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 monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

This article introduced the research design and main results of the article " Effect of Moderate and Vigorous Aerobic Exercise on Incident Diabetes in Adults with Obesity: A 10-Year Follow-up of a Randomized Clinical Trial" recently published in JAMA Internal Medicine, and addressed the scientific significance of the study. The importance of obesity management has been well discussed recently. This study investigated obesity management strategies for obese individuals and their long-term metabolic benefits.

Sleep is a complex physiological process of great significance to physical and mental health, and its research scope involves multiple disciplines. At present, the quantitative analysis of sleep mainly relies on the "gold standard" of polysomnography (PSG). However, PSG has great interference to the human body and cannot reflect the hemodynamic status of the brain. Functional near infrared spectroscopy (fNIRS) is used in sleep research, which can not only meet the demand of low interference to human body, but also reflect the hemodynamics of brain. Therefore, this paper has collected and sorted out the related literatures about fNIRS used in sleep research, concluding sleep staging research, clinical sleep monitoring research, fatigue detection research, etc. This paper provides a theoretical reference for scholars who will use fNIRS for fatigue and sleep related research in the future. Moreover, this article concludes the limitation of existing studies and points out the possible development direction of fNIRS for sleep research, in the hope of providing reference for the study of sleep and cerebral hemodynamics.
Brain/diagnostic imaging* ; Hemodynamics ; Humans ; Polysomnography ; Sleep ; Spectroscopy, Near-Infrared

Objective:To understand application value of pathogen detection in elderly patients with respiratory infection by using multiple RT-PCR to detect 13 common pathogens of respiratory tract infection.Methods:This is a retrospective study, which included 317 elderly patients, aged 60 to 98 years with respiratory symptoms, who visited Geriatrics of the First Hospital of Shijiazhuang between June 2016 and May 2017. Sputum of each patient was collected. After the viral DNA/RNA was extracted, 13 respiratory pathogens were detected by multiplex RT-PCR and capillary electrophoresis. The clinical performance of the assay was evaluated in comparison to direct sequencing and Real-time PCR.Results:Compared with the direct sequencing and Real-time PCR, the accuracy of multiple RT-PCR was 99.93% (95% CI: 99.79%-99.98%), positive predictive value was 99.24% (95% CI: 97.78%-99.74%), negative predictive value was 100% (95% CI: 99.9%-100%), and Cohen’s kappa was 0.9958 (95% CI: 0.9652-1.026). Among the 317 elderly patients, the positive rate of respiratory infection was 75.7% (240/317). The highest was influenza A, 20.2% (64/317), mainly H3N2, 70.3% (45/64), followed by rhinovirus, adenovirus, Mycoplasma pneumoniae and influenza B, with the positive rates 15.5% (49/317), 13.6% (43/317), 11.0% (35/317) and 10.1% (32/317), respectively. In addition, 81 (25.6%) elderly patients were infected with two or more pathogens. Conclusions:Multiple RT-PCR meet the needs of clinical detection of respiratory pathogens and provide information for the prevention and treatment of respiratory system Infection.

Objective To investigate the distribution and drug resistance of carbapenem-resistant Enterobacteriaceae ( CRE) isolated from children in China. Methods CRE strains were collected in 10 ter-tiary children's hospitals of China from January 1, 2016 to December 31, 2017. Antimicrobial susceptibility of the clinical strains was detected with disk diffusion method ( KB method) and automated method. The re-sults were analyzed according to the Clinical and Laboratory Standards Institute ( CLSI) Standards published in 2017. WHONET 5. 6 software was used to retrospectively analyze the distribution characteristics and drug resistance of these strains. Results A total of 3065 CRE clinical strains were isolated from children with an overall prevalence of 7. 7％ and among them, 13. 5％ were isolated in neonatal group and 5. 8％ in non-neo-natal group. The detection rate of CRE in 2017 was higher than that in 2016 (9. 7％ vs 5. 7％). Among the 3065 CRE strains, there were 1912 strains of Klebsiella pneumoniae (62. 0％), 667 strains of Escherichia coli (22. 0％), 206 strains of Enterobacter cloacae (7. 0％), 56 strains of Klebsiella aerogenes (1. 8％) and 47 strains of Serratia marcescens (1. 5％). Most of the strains were isolate in neonatology departments including neonatal intensive care units (NICU) and intensive care units (ICU), accounting for 44. 8％ and 19. 7％, respectively. Respiratory tract (61. 8％), urine (19. 4％) and blood (5. 7％) specimens were the main sources of CRE isolates. Results of antimicrobial susceptibility test showed that the CRE strains were highly resistant to carbapenem antibiotics such as imipenem, meropenem and ertapenem, as well as penicillins and most cephalosporins (79. 6％-100％), especially those isolated in the neonatal group (P<0. 05). Children had relatively low resistance rates to aminoglycosides such as amikacin (19. 7％) and fos-fomycin (11. 9％), fluoroquinolones such as levofloxacin (37. 7％) and ciprofloxacin (43. 3％), and tige-cycline (3. 8％). Currently, no polymyxin B-resistant strains were isolated. Conclusions The prevalence of common CRE strains in children in 2017 was higher than that in 2016, especially in newborns. Drug re-sistance in CRE strains isolated from neonates to common antibiotics was more severe, suggesting that great attention should be paid to it and timely measures should also be taken.

Objective To investigate the optimal condition for the detection of anti-non-galactose (Gal) xenoantigen and antibody in human serum.Mehtods Peripheral blood mononuclear cell (PBMC) obtained from Wuzhishan miniature pig models with α-1,3-galactosyltransferase gene knockout (GTKO) were used as target cells,mixed and incubated with healthy human serum of different concentrations (4.8％,16.7％ and 100％) for 0.5,1.0,2.0,3.0 and 6.0 h,respectively.The abilities of PBMC to bind with IgM and IgG were detected by flow cytometry.Results At the serum concentration of 16.7％,the ability ofnon-Gal IgM to bind with PBMC was significantly enhanced from 0.5 h to 3.0 h incubation (P＜0.01),whereas no statistical significance was noted in terms of IgG (P＞0.05).Increasing serum concentration could also enhance the ability of non-Gal IgM to bind with PBMC.At the serum concentration of 100％ and incubation for 3 h,the ability of IgM to bind with PBMC was the highest among all groups (P＜0.01).At the serum concentration of 100％ and incubation for 6 h,the ability of IgG to bind with PBMC was significantly enhanced (P＜0.05).Prolonging incubation time and increasing serum concentration did not affect the activity of PBMC.Conclusions The optimal condition for detection of anti-non-Gal xenoantigen and antibody is determined.A quantity of 1×105 PBMC from pig should be incubated with 100％ human serum for 3 h for detection of IgM level,or incubated with 100％ human serum for 6 h for measurement of IgG level.This optimized condition contributes to screening the donor pigs which lowly express non-Gal antigen.

Objective To observe and comparatively analysize the effect of intraperitoneal injection of hydrogen and hydrogen-rich saline in neonatal rats with hyperoxia-induced lung injury.Methods Sprague-Dawley(SD) newborn rats were randomly divided into six groups(n=10).air group(A),air+ hydrogen-rich saline group(B),air+hydrogen group(C),hyperoxia group(D),hyperoxia+hydrogen-rich saline group (E) and hyperoxia+ hydrogen group(F).The group A,B and C were exposed to air and group D,E and F were exposed to 95 ％ oxygen.The group B and E were intraperitoneally injected with hydrogen-rich saline (10 mL/kg,twice daily),while the groups C and F with hydrogen (10 mL/kg,twice daily).The group A and D were injected with normal saline(10 mL/kg,twice daily).Lung tissue and serum samples were collected on 15 d of experiment.The pathological changes of lung tissue and radiate alveoli count (RAC) were observed by HE staining.The content of HYP in lung tissue was detected by the alkaline hydrolysis method,serum SOD and MDA levels were measured.The expression of α-SMA in lung tissue was detected by immunohistochemistry SP method.Results Compared with the A group,RAC and SOD activities in the D group were significantly decreased,while the HYP and MDA levels and α-SMA expression were significantly increased.Hydrogen intervention could significantly alleviate these changes caused by hyperoxia.while intraperitoneal injection of hydrogen got better effect than intraperitoneal injection of hydrogen-rich saline.Conclusion Hydrogen can extenuate the indexes of hyperoxia-induced lung oxidative damage,impairment development and fibrosis to a certain extent.Intraperitoneal injection of hydrogen has slightly better effect than hydrogen-rich saline.

AIM To study the effects of No.1 Weiyan Decoction (Codonopsis Radix,Paeoniae Radix alba,Taraxaci Herba,etc.) on hypoxia and hypoxic tolerance in gastric mucosal epithelial cells in rats with precancerous lesion of gastric cancer (PLGC).METHODS Forty rats were randomly divided into normal,model,Vitacoenzyme Tablets and No.1 Weiyan Decoction groups.Except for the normal group,the rats in the other groups were given with N-methyl-N'-nitro-N-nitrosoguanidine and Little Chengqi Decoction to establish a PLGC rat model.Ten weeks after the administration,the gastric mucosal epithelial microvascular ultrastructure was observed,the expressions of Hif1a mRNA,HIF-1 α protein and VEGF protein in gastric mucosal epithelium were detected.RESULTS Compared with the normal group,the number of microvasculatures in gastric mucosal epithelium was decreased;lumen was severely stenosed or expansive;inner wall was not smooth and had adhesion;vascular endothelial cells were swollen;the expression of Hif1α mRNA showed an increasing trend;the expressions of HIF-1α protein and VEGF protein were anomalous in the model group.Compared with the model group,the gastric mucosal vascular lesion of PLGC rats was improved,and the expressions of Hif1a mRNA,HIF-1α protein and VEGF protein were significantly decreased in the No.1 Weiyan Decoction group.CONCLUSION No.1 Weiyan Decoction can improve hypoxia and hypoxia tolerance,and induce angiogenesis in gastric mucosal epithelium in PLGC rats.

This study was aimed to summarize the clinical medication rule of professor Shi Qi in the treatment of cervical spondylosis of vertebral artery type (CSA),in order to explore the academic ideas.A total of 265 CSA cases from professor Shi Qi's outpatient clinic were collected in Longhua Hospital from 2009 to 2015.Frequency analysis and cluster analysis were conducted on used herbal medicine from included cases by SPSS 21.00 software.The results showed that there were a total of 202 types of herbs used.The five most commonly used herbs were Rhizoma Ligustici Wallichii,Radix bupleuri,Radix Achyranthis Bidentatae,Codonopsis and Gastrodia elata.The cluster analysis revealed that professor Shi Qi frequently used Huo-Xue Hua-Yu herbs,Bu-Xu herbs,Ping-Gan Xi-Feng herbs,Qu-Feng-Shi herbs.Sheng-Yu decoction and Tian-Ma Gou-Teng decoction were the core prescriptions used by professor Shi Qi in the treatment of CSA.It was concluded that the cluster analysis showed that academic ideas of professor She in the treatment of CSA was to pay equal attention to both qi and blood,to focus on liver and kidney,as well as to remove phlegm and blood stagnation,to treat both the branch and the root.The cluster analysis revealed a certain medication rule of professor Shi Qi in the treatment of CSA.It can be used as guidance in the clinical practice.