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*

Bipolar disorder (BD) affects 1% of the global population. BD is a group of chronic psychiatric disorders characterized by recurrent manic or hypomanic episodes that may alternate with depressive episodes. Given the current diagnostic modalities, accurately diagnosing BD, particularly distinguishing it from unipolar depression (UD), is challenging. Biomarkers have emerged as potent instruments for establishing objective diagnostic criteria for BD, and their identification, which reflects the pathophysiological processes of BD, can facilitate the precise diagnosis of the disorder. In this review, the search terms "BD" and "diagnosis" or "biomarker" were used as the key search syntax. In total, 110 studies were included. This review systematically examines the research in the field and summarizes current studies on biomarkers of BD in omics and neuroimaging. We hope that this review will benefit research aimed at establishing objective diagnostic criteria for BD and developing novel therapeutic interventions.

Objective:To explore the feasibility of sirolimus as an alternative graft versus host disease (GVHD) prophylaxis in patients with kidney injury after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Retrospective case series study. Medical records of 11 patients in Peking University People′s Hospital from 1 August 2008 to 31 October 2022, who received sirolimus instead of cyclosporine to prevent GVHD, due to renal insufficiency after allo-HSCT, were analyzed retrospectively. Incidence of GVHD, infection, and transplant-associated thrombotic microangiopathy (TA-TMA), as well as renal function, were evaluated.Results:Among the 11 patients who received sirolimus, 6 were treated with haploidentical donor HSCT, and 5 were treated using matched sibling donor HSCT. The median (range) time of sirolimus administration was 30 (7-167) days after allo-HSCT, and the median (range) sirolimus course duration was 52 (9-120) days. During sirolimus treatment, 1 case did not undergo combined treatment with other prophylactic drugs, 3 cases received combined mycophenolate mofetil (MMF), and 1 case underwent combined CD25 monoclonal antibody treatment, while 6 cases had combined therapy with both MMF and CD25 monoclonal antibody. Of the 11 patients, 2 developed Grade Ⅲ acute GVHD, 1 developed severe pneumonia and died, and 1 developed TA-TMA, while nine patients had normal or improved renal function. Median (range) follow-up time was 130 (54-819) days. Non-relapse mortality was observed in 1 patient. Relapse mortality was also observed in 1 patient.Conclusion:Sirolimus-based alternative GVHD prophylaxis is a potentially viable option for patients undergoing allo-HSCT who cannot tolerate cyclosporine, but its efficacy and safety require further optimization and verification in prospective studies.

Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.

BACKGROUND: Coronary artery disease (CAD) is the commonest cause of heart failure (HF), whereas pulmonary hypertension (PH) has not been established or reported in this patient population. Therefore, we assessed the prevalence, risk factors, and survival in CAD-associated HF (CAD-HF) complicated with PH. METHODS: Symptomatic CAD-HF patients were continuously enrolled in this prospective, multicenter registry study. Echocardiography, coronary arteriography, left and right heart catheterization (RHC), and other baseline clinical data were recorded. Patients were followed up and their survival was recorded. RESULTS: One hundred and eighty-two CAD-HF patients were enrolled, including 142 with HF with a preserved ejection fraction (heart failure with preserved ejection fraction [HFpEF]; left ventricular ejection fraction [LVEF] ≥50%) and 40 with a reduced ejection fraction (heart failure with reduced ejection fraction [HFrEF]; LVEF < 50%). PH was diagnosed with RHC in 77.5% of patients. Patients with PH showed worse hemodynamic parameters and higher mortality. HFrEF-PH patients had worse survival than HFpEF-PH patients. CAD-HF patients with an enlarged left ventricular end-diastolic diameter and reduced hemoglobin were at higher risk of PH. Nitrate treatment reduced the risk of PH. Elevated creatinine and mean pulmonary arterial pressure (mPAP), diastolic pressure gradient (DPG) ≥7 mmHg, and previous myocardial infarction (MI) entailed a higher risk of mortality in CAD-HF patients with PH. CONCLUSIONS: PH is common in CAD-HF and worsens the hemodynamics and survival in these patients. Left ventricle enlargement and anemia increase the risk of PH in CAD-HF. Patients may benefit from nitrate medications. Renal impairment, elevated mPAP, DPG ≥7 mmHg, and previous MI are strong predictors of mortality in CAD-HF-PH patients. TRIAL REGISTRATION ClinicalTrials.gov, NCT02164526.
Coronary Artery Disease/epidemiology* ; Creatinine ; Heart Failure/complications* ; Humans ; Hypertension, Pulmonary/complications* ; Nitrates ; Prevalence ; Prognosis ; Prospective Studies ; Registries ; Risk Factors ; Stroke Volume ; Ventricular Function, Left

OBJECTIVE: To study the intervention effects of participatory training on the occupational health in polishing workers. METHODS: By the stratified random sampling method,930 front-line polishing workers were selected from 50 manufacturing enterprises in Guangzhou,467 workers in the intervention group and 463 workers in the control group. The intervention group adopted participatory training and the control group adopted the traditional training. We evaluated the changes of occupational health knowledge,attitude and practice( KAP) in workers of these two groups using the questionnaire table of occupational health KAP for polishing workers. Data of before intervention,immediately after intervention and 3 months after intervention were collected. RESULTS: The workers 'knowledge,attitude and practice scores at the time point of immediately after intervention were higher than those before intervention in the same group( P <0. 05). The workers' knowledge and practice scores of 3 months after intervention in intervention group were higher than those before intervention( P < 0. 05). The knowledge and practice scores of 3 months after intervention in the intervention group were higher than that in the control group( P < 0. 05). The evaluation scores on protection measure and warning signs of workers in the intervention group were lower than those in workers of control group 3 months after the intervention( P < 0. 05). Three months after the intervention,the workers in intervention group believed that the training was more effective than that in the control group in the following 6 aspects: improving the knowledge of occupational health,improving the ability of identifying risk factors, learning to use the personal protective equipment, helping other workmates,having confidence to make suggestions and introducing other workmates to participate in training( P < 0. 05).CONCLUSION: The participatory training is an effective intervention model in improving the workers ' awareness of occupational health KAP.

Objective To investigate effect of Xiaoyao pill on superoxide dismutase (SOD), malondialdehyde (MDA), interleukin family and clinical efficacy in patients with pelvic inflammation.Methods 75 cases with pelvic inflammation were selected and divided into experimental group and control group randomly according to random number table method.37 cases in control group were treated with conventional anti-inflammatory and Qianjin pill, 38 cases in experimental group were treated with conventional anti-inflammatory and Xiaoyao pill, 14 days for a course.SOD, MDA and interleukin family were compared and the effective rate and adverse reaction rate were compared.Results Compared with control group post-treatment, SOD in serum in experimental group was higher(P<0.05),MDA in serum was lower(P<0.05);IL-1 and IL-8 were lower(P<0.05);IL-4 and IL-10 were higher(P<0.05).The total efficiency of experimental group was significantly higher than that of control group, the adverse reactions were lower (P<0.05).Conclusion Xiaoyao pill has good curative effect on the patients with pelvic inflammatory disease,the mechanism may be related to the elevation of serum SOD,IL-4, IL-10 levels and reduce the levels of MDA,IL-1,IL-8.

In order to find the most suitable algorithm of T-wave end point detection for clinical detection, we tested three methods, which are not just dependent on the threshold value of T-wave end point detection, i. e. wavelet method, cumulative point area method and trapezium area method, in PhysioNet QT database (20 records with 3 569 beats each). We analyzed and compared their detection performance. First, we used the wavelet method to locate the QRS complex and T-wave. Then we divided the T-wave into four morphologies, and we used the three algorithms mentioned above to detect T-wave end point. Finally, we proposed an adaptive selection T-wave end point detection algorithm based on T-wave morphology and tested it with experiments. The results showed that this adaptive selection method had better detection performance than that of the single T-wave end point detection algorithm. The sensitivity, positive predictive value and the average time errors were 98.93%, 99.11% and (--2.33 ± 19.70) ms, respectively. Consequently, it can be concluded that the adaptive selection algorithm based on T-wave morphology improves the efficiency of T-wave end point detection.
Algorithms ; Electrocardiography ; Humans ; Wavelet Analysis

Objective To investigate the serum levels of IL-10 and TGF-β1 and their significance for patients with sys-temic lupus erythematosus( SLE) .Methods A total of 135 cases were available for the study including 63 cases in primary group(A), 40 cases in remission group(B) and 32 cases in healthy control group(C).ELISA method was used to deter-mine the concentrations of IL-10 and TGF-β1 in serum.Finally, the results of group A were analyzed on the basis of System-ic Lupus Erythematosus Disease Activity Index( SLEDAI) .Results The level of IL-10 in serum of group A was significant-ly higher than that of group B and group C.The level of IL-10 in serum of group B was significantly higher than that of group C(P<0.05).The level of IL-10 in group A had active correlation with SLEDAI.The level of TGF-β1 in serum of group A was significantly lower than that of group B and group C.There was no statistical difference between group B and group C(P>0.05).The level of TGF-β1 in serum of group A had negative correlation with SLEDAI.The cases in group A were divided into three subgroups by SLEDAI:21 cases in mild activities subgroup, 30 cases in moderate activities sub-group,and 12 cases in severe activities subgroup, the levels of IL-10 and TGF-β1 in the three subgroups were significantly different(P<0.05).Conclusions IL-10 and TGF-β1 are involved in activity and severity of SLE.

As an effective vehicle for bio-research and for gene therapy, Lentiviral Vector (LV) has been drawn large attention in recent years. However, transcriptional read-through limits its application. In order to understand the extend of LV read-through in chromosome, a reliable method to assess transcriptional read-through rate is needed. Here, we report the method as follows: 293T cells were transfected with the lentiviral transfer vectors which borne with two LTRs at its two ends in order to mimic the state of "proviral vectors" in chromosome. Using the primers specific for 3'U5 and 3'U3, read-through and total transcripts were reverse transcribed, respectively. These two cDNAs were quantified by realtime PCR using the primers and probe specific for 5'end of 3'U3. Read-through rate was then calculated by the division of the two. Meanwhile, read-through product of green fluorescence protein was also analyzed by Fluorescence Activated Cell Sorter. They both reciprocally proved the principal and confirmed that self-inactivated LV appeared higher read-through rate than the wild type one. The method described in this article, therefore, provides a useful technique to study how to reduce read-through rate, and improve the bio-safety of LV.
Flow Cytometry ; Genetic Therapy ; Genetic Vectors ; Green Fluorescent Proteins ; biosynthesis ; HEK293 Cells ; Humans ; Lentivirus ; Transfection