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

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Objective To investigate the selection of treatment strategies and prognostic factors for patients with stage T3 and T4 laryngeal carcinoma. Methods A total of 132 patients with stage T3 and T4 laryngeal cancer admitted to our hospital from March 2010 to March 2019 were retrospectively selected as research objects. According to the different treatment strategies, the patients were divided into simple surgery group (group A, 57 cases), simple chemoradiotherapy group (group B, 32 cases), and surgery combined with chemoradiotherapy group (group C, 43 cases). The general data and clinicopathological features of the three groups were compared, and a survival curve was drawn by the Kaplan–Meier method. The 3-year survival rates of the three groups were compared. Then, the same 132 patients were divided into survival and death groups. The clinical data of the two groups were compared, and the prognostic factors were analyzed by multivariate logistic regression. A back propagation (BP) neural network model was constructed, and its differentiation and accuracy were evaluated. Results The proportions and 3 year survival rates of patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule in group C were significantly higher than those in groups A and B (P < 0.05). The 3 year survival rate of 132 patients was 68.94%(41/132). Poor differentiation, N2-N3 stage, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule were risk factors for death (P < 0.05), whereas surgery combined with radiotherapy and chemotherapy were protective factors (P < 0.05). The BP neural network model exhibited good discrimination and high accuracy. Conclusion Surgery combined with radiotherapy and chemotherapy can significantly improve survival rate in patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule. Close attention should be paid to patients with stage N2-N3 in the formulation of reasonable treatment strategies.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Background Global warming may increase the frequency of compound hot extreme (CHE).However, there is still a lack of studies assessing the associations between CHE and preterm birth (PTB), and the underlying biological mechanisms remain unclear. Objective To estimate the association of exposure to CHE during pregnancy with PTB, and to explore the roles of inflammatory, endothelial dysfunction, and oxidative stress in the association between CHE and PTB. Methods All participants were selected from the Prenatal Environments and Offspring Health (PEOH), a prospective birth cohort conducted in Guangzhou. In this study, a total of 2449 participants who gave birth from May to October in 2014 to 2017 were enrolled, and among them blood samples were collected from 311 preterm (n=43) and full-term (n=268) pregnant women at the time of delivery. A hot day/night was identified as a day when the daily maximum temperature/minimum temperature was higher than its 90th percentile in the study period, and a CHE was defined as having both a hot night and a following hot day. The meteorological data were obtained from the China Meteorological Data Sharing Service System. Anusplin was used to assess the daily maximum temperature, daily minimum temperature, and relative humidity of the participant residence. Enzyme-linked immunosorbent assay (ELISA) was used to measure C reactive protein (CRP), endothelin-1 (ET-1), and malondialdehyde (MDA) levels in maternal serum, and their results were transformed by natural logarithm. A distributed lag nonlinear model was used to investigate the associations of exposures to hot day, hot night, and CHE during pregnancy with PTB at different lag days, and a logistic regression model was used to investigate the associations of CRP, ET-1, and MDA with PTB. Results The incidence rate of PTB was 6.2% in all selected participants. Compared with the non-hot day, the RRs (95%CIs) of CHE in lag 3, 7, and 14 days on PTB were 1.43 (1.12-1.84), 1.24 (1.08-1.43), and 1.17 (1.05-1.30), respectively, and the cumulative effects (% difference) (95%CI) of CHE in lag 14 days on maternal serum CRP, ET-1, and MDA were 0.33% (−0.45%-1.12%), 0.59% (0.11%-1.07%), and 0.57% (0.09%-1.05%), respectively. Compared with the Q1 (lowest quartile) for CRP, ET-1 and MDA, the RRs (95%CIs) of Q4 (highest quartile) for PTB were 1.27 (0.50-3.22), 1.51 (0.61-3.72), and 2.07(0.81-5.27), respectively. Conclusion Maternal exposure to CHE during pregnancy might be associated with an increased risk of PTB. Prenatal exposure to CHE is positively associated with maternal serum CRP, ET-1, and MDA, and the three biochemical indicators are also positively associated with PTB. However, the above conclusions still need further confirmation.

Cardio-cerebrovascular disease (CCVD) is a major comorbidity of Coronavirus disease 2019 (COVID-19). However, the clinical characteristics and outcomes remain unclear. In this study, 102 cases of COVID-19 from January 22, 2020 to March 26, 2020 in Xixi Hospital of Hangzhou were included. Twenty cases had pre-existing CCVD. Results showed that compared with non-CCVD patients, those with CCVD are more likely to develop severe disease (15% versus 1%), and the proportion of pneumonia severity index grade IV was significantly higher (25% versus 3.6%). Computed tomography images demonstrated that the proportion of multiple lobe lesion involvement was significantly higher in the CCVD group than in the non-CCVD group (90% versus 63.4%). Compared with non-CCVD group, the levels of C-reactive protein, fibrinogen, D-dimer, and serum amyloid-A were higher, whereas the total protein and arterial partial PaO
COVID-19 ; Cerebrovascular Disorders/epidemiology* ; Comorbidity ; Humans ; SARS-CoV-2 ; Tomography, X-Ray Computed

Objective:To explore the risk factors for early hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH), and construct a clinical-radiomics combined model to predict HE after sICH.Methods:From April 2014 to September 2020, 339 patients with sICH who underwent plain CT scans in Radiology Department of our hospital were recruited. Patients were divided into HE group and non-HE group according to whether HE occurred (HE was defined as an increase in hematoma volume>33% or 6 mL on the follow-up CT within 24 h). The clinical data of non-HE group and HE group were compared, and multivariate Logistic regression analysis was used to detect independent risk factors for HE. The radiomics features were extracted from the regions of interest of the hematoma in the first CT scan images; the optimal radiomics features were selected using least absolute shrinkage and selection operator (LASSO) regression model and 10-fold cross-validation method, and then, the radiomics scores (R-score) were calculated; the risk factors for HE (clinical data) and R-score (radiomics data) were used to construct the clinical model, R-score model, and clinical-radiomics combined model; receiver operating characteristic (ROC) curve was performed to evaluate the prediction performance of clinical model, R-score model, and clinical-radiomics combined model; the best model was visualized as a nomogram and a calibration curve was drawn to evaluate the prediction accuracy of this model.Results:As compared with patients in the non-HE group, patients in the HE group had shorter time from sICH onset to first CT, higher percentage of patients with diabetes, lower platelet count, lower Glasgow Coma Scale (GCS) scores, and larger baseline hematoma volume in CT image, with significant differences ( P<0.05). Multivariate Logistic regression analysis showed that baseline hematoma volume ( OR=1.015, 95%CI: 1.000-1.030, P=0.046), GCS scores ( OR=0.914, 95%CI: 0.839-0.995, P=0.039), time from sICH onset to first CT ( OR=0.855, 95%CI: 0.741-0.987, P=0.032), and diabetes ( OR=0.522, 95%CI: 0.311-0.875, P=0.014) were independent risk factors for HE. By using LