEEK-Cage implantation in anterior cervical surgery for ossification of the posterior longitudinal ligament of the cervical spine(OPLL).Methods The clinical data of 15 patients with OPLL who underwent anterior cervical surgery with 3D-printed artificial vertebral body and PEEK-Cage implantation in the Fifth Department of Orthopaedics,Liaoning Provincial People's Hospital from September 2022 to June 2023 was retrospectively analyzed.The surgical time,intraoperative blood loss,postoperative drainage volume,bed rest time,hospital stay,and surgery-related complications of patients were analyzed.The Japanese Orthopaedic Association(JOA)score and visual analogue scale(VAS)score of patients were counted before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.The changes of Cobb angle of fusion segment of patients were recorded before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.Results All 15 patients successfully completed the surgery.The surgical time was 130 to 160 minutes,with an average of(148.68±10.04)minutes.The intraoperative blood loss was 50 to 200 mL,with an average of(130.0±18.8)mL.The postoperative drainage volume was 220 to 980 mL,with an average of(270.0±24.6)mL.The bed rest time was 3 to 11 days,with an average of(3.6±2.8)days.The hospital stay was 7 to 16 days,with an average of(8.2±2.6)days.All patients'incisions healed in the first stage,and no infection occurred.One patient suffered from dural sac tear during surgery;4 patients had dysphagia after surgery;1 patient suffered from muscle weakness of one limb after surgery;Hematoma formed in the incision of cervical spine in 1 patient 3 days after surgery.At 3 days,1 month,and 6 months after surgery,the Cobb angle,VAS score and JOA score of 3 patients with myeloid symptoms and upper limb root pain were significantly improved compared with those before surgery(P<0.05),and the Cobb angle and JOA score of 12 patients with only myeloid symptoms were significantly improved compared with those before surgery(P<0.05).Conclusion 3D-printed artificial vertebral body combined with PEEK-Cage implantation in anterior cervical surgery is an effective method for the treatment of OPLL,which can significantly relieve patients'pain and improve their dysfunction in a short time,with good stability and fusion effect.

Objective To investigate the short-term efficacy of 3D-printed artificial vertebral body combined with PEEK-Cage implantation in anterior cervical surgery for ossification of the posterior longitudinal ligament of the cervical spine(OPLL).Methods The clinical data of 15 patients with OPLL who underwent anterior cervical surgery with 3D-printed artificial vertebral body and PEEK-Cage implantation in the Fifth Department of Orthopaedics,Liaoning Provincial People's Hospital from September 2022 to June 2023 was retrospectively analyzed.The surgical time,intraoperative blood loss,postoperative drainage volume,bed rest time,hospital stay,and surgery-related complications of patients were analyzed.The Japanese Orthopaedic Association(JOA)score and visual analogue scale(VAS)score of patients were counted before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.The changes of Cobb angle of fusion segment of patients were recorded before surgery,3 days after surgery,1 month after surgery and 6 months after surgery.Results All 15 patients successfully completed the surgery.The surgical time was 130 to 160 minutes,with an average of(148.68±10.04)minutes.The intraoperative blood loss was 50 to 200 mL,with an average of(130.0±18.8)mL.The postoperative drainage volume was 220 to 980 mL,with an average of(270.0±24.6)mL.The bed rest time was 3 to 11 days,with an average of(3.6±2.8)days.The hospital stay was 7 to 16 days,with an average of(8.2±2.6)days.All patients'incisions healed in the first stage,and no infection occurred.One patient suffered from dural sac tear during surgery;4 patients had dysphagia after surgery;1 patient suffered from muscle weakness of one limb after surgery;Hematoma formed in the incision of cervical spine in 1 patient 3 days after surgery.At 3 days,1 month,and 6 months after surgery,the Cobb angle,VAS score and JOA score of 3 patients with myeloid symptoms and upper limb root pain were significantly improved compared with those before surgery(P<0.05),and the Cobb angle and JOA score of 12 patients with only myeloid symptoms were significantly improved compared with those before surgery(P<0.05).Conclusion 3D-printed artificial vertebral body combined with PEEK-Cage implantation in anterior cervical surgery is an effective method for the treatment of OPLL,which can significantly relieve patients'pain and improve their dysfunction in a short time,with good stability and fusion effect.

Objective To investigate the short-term efficacy of transforaminal endoscope combined with percutaneous fixation in the treatment of single-segment Brucella spondylitis with intraspinal abscess. Methods The clinical data of 14 patients with single-segment lumbar Brucella spondylitis with intraspinal abscess treated by transforaminal endoscopic decompression combined with percutaneous fixation in our hospital from March 2021 to August 2022 were retrospectively analyzed. The operation time,intraoperative blood loss,erythrocyte sedimen-tation rate(ESR) and C-reactive protein(CRP) before operation,3 days and 3 months after operation,postoperative drainage volume,post-operative bed rest time and occurrence of complications were recorded. Before operation,3 days and 3 months after operation,the visual analogue scale (VAS) was used to evaluate the pain degree of lower back and leg,the lumbar function was evaluated by Japanese Orthopaedic Association (JOA) score,Oswestry disability index (ODI)was used to evaluate the dysfunction,and the modified Macnab criteria was used to evaluate the good to excellent rate of efficacy. Results The operation time of 14 patients was 182～217 min,with an average of (197.3±18.6) minutes. The mean intraoperative blood loss was (37.8±15.5)mL;the mean drainage volume was (23.5±5.8)mL;the postoperative bed rest time was (3.5±1.4) days. ESR and CRP gradually decreased 3 days and 3 months after operation compared with those before opera-tion,with statistically significant differences(P<0.05). The VAS scores of lower back and legs,JOA scores,and ODI at each time point of follow-up after operation were significantly improved compared with those before operation,with statistically significant differences (P<0.05). After 3 months of follow-up,the good to excellent rate of efficacy was 85.7％.Conclusion The minimally invasive technique of transforaminal endoscope in the treatment of Brucella spondylitis with intraspinal abscess can conduct neuraxial root decompression,abscess removal,and local surgical area irrigation,significantly relieve the pain of lower limbs,and combined with the percutaneous fixation can significantly alleviate the low back pain and improve the function of patients. The combination of the two methods is minimally invasive,safe and effective in the treatment of Brucella spondylitis with intraspinal abscess.