Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

The growth and atrophy of bones are closely related to the mechanical stress they experience. Mechanotransduction, a fundamental biological signal transmission mechanism, enables cells to convert external mechanical forces into intracellular signaling responses through the secretion of protein factors and activation of signaling pathways. Piezo1 is a mechanosensitive ion channel that detects mechanical stress (such as pressure, stretch, and shear force), induces Ca 2+ influx, and transduces these signals into intracellular responses, playing a crucial role in bone homeostasis. Encoded by the Fam38A gene, Piezo1 possesses a distinctive 38-transmembrane helical structure that forms a bowl-shaped, trimeric propeller-like configuration. This unique structure allows it to function as a mechanical transducer, sensing mechanical stimuli at the cell membrane and transmitting mechanical signals. In the skeletal system, Piezo1 contributes to maintaining the dynamic balance between bone formation and resorption by regulating the functions of macrophages, bone marrow mesenchymal stem cells, chondrocytes, osteocytes, osteoblasts, and osteoclasts, as well as through signaling pathways such as Akt, Wnt/β-catenin, TGF-β, and MAPK. Additionally, studies have demonstrated a significant association between Piezo1 gene polymorphisms and bone mineral density, highlighting its potential therapeutic applications in osteoporosis treatment via the osteogenic-angiogenic coupling mechanism. This review summarizes the mechanisms and recent research progress on the Piezo1 mechanosensitive ion channel in bone homeostasis. By elucidating Piezo1’s role in bone metabolism, this review aims to provide a theoretical foundation and potential strategies for the prevention and treatment of osteoporosis and other bone-related diseases in clinical practice.

The growth and atrophy of bones are closely related to the mechanical stress they experience. Mechanotransduction, a fundamental biological signal transmission mechanism, enables cells to convert external mechanical forces into intracellular signaling responses through the secretion of protein factors and activation of signaling pathways. Piezo1 is a mechanosensitive ion channel that detects mechanical stress (such as pressure, stretch, and shear force), induces Ca 2+ influx, and transduces these signals into intracellular responses, playing a crucial role in bone homeostasis. Encoded by the Fam38A gene, Piezo1 possesses a distinctive 38-transmembrane helical structure that forms a bowl-shaped, trimeric propeller-like configuration. This unique structure allows it to function as a mechanical transducer, sensing mechanical stimuli at the cell membrane and transmitting mechanical signals. In the skeletal system, Piezo1 contributes to maintaining the dynamic balance between bone formation and resorption by regulating the functions of macrophages, bone marrow mesenchymal stem cells, chondrocytes, osteocytes, osteoblasts, and osteoclasts, as well as through signaling pathways such as Akt, Wnt/β-catenin, TGF-β, and MAPK. Additionally, studies have demonstrated a significant association between Piezo1 gene polymorphisms and bone mineral density, highlighting its potential therapeutic applications in osteoporosis treatment via the osteogenic-angiogenic coupling mechanism. This review summarizes the mechanisms and recent research progress on the Piezo1 mechanosensitive ion channel in bone homeostasis. By elucidating Piezo1’s role in bone metabolism, this review aims to provide a theoretical foundation and potential strategies for the prevention and treatment of osteoporosis and other bone-related diseases in clinical practice.

Objective To explore the mechanism of Chaipo Decoction in intervening lipopolysaccharide(LPS)-induced acute lung injury(ALI)based on network pharmacology and experimental verification.Methods TCMSP database was used to screen the active components and targets of Chaipo Decoction.ALI disease targets were retrieved through GeneCards and OMIM databases,the intersection genes of drug and disease were obtained.They were imported into STRING platform and Cytoscape 3.9.1 software to construct protein interaction network and drug-active components-target network,core components and targets were screened,and GO and KEGG pathway enrichment analysis was performed on them.AutoDock 1.5.6 and PyMOL software were used to verify the molecular docking between the main active components and core targets.The ALI model of mice was induced by LPS,and was intervened by Chaipo Decoction.The pathological changes of lung tissue in mice were observed by HE staining.The contents of IL-6,IL-10 and TNF-α in serum of mice were detected by ELISA.Western blot was used to verify the expressions of target proteins in lung tissue.Results Totally 214 active components of Chaipo Decoction,such as norwogonin,baicalein,quercetin and ursolic acid were screened,with 1 101 targets and 271 potential targets for intervention in ALI,mainly SRC,STAT3,AKT1,EGFR,GRB2,PIK3CA,etc.It mainly affected PI3K/Akt signaling pathway,MAPK signaling pathway,apoptosis,Ras signaling pathway,etc.Molecular docking showed that the main active components of Chaipo Decoction had strong binding ability with core targets SRC,STAT3,AKT1,EGFR and GRB2.The results of animal experiments showed that Chaipo Decoction could alleviate the lung lesions in ALI mice,decrease the contents of IL-6 and TNF-α in serum,increase the content of IL-10,and significantly decreased the expressions of EGFR,PI3K,AKT and NF-κB p65 protein in lung tissue.Conclusion Chaipo Decoction can exert anti-ALI effect through multiple pathways and multiple targets,and its mechanism may be related to the inhibition of EGFR/PI3K/Akt signaling pathway.

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*

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans ; Consensus ; Orthodontic Appliance Design ; Orthodontic Appliances, Removable ; Tooth Movement Techniques/methods* ; Malocclusion/therapy* ; Orthodontics, Corrective/instrumentation*

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic