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

Severe muscle injury is hard to heal and always results in a poor prognosis. Recent studies found that extracellular vesicle-based therapy has promising prospects for regeneration medicine, however, whether extracellular vesicles have therapeutic effects on severe muscle injury is still unknown. Herein, we extracted apoptotic extracellular vesicles derived from mesenchymal stem cells (MSCs-ApoEVs) to treat cardiotoxin induced tibialis anterior (TA) injury and found that MSCs-ApoEVs promoted muscles regeneration and increased the proportion of multinucleated cells. Besides that, we also found that apoptosis was synchronized during myoblasts fusion and MSCs-ApoEVs promoted the apoptosis ratio as well as the fusion index of myoblasts. Furthermore, we revealed that MSCs-ApoEVs increased the relative level of creatine during myoblasts fusion, which was released via activated Pannexin 1 channel. Moreover, we also found that activated Pannexin 1 channel was highly expressed on the membrane of myoblasts-derived ApoEVs (Myo-ApoEVs) instead of apoptotic myoblasts, and creatine was the pivotal metabolite involved in myoblasts fusion. Collectively, our findings firstly revealed that MSCs-ApoEVs can promote muscle regeneration and elucidated that the new function of ApoEVs as passing inter-cell messages through releasing metabolites from activated Pannexin 1 channel, which will provide new evidence for extracellular vesicles-based therapy as well as improving the understanding of new functions of extracellular vesicles.
Creatine/metabolism* ; Extracellular Vesicles ; Muscle, Skeletal/metabolism* ; Myoblasts/metabolism* ; Regeneration ; Connexins/metabolism*

Objective:To study factors influencing postoperative pancreatic fistula rates with a view to prevent postoperation pancreatic fistula from happening.Methods:This is a retrospective study on 281 patients who underwent distal pancreatectomy at the First Affiliated Hospital of China Medical University from March 2011 to April 2018. There were 89 males and 192 females, with the age of (51.01±13.65) years. Univariate and multivariate logistic regression analyses were used to analyze the following factors on the occurrence of pancreatic fistula after operation: gender, age, body mass index(BMI), tumor characteristics, preoperative fasting blood glucose, blood biochemistry, liver function and surgical indications.Results:Of the 281 patients who underwent distal pancreatectomy in this study, 245 (87.2%) did not develop pancreatic fistula / biochemical leakage, while 36(12.8%) patients developed clinically significant pancreatic fistula (B/C grade). Univariate analysis showed the factors which affected the incidence of pancreatic fistula after surgery to include: BMI, preoperative fasting blood glucose, and whether the main pancreatic duct was ligated (all P<0.05). Multivariate logistic regression analysis showed that the independent factors affecting pancreatic fistula incidence after surgery were BMI≥25 kg/m 2 ( OR=2.354, 95% CI: 1.137-4.873, P<0.05), and main pancreatic duct was not ligated ( OR=4.067, 95% CI: 1.191-13.885, P<0.05). Conclusions:A high BMI increased the risk of postoperative pancreatic fistula, while ligation of main pancreatic duct during surgery reduced the risk.

100 patients with recurrent aphthous ulcer (RAU) were randomly divided into two groups, 50 in each group. The patients in test group were treated with Xipayi mouthwash, those in control were given Chlorhexidine mouthwash. All the patients were treated for 7 days. The efficacy of Xipayi mouthwash is superior to Chlorhexidine in the treatment of RAU.

Objective Whether combination of ganoderma spore and L-NNA(NOS inhibitor) could promote the neuronal survival and axonal regeneration in Clarke's nucleus(CN) and red nucleus(RN) following spinal cord hemisection was explored. Methods Thirty adult female rats were divided into control group,L-NNA group,low dosage of ganoderma spore group,low dosage of ganoderma spore+L-NNA group,high dosage of ganoderma spore group and high dosage of ganoderma spore+L-NNA group.L-NNA was intraperitoneally injected and high dosage of ganoderma spore was irrigated into the rat's stomach after hemisection of T11 spinal cord segment in high dosage of ganoderma spore+L-NNA group. Results Thirty days after spinal cord hemisection,the number of CN neurons was decreased and some neurons were expressing NOS on lesioned side of L1 spinal cord in control group.The number of CN neurons on lesioned side of L1 spinal cord was increased in L-NNA group and low dosage of ganoderma spore group,but the number of NOS-positive neurons was decreased.In low dosage of ganoderma spore+L-NNA group and high dosage of ganoderma spore group,the number of CN neurons was significantly increased and NOS-positive neurons were also significantly decreased on lesioned side of L1 spinal cord.In high dosage of ganoderma spore+L-NNA group,there were most CN neurons surviving and least NOS-positive CN neurons,and some neurons were labeled by flourogold on lesioned side of LI spinal cord.The density of RN neurons on lesioned side was decreased in control group and L-NNA group.The density of RN neurons on lesioned side was increased in low dosage of ganoderma spore group and low dosage of ganoderma spore+L-NNA group.The density of RN neurons on lesioned side was significantly increased in high dosage of ganoderma spore group and high dosage of ganoderma spore+L-NNA group.Conclusion Ganoderma spore or L-NNA can promote the survival of injuried CN neurons after spinal cord hemisection.Combination of ganoderma spore and L-NNA can better promote injuried CN neuronal survival and axonal regeneration.Ganoderma spore can also enhance injuried RN neuronal survival.