Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
Humans ; Consensus ; Endodontics/methods* ; Tooth ; Printing, Three-Dimensional ; Dental Care ; Cone-Beam Computed Tomography ; Root Canal Therapy

Osteoporosis (OP) is a systemic skeletal disease that primarily affects the elderly population, which greatly increases the risk of fractures. Here we report that Kindlin-2 expression in adipose tissue increases during aging and high-fat diet fed and is accompanied by decreased bone mass. Kindlin-2 specific deletion (K2KO) controlled by Adipoq-Cre mice or adipose tissue-targeting AAV (AAV-Rec2-CasRx-sgK2) significantly increases bone mass. Mechanistically, Kindlin-2 promotes peroxisome proliferator-activated receptor gamma (PPARγ) activation and downstream fatty acid binding protein 4 (FABP4) expression through stabilizing fatty acid synthase (FAS), and increased FABP4 inhibits insulin expression and decreases bone mass. Kindlin-2 inhibition results in accelerated FAS degradation, decreased PPARγ activation and FABP4 expression, and therefore increased insulin expression and bone mass. Interestingly, we find that FABP4 is increased while insulin is decreased in serum of OP patients. Increased FABP4 expression through PPARγ activation by rosiglitazone reverses the high bone mass phenotype of K2KO mice. Inhibition of FAS by C75 phenocopies the high bone mass phenotype of K2KO mice. Collectively, our study establishes a novel Kindlin-2/FAS/PPARγ/FABP4/insulin axis in adipose tissue modulating bone mass and strongly indicates that FAS and Kindlin-2 are new potential targets and C75 or AAV-Rec2-CasRx-sgK2 treatment are potential strategies for OP treatment.

Severe acute pancreatitis-associated acute lung injury (SAP-ALI) is a serious disease associated with high mortality. Emodin has been applied to alleviate SAP-ALI; however, the mechanism remains unclear. We report that the therapeutic role of emodin in attenuating SAP-ALI is partly dependent on an exosomal mechanism. SAP rats had increased levels of plasma exosomes with altered protein contents compared to the sham rats. These infused plasma exosomes tended to accumulate in the lungs and promoted the hyper-activation of alveolar macrophages and inflammatory damage. Conversely, emodin treatment decreased the plasma/pancreatic exosome levels in the SAP rats. Emodin-primed exosomes showed less pro-inflammatory effects in alveolar macrophages and lung tissues than SAP exosomes. In detail, emodin-primed exosomes suppressed the NF-κB pathway to reduce the activation of alveolar macrophage and ameliorate lung inflammation by regulating PPARγ pathway, while these effects were amplified/abolished by PPARγ agonist/antagonist. Blockage of pancreatic acinar cell exosome biogenesis also exhibited suppression of alveolar macrophage activation and reduction of lung inflammation. This study suggests a vital role of exosomes in participating inflammation-associated organ-injury, and indicates emodin can attenuate SAP-ALI by reducing the pancreatic exosome-mediated alveolar macrophage activation.

Objective To explore the application value of telepathological consultation in helping grassroots hospitals.Methods 578 cases of intraoperative telepathology consultation were reviewed,and the accuracy and the timely rate of diagnosis were calculated.The systematic distribution,benign and malignant distribution,and the distribution difference in different primary hospitals were analyzed,so as to evaluate the popularization value of the intraoperative telepathology consultation.Results The accuracy rate of 578 cases of intraoperative telepathology consultation was 99.83％.The timely rate of consultation in 30min was 96.02％,and most reports could be diagnosed in 2 to 5 mins.The source of tissues involved in consultation were thyroid,breast,ovary/fallopian tube and lung.In all cases,24.39％ of the malignant tumors were found.Among the diseases of different systems,the proportion of malignant tumors is the highest in breast diseases,followed by lung,thyroid and ovary.Among the four hospitals with most of the consultations,the rate of malignant tumor in Renmin Hospital of Jianli County was the highest,followed by Renmin Hospital of Yingshan County,Renmin Hospital of Xiaochang County,and Fifth Division Hospital of Xinjiang.Conclusion Intraoperative telepathology consultation can provide accurate and timely expert consultation for grassmots hospitals,avoid the "second operations" of the patients,improve the access of medical treatment for people living in relatively remote areas,solve the shortage of pathologists at the grassroots hospitals,and improve the level of doctors' diagnosis and treatment at the grassroots hospitals,which is worth popularizing and applying in Pathology Department of the grassroots hospitals.

Objective To observe the oral part of the facial artery and facial vein and to provide anatomical data for clinical applica-tion. Methods The origin, branches, course, diameter, position of oral part of facial artery and facial vein were observed on 32 fixed cada-ves (64 sides). Results The position relation between the facial artery and facial vein is non-constant. Measure the distance from inferior border of mandible to corner of the mouth, angulus mandibulae, mental protuberance midpoint. It is (5. 49 ± 0. 63) cm, (2. 50 ± 0. 89) cm and (6. 20 ± 1. 68) cm in the left side respectively, and (5. 69 ± 0. 72) cm, (2. 56 ± 1. 08) cm and (6. 85 ± 1. 86) cm in the right side re-spectively. The diameter of facial artery in inferior border of mandible is (0. 33 ± 0. 08) cm in the left side and (0. 38 ± 0. 07) cm in the right side;while the diameter of facial vein is (0. 40 ± 0. 12) cm in the left side and (0. 42 ± 0. 18) cm in the right side. The facial artery and facial vein are not concomitant and they are not asymmetry also. The position of superior labial artery arteries is constant, but the position of inferior labial artery arteries have more variations. Conclusion The branches, course, diameter and position of oral part of facial artery and facial vein have a number of variations. The superior labial artery arteries could be positioned more easily than inferior labial artery arter-ies. Being familiar with their distribution is of great importance for clinical application.

