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*

Objective To investigate the Oncomelania hupensis snails spread and its spatio-temporal clustering characteristics in Suzhou City, Jiangsu Province from 2016 to 2023, so as to provide insights into precision control of O. hupensis snails in the City. Methods O. hupensis snail surveillance data in Suzhou City from 2016 to 2023 were collected, and the areas of O. hupensis snail spread and areas of emerging and re-emerging snail habitats were retrieved. The spatial distribution characteristics and clustering types and locations of environments with O. hupensis snail spread were investigated using global and local spatial auto correlation analyses with the software ArcGIS 10.7, and the clustering and cluster areas of O. hupensis snail spread were identified in Suzhou City using spatio-temporal scans with the software SaTScan 10.0.2. Results O. hupensis snail spread covered an area of 677 171 m² in Suzhou City from 2016 to 2023, including 376 230 m² emerging snail habitats and 300 941 m² re-emerging snail habitats. Global spatial autocorrelation analysis showed overall clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023 (Moran’s I = 0.066, P = 0.007), and there were spatial clustering of areas with O. hupensis snail spread in 2019 (Moran’s I = 0.086, P = 0.001) and 2021 (Moran’s I = 0.045, P = 0.003). Local spatial autocorrelation analysis showed clusters of O. hupensis snail spread in Suzhou City from 2016 to 2023, with high-high clusters in Guangfu Township and Dongzhu Street, and the high-high clusters of O. hupensis snail spread were mainly distributed in southwestern Suzhou City. Spatio-temporal scans identified two clusters of areas with O. hupensis snail spread and areas of re-emerging snail habitats in Suzhou City from 2016 to 2023, with large clustering areas found in Guangfu Township, Dongzhu Street, Tong’an Township and Wangting Township [relative risk (RR) = 22.34, log likelihood ratio (LLR) = 163 295.32, P < 0.001] and small clustering areas in Xukou Township, Mudu Township and Xiangshan Street (RR = 2.73, LLR = 921.92, P < 0.001). Conclusions There was spatial clustering of O. hupensis snail spread in Suzhou City from 2016 to 2023. Improved quality of O. hupensis snail control and intensified management of environments at a high risk of O. hupensis snail spread are recommended in Suzhou City.

Objective:To explore the radiological protection measures for yttrium-90 ( 90Y)-loaded resin microsphere therapy in clinical application. Methods:The surgical operation process for 90Y-loaded resin microsphere therapy was simulated, involving measurement of ambient dose equivalent rates at various stages: preoperative preparation (dominated by drug package), drug transfer, intraoperative procedures (drug operation and injection), and postoperative care and observation within the hospital. Based on the simulation, the protection measures in clinical application were analyzed. Results:The dose equivalent rate ranged from 0.12 to 0.42 μSv/h around the active chamber and from 1.04 to 3.32 μSv/h in the fume hood. Around the digital subtraction angiography (DSA) room, the maximum dose equivalent rate was 0.78 μSv/h when 90Y and DSA were applied simultaneously and 0.36 μSv/h when 99Tc m and DSA were applied. For the first operating position in the fluoroscopy protection area, the maximum dose equivalent rate was 13.19 μSv/h at 155 cm height when only 90Y was applied, and 315.01 μSv/h at 80 cm height when 90Y and DSA were applied. For the second operating position, the maximum dose equivalent rate was 6.28 μSv/h at 155 cm height when only 90Y was applied and 291.03 μSv/h at the same height when 90Y and DSA were applied. The dose-equivalent rates ranged from 0.11 to 0.58 μSv/h around the dedicated ward for postoperative patients. Conclusions:The existing shielding measures, such as those in the nuclear medicine department and interventional room, meet the radiation protection requirements for 90Y-loaded resin microsphere therapy. However, it is still necessary to conduct a scientific assessment based on the actual situation. Additionally, radiation protection measures and surface contamination treatment should be enhanced during drug operation.

Objective To investigate the prevalence and influencing factors of thyroid nodules in children aged 8-10 years in Suzhou , and to provide a scientific basis for the rational prevention and treatment of iodine deficiency disorders (IDD). Methods PPS sampling method was used in this study. Questionnaire survey, physical examination and thyroid B-ultrasound examination were conducted on students aged 8-10 years. Salt samples and urine samples were collected for laboratory detection of the salt iodine and urinary iodine. Univariate and multivariate logistic regression models were used to analyze the risk factors related to thyroid nodules. Results A total of 2 048 children aged 8-10 years were included in the present survey, and the prevalence of thyroid nodules was 23.34% (478/2 048). The prevalence of nodules in boys was 20.98% (218/1 039), and the prevalence of nodules in girls was 25.77% (260/1 009). Multivariate analysis showed that gender (OR=1.338, P=0.006), height (OR=1.993, P=0.001), frequency of iodine-rich food intake (OR=0.862, P=0.048) and nutritional supplements (OR=1.469, P=0.008) were correlated with the prevalence of thyroid nodules. Conclusion The prevalence rate of thyroid nodules in children aged 8-10 years old in Suzhou is 23.34%. Female gender, higher height, regular intake of iodine-rich foods and dietary supplements are statistically associated with the prevalence of thyroid nodules, which may be risk factors for the prevalence of thyroid nodules , but further research is needed to confirm.

Objective:To investigate the size of thyroid of children aged 8 - 10 in Suzhou City and explore its influencing factors.Methods:According to the requirements of the "Jiangsu Province Iodine Deficiency Disorders Monitoring Plan", a stratified multi-stage sampling method was conducted in 10 counties (cities, districts) under the jurisdiction of Suzhou City in five directions: east, west, south, north, and middle from May 2019 to July 2020. Forty children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school for thyroid volume examination, height and weight measurement, and questionnaire survey. At the same time, salt samples from children's homes and random urine samples were collected for iodine content testing, and explore the influencing factors of the thyroid volume.Results:A total of 2 046 children aged 8 - 10 were selected, including 1 038 boys and 1 008 girls. The thyroid volume of children was (3.183 ± 1.042) ml, while the total goiter rate (TGR) was 2.93% (60/2 046). Univariate analysis showed that there were statistically significant differences in thyroid volume among groups with different age, height, weight, body mass index (BMI), presence or absence of nodules, and different dietary frequencies (eating solid snacks, iodine-rich foods, cruciferous vegetables, and meat at different frequencies, P < 0.05). Correlation analysis showed that thyroid volume was positively correlated with age, height, weight, BMI, body surface area (BSA), thyroid nodules, consumption of iodine-rich foods and cruciferous vegetables ( r = 0.24, 0.34, 0.32, 0.21, 0.35, 0.19, 0.05, 0.04, P < 0.05), while negatively correlated with consumption of meat ( r = - 0.04, P = 0.047). Multivariate linear regression analysis showed that age, BSA, thyroid nodules, consumption of solid snacks and cruciferous vegetables entered the equation, with standardized partial regression coefficient values were 0.11, 0.30, 0.16, 0.05, 0.05, respectively. Conclusions:The thyroid volume of children aged 8 - 10 in Suzhou City is not only influenced by age, but also by factors such as BSA, thyroid nodules, consumption of solid snacks, and cruciferous vegetables.

Objective To analyze the results of national personal dose monitoring intercomparison and assessment of Hubei Provincial Hospital for Occupational Disease in 2016—2021, to investigate the influencing factors for monitoring results, and to improve the ability of personal dose monitoring. Methods The assessment was completed according to the requirements of The National Comparison Scheme for Individual Dose Monitoring Ability and Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016). Results The assessment results were qualified in 2016—2017 and 2020 and excellent in 2018—2019 and 2021. Conclusion The ability of personal dose monitoring in our laboratory has been continuously improved. The monitoring results are accurate and the data processing is standardized, which meet the requirements of relevant standards for personal external exposure dose monitoring.

Objective:To investigate the effect of cyclin A1 on the invasion, metastasis, and prognosis of hepatocellular carcinoma (HCC).Methods:Immunohistochemistry (IHC) was used to detect the expressional condition of cyclin A1 in HCC and paraffin-embedded non-tumor adjacent tissues. Kaplan-Meier method was used for the survival analysis of patients with HCC. Western blot (WB) was used to detect the expression of cyclin A1 in HCCLM3 and QGY-7703 cells. Scratch wound healing assay, transwell migration, and invasion assay were used to detect the effect of cyclin A1 overexpression on cell migration and invasion ability. WB was used to detect changes in the expression of matrix metalloproteinase (MMP) 2, MMP9, and vascular endothelial growth factor (VEGF) after overexpression of cyclin A1. Measurement data were compared using a t-test and analysis of variance. Count data was measured using χ2 test and the Log-rank method was performed for survival analysis. Results:Cyclin A1 expression rates were higher in the tissues of HCC patients with recurrent metastasis than in the tissues of patients without recurrent metastasis (60.42% vs. 46.81%, χ2 = 4.711, P < 0.05). The overall postoperative survival time (OS) and disease-free survival (DFS) were shorter in patients with high cyclin A1 expression than those with low cyclin A1 expression (45.9 months vs. 53.1 months; 42.9 months vs. 51.3 months, and P < 0.01). The postoperative OS and DFS were shorter in patients with high cyclin A1 expression and recurrent metastasis than those with low cyclin A1 expression without recurrent metastasis (31.7 months vs. 43.9 months; 18.0 months vs. 31.5 months, and P < 0.05). HCCLM3 and QGY-7703 cells were higher in the cyclin A1-pEX group than in the empty vector (vector) group (1.56 ± 0.06 vs. 0.18 ± 0.01, t = 18.75, P < 0.001; 1.31 ± 0.05 vs.0.37 ± 0.02, t = 15.17, P < 0.001). The migrated distances of HCCLM3 cells in the cyclin A1-pEX group and the vector group were (536.7 ± 14.5) μm and (327.3 ± 9.3) μm, t = 11.84, P < 0.05, respectively, while the migrated distances of QGY-7703 cells in the two groups were (916.7 ± 35.3) μm and (320.0 ± 20.8) μm, t = 13.54, P < 0.01. The migrated numbers of HCCLM3 cells in the cyclin A1-pEX group and vector group were (37.3 ± 2.4) and (7.0 ± 1.2), t = 12.67, P < 0.001, and the number of invasive cells was (73.7 ± 4.1) and (12.6 ± 1.5), t = 12.36, P < 0.001, respectively. The migrated numbers of QGY-7703 cells in the two groups were (153.3 ± 6.0) and (17.7 ± 3.7), t = 17.59, P < 0.001, and the number of invasive cells was (45.0 ± 2.9) and (9.3 ± 1.5), t = 10.66, P < 0.001, respectively. The expression levels of MMP2, MMP9, and VEGF in HCCLM3 and QGY-7703 cells were significantly higher in the cyclin A1-pEX group than those in the vector group ( P < 0.05). Conclusion:Cyclin A1 plays an important role in HCC invasion and metastasis, but HCC patients with high cyclin A1 expression have a poor prognosis. Hence, cyclin A1 has high guiding significance for evaluating patient prognosis.

Objective To understand the current situation of patients with advanced schistosomiasis in Suzhou, and to provide a basis for scientific management, medical assistance, and improvement of patients' quality of life. Methods Questionnaire survey, physical examination and B-ultrasound examination were performed on the registered patients with advanced schistosomiasis. The diagnosis and classification were carried out according to the “Schistosomiasis Control Manual”. The epidemiological and clinical characteristics, disease classification, and medical and financial assistance of all existing patients were analyzed. Results There were 2 420 cases of advanced schistosomiasis in Suzhou. Their distribution was highly correlated with the cumulative area of oncomelania snails and the cumulative number of schistosomiasis patients in each district (county) (r=0.949, P<0.01; r=0.946, P<0.01). There were 845 males and 1 575 females. The highest proportion of male patients was found in Suzhou Industrial Park and the lowest in Kunshan (χ²=26.591, P<0.001). The average age of patients was (76.80±7.55) years old, and the age of female patients were higher that of male patients (F=72.01, P<0.001). The splenomegaly type was the most common (2 165), ascites type was the second (198), colonic proliferative type was the third (55), and pygmy type was the least (2). A total of 895 patients were cured and 1 337 patients were improved, while 188 patients were not cured. The condition of advanced schistosomiasis patients with different clinical types was different (χ² =226.034, P<0.001), and the condition of patients with ascites was the worst. 1 438 patients' labor level was reduced, and 540 patients lost their labor ability, while only 442 patients were normal. Age increase (β=0.012，P<0.001), clinical classification being ascites type (β=0.346，P<0.001) and need for treatment (β=0.298，P<0.001) were risk factors for the loss of labor ability in patients with late schistosomiasis. The stable condition of the disease (β= -0.089，P=0.001) was a protective factor. Conclusion There are a large number of advanced schistosomiasis cases in Suzhou, and the epidemiological characteristics of advanced schistosomiasis patients in different districts (cities) are different. The relief work of advanced schistosomiasis in Suzhou should focus on the historical heavy epidemic areas, strengthen the nursing care of the elderly patients, and pay attention to the quality of life of patients with ascites. It is also important to strengthen the follow-up nursing of patients with splenomegaly to avoid turning into ascites. All districts and counties should be guided by the characteristics of local patients and formulate targeted scientific management methods and rescue policies to improve the quality of life of patients.