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:To investigate the effect of adenosine deaminase acting on RNA 1 (ADAR1) on 5-serotonin-2c receptor in alleviating aggression in socially isolated mice.Methods:Sixty healthy male BALB / c mice aged 21 days were randomly divided into six groups: social isolation group, social control group, ADAR1 inducer social isolation group, ADAR1 inhibitor social isolation group, ADAR1 inducer social control group and ADAR1 inhibitor control group.The mice fed in single cage for 4 weeks were used as social isolation model while the mice fed in group were used as control group.ADAR1 inducer (5.0×10 4 U/kg) and inhibitor (10 mg/kg) were given intraperitoneally to mice in the ADAR1 inducer social isolation group and the ADAR1 inhibitor social isolation group respectively.The aggressive behavior of mice was evaluated by resident-intruder test.The expression of ADAR1 and 5-serotonin-2c receptors in the brain of mice was detected by immunohistochemistry and Western blot. Results:The attack latency of social isolation group was significantly lower than that of social control group ((43.15±6.99) s, (542.40±30.50) s; t=15.906, P<0.01), and the latency of attack ((256.70±29.49) s) in the ADAR1 inducer social isolation group was significantly higher than that in the social isolation group ( t=7.046, P<0.01). The latency of attack ((15.25±2.18)s) in the ADAR1 inhibitor social isolation group was significantly lower than that in the social isolation group ( t=3.809, P<0.01). The optical density of ADAR1 immunoreactive cells in the amygdala of the social isolation group mice was significantly lower than that in the corresponding brain area of the social control group (BLA: (0.038±0.002), (0.074±0.004); LaDL: (0.033±0.002), (0.060±0.002); LaVM: (0.045±0.003), (0.073±0.004); Lavl area: (0.044±0.003), (0.070±0.003); t=8.428, 9.037, 6.462, 5.698, all P<0.01). The optical density of ADAR1 immunoreactive positive cells in the amygdala (BLA: (0.060±0.003), LaDL: (0.042±0.002), LaVM: (0.056±0.004), Lavl: (0.054±0.003) in the ADAR1 inducer social isolation group was significantly higher than those in the corresponding brain area of the social isolation group mice ( t=6.055, 2.876, 2.312, 2.492; all P<0.05). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in amygdala of social isolation group were significantly lower than those of social isolation group ( t=11.37, 12.65; P<0.01). The expression of ADAR1 protein and 5-serotonin-2c receptor protein in the amygdala of the ADAR1 inducer social isolation group were significantly higher than those of the social isolation group ( t=3.02, 4.401; P<0.05). Conclusion:ADAR1 inducer alleviates the aggressive behavior of social isolated BALB / c mice by enhancing the protein expression of 5-serotonin-2c receptor in the amygdala of social isolated BALB/c mice.

Objective To explore the changes of brain structure network in patients with Parkinson's disease with mild cognitive impairment(PD-MCI),and to provide novel markers for the early recognition of PD-MCI. Methods Total 47 patients with primary PD were continuously enrolled at the De-partment of Neurology,Affiliated Hospital of Xuzhou Medical University from May 2017 to May 2018. Twenty-four healthy volunteers were selected as the healthy control (HC) group. General demographic data were col-lected from all subjects. The overall cognitive function and the five cognitive domains (attention and working memory,executive function,language,memory and visual spatial function) were comprehensively evaluated, then the patients with PD were further divided into PD-MCI group(n=22) and PD-NC group(n=25) based on their cognitive evaluation results. All subjects completed the diffusion tensor imaging( DTI) scan and the individual structural brain connection was obtained by deterministic diffusion-tensor tractography. By graph theory analysis technology,the network properties (global properties and node properties) and edge-wise dis- tributions were compared to assess structural connectivity differences among the three groups. Results Com-pared with the PD-NC and HC groups,the PD-MCI group had a larger characteristic path length(PD-NC:(8. 33±0. 95),HC:(8. 18±1. 35),PD-MCI:(9. 20±1. 52),F=4. 14,P<0. 05) and reduced global efficien-cy (PD-NC:(0. 13±0. 05),HC:(0. 13±0. 04),PD-MCI:(0. 10±0. 04),F=3. 73,P<0. 05) in addition to a lower nodal efficiency in frontoparietal areas,thalamus,cingulate gyrus,and insular(P=0 . 003-0. 040,FDR correction). Compared with the HC group,the PD-MCI group had a large frontotemporoparietal areas,basal ganglia,and insular network with decreased connection strength (P<0. 05,FDR correction). Compared with the PD-NC group,the PD-MCI group had a lower network connection strength in the frontoparietal areas (P<0. 05,FDR correction). Conclusion A disruption of structural connections that make up the brain network can lead to changes in information integration and delivery,leading to cognitive dysfunction in patients with PD. The distribution pattern of brain network structure connection changes is expected to become a new marker for identifying PD-MCI.

Objective To explore the effects of ADAR1 inducer and inhibitor on cognition and ADAR1 expression of isolated BALB/c mice.Methods Sixty healthy BALB/c mice were divided into 6 groups according to randomized design with 10 animals each group,the gregarious control group (GH),social isolation model group (SI),ADAR1 inducer treated gregarious group (GH+IFN-γ),ADAR1 inhibitor treated gregarious group (GH+EHNA),ADAR1 inducer treated isolation group (SI+IFN-γ) and ADAR1 inhibitor treated isolation group (SI+EHNA).Mice in drug treatment groups were treated with ADAR1 inducer (5.0? 104 U/kg,20 ml/kg,ip) and inhibitor (10 mg/kg,20 ml/kg,ip).Objection recognition test was used to measure cognition.Immunohistochenmistry was used to measure ADARI immunoreactivity and Western blotwas used to measure ADAR1 protein expression.Results In the objection recognition test,the non-spatial discrimination index of mice in SI group (-0.16±0.09) was significantly lower than that of GH group (0.41 ±0.17,P＜0.01),the non-spatial discrimination index of mice in SI+IFN-γ group (0.20±0.09) and in SI+ EHNA group (-0.29±0.12) was higher (P＜0.01) and lower (P＜0.05) than that of the SI group respectively.The immunohistochemistry results showed that the ADAR1 immunoreactivity in hippocampus of mice in SI group (Hilus:(0.013±0.003),CAI:(0.021±0.005)) decreased significantly compared to those of GH group(Hilus:(0.021 ±0.002),(0.047±0.004);both P＜0.05).And GH+IFN-γgroup mice showed increased ADAR1 immunoreactivity obviously in Hilus ((0.013±0.003) vs (0.023±0.004),P＜0.01) and in CA1 ((0.021±0.005) vs (0.040±0.005),P＜0.01) compared with that of SI group,ADAR1 inducer recovered the above abnornal ADAR1 immunoreactivity.Western blot results showed that the ADAR1 protein expression of mice in SI group (0.48 ±0.07) in hippocampus was significantly decreased (P＜0.01) compared to that of GH group (1.00 ±0.00).The level of ADAR1 protein in SI+IFN-γgroup(0.82 ±0.04) increased compared with that of SI group.Conclusions Four weeks of social isolation can reduce the non-spatial cognitive ability of BALB/c mice and decrease the expression of ADAR1 in the hippocampus.The ADAR1 inducers and inhibitors can reverse and aggravate the cognitive impairment caused by social isolation respectively.The related mechanisms may be related to the expression of ADAR1.

To better standardize clinical standard of medicinal materials and cut crude drugs in Chinese Pharmacopoeia (2010 edition, Volume I) and finish compiling work of relevant matching book named Clinical Guide to the Chinese Pharmacopoeia, based on analyzing the problems in clinical standard of medicinal materials and cut crude drugs in Chinese Pharmacopoeia (2005 edition, Volume I), feasibly practicable revising suggestion of standardizing clinical standard of medicinal materials and cut crude drugs in Chinese Pharmacopoeia (2010 edition, Volume I) is proposed.
China ; Drug and Narcotic Control ; Drugs, Chinese Herbal ; standards ; Pharmacopoeias as Topic

This research has analyzed the current status, problems for the properties theory of Chinese medicinal herbs. Proposed that the Chinese medicine literature research is a foundation, the research of properties theory of Chinese medicinal herbs should under the'Chinese medicine theory instruction. It must use the modern scientific method to study and unify the Chinese medicine superiority, establish the standards and reveal the scientific essence of Chinese medicine property.
Animals ; Drug Therapy ; trends ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; trends ; Plants, Medicinal ; chemistry

Objective To investigate the relationship between age and biochemical markers of bone absorption and bone formation in old men. Methods Urinary deoxypyridinoline crosslinks (Dpd),calcium (Ca),serum bone g1aprotein (BGP),procollagen I C terminal peptides (PICP) and testosterone (Tes) were determined by ELISA. Urinary hydroxyproline (Hyp) was tested by HPLC,and bone specific alkaline phosphatase (BALP) was assayed by electrophoresis. The data from 210 old man were compared with those of postmenopausal women and young men. Results As the age increased in old men, the levels of bone absorption markers increased (Dpd:12.6%,Hyp:23.5%), and bone formation markers decreased (BGP:3.1%,PICP:45.9%).The average level of Dpd in old men was (4.53?1.34) nmol/mmolCre, lower than that of postmenopausal women [(7.90?3.27) nmol/mmolCre] and young men [(6.78?3.31) mol/mmolCre], t test P

This paper is to report our results of the observation on the changes of the pulmonary water content of the rats and mice after their exposure to a simulated altitude of 6000 meters above sea level for seven days.It was found that the changes of the pulmonary water content varied with the duration of exposing to the high altitude. It was lower than the control value on the first day of exposure, and then it increased approaching or even being a little higher than the control value on the second and third day. But it decreased and was below the control value again from the fourth day to the seventh day. The lung weight was increasing continuously in the same period.In addition, there were progressive increase of both the wet-lung/body and dry-lung/body indices, progressive decrease of left/right ventricles ratio, and gradual rising of hemoglobin in the animals studied.

Rats were made to bleed and about 40% of the total blood volume was lost. A replacement of Ringer's solution of the volume four times the lost blood volume was given and the animals were closely monitored for 24 hours. The hemoglobin level of the animals was low throughout the course of observation. The plasma colloid osmotic pressure reached the lowest point 15 minutes after bleeding, and then gradually rising up returned to a level about 90% of the control value at the end of 24 hours. The relativity between the plasma colloid osmotic pressure and the lung water content was quite significant in those rats in a low altitude environment (P0.05).The result indicates that the increased lung water content due to decreased plasma osmotic pressure could not be made further worse by hypoxia due to high altitude. The characteristic pulmonary hemodynamic changSs caused by hypoxia might be considered as the explanation of the phenomenon.