Exosome is a kind of biological membrane structure at nanometer level. It is secreted by various cells in the body and widely distributed in most body fluids, such as saliva, blood, and milk. Biological active substances, including mRNAs, microRNAs, cytokines, and transcription factor, have been identified in the exosomes. MiRNAs are short and non-coding RNAs that modulate gene expression at the posttranscriptional level. MiRNAs extensively involves in henogenesis, cell proliferation and apoptosis. With various biological functions, exosome-derived miRNAs can not only be served as biomarkers to diagnose tumor, neurological diseases and mental disorders, but also possess potential as therapeutic targets.
Apoptosis ; Biomarkers ; Cell Proliferation ; Exosomes ; genetics ; Humans ; Mental Disorders ; diagnosis ; therapy ; MicroRNAs ; genetics ; Neoplasms ; diagnosis ; therapy ; Nervous System Diseases ; diagnosis ; therapy

Objective Wnt signaling plays an important role in the development and progression of renal cell carcinoma (RCC).This study aimed to evaluate the effects of the Wnt signaling inhibitor 15-oxospiramilactone on the proliferation , migration, cell apoptosis, and cycles of the human RCC cell line 786-0, and to investigate the possible mechanisms of this small molecule acting on RCC in ivtro. Methods We treated 786-0 cells with DMSO ( blank control group ) and 15-oxospiramilactone at the concentrations of1.25μmol/L (low 15 -OSL), 2.5μmol/L (medium 15-OSL), and 5μmol/L (high 15-OSL), respectively, for 72 hours.Then we observed the changes in the proliferation and migration of the 786-0 cells by MTT and scratch-wound assay and determined their apopto-sis and cycles by Annexin V-FITC/PI assay and flow cytometry . Results 15-oxospiramilactone significantly inhibited the growth of the 7860-cells, with the IC 50of 1.088 μmol/L at 72 hours, and decreased their migration distance (P<0.05).After 36 hours of treatment, the apoptosis rates of the 786-0 cells in the low, medium, and high 15-OSL groups were (12.17 ±0.56), (18.54 ± 1.07), and (50.74 ±1.28) %, respectively, significantly increased as compared with (7.85 ±0.42) %in the blank control group (P<0.05), and in an obviously concentration-dependent manner.15-oxospiramilactone remarkably reduced the number of cells in the G0/G1 phase and increased that in the G 2/M phase (P<0.05). Conclusion 15-oxospiramilactone can significantly inhibit the pro -liferation and migration and induce the apoptosis of 786-0cells in vitro.It may be a potential anti-RCC agent.

Objective To explore the effect of a tobacco control manual for smokers in communities of Changsha.Methods 159 qualified smokers were selected from 6 communities of Yuelu District by Multistage cluster sampling.According to their different locations.the samples were divided into two groups:77 in intervention group and 82 in control group.4 times in assessment were carried out for smokers in two groups at baseline(V0),1 month after intervention(V 1),3 months after intervention (end,V3) and follow-up(6 months after Baseline,V6).Results After intervention,the quit rates in intervention group were 12.5％,23.6％ and 20.8％ respectively.Cigarettes per day,times attempting to quit smoking for 24 h and 7 d or more,quit rates were significantly different(P＜0.05).Conclusion The intervention reduces the cigarettes per day,increases the times attempting to quit smoking,advances the stages and increase the quit rate.It is one of the proper choices for smokers and smoking cessation clinic in communities.

Objective To understand the situation of the junior nurses ’ demands for standardized training, and explore the content of standardized training to junior nurses , in order to provide a basis for the development of standardized training syllabus for junior nurses .Methods One thousand one hundred and eighty-three junior nurses in Beijing were surveyed by the self-designed questionnaire about the junior nurses ’ demands for standardized training .Results In the junior nurses ’ demands for standardized training content , the top three in the humanistic quality were respectively nurses ’ self-emotional management and psychological decompression , interpersonal relationship and communication , nursing psychology , and the scores were respectively (4.66 ±0.55), (4.58 ±0.57), (4.39 ±0.64); the top three in the theory knowledge were respectively theoretical knowledge of specific nursing , basic nursing and overall nursing , and the scores were respectively (4.60 ±0.57), (4.55 ±0.61), (4.50 ±0.63); the top three in the clinical practice were respectively emergency nursing , the ability of disease observation and the process of emergency handling , and the scores were respectively (4.62 ±0.57), (4.60 ±0.59), (4.58 ±0.61); the top one in the ability of teaching was health education , and the score was (4.37 ±0.64); the top three in the way of training were respectively cooperation between doctors and nurses , centralism training and nursing rounds , and the scores were respectively (4.28 ±0.64), (4.24 ±0.71), (4.23 ±0.67); the top three in the way of teaching were respectively demonstration , case discussion and exchange of experiences , and the scores were respectively (4.48 ±0.61), (4.35 ±0.65), (4.28 ±0.66).35%of junior nurses thought they could independently work after 3 months of training , and 30 .6% thought after 6 months of training .Conclusions Nursing managers should improve the standardization of training programs according to the demand of the junior nurses so as to provide the higher development platform for the development of junior nurses ’ career.

Objective To establish the norm of occupational stress on the nurse in China. Methods Used stratified random cluster sampling,a total of 3091 nurses in 21 from China' s eastern,central and western parts of three regional hospitals, hospital were tested by Chinese nurse stressor scale (CNNS). Results ①The total norms for the CNNS and each factor are established. ②Descriptive statistics for CNSS for different regions samples, different working year' s samples,different marital status samples,different titles samples,different age's samples, different education background samples and different work nature samples were modulated. Conclusion The norm established can basically represent the occupational stress on nurses in China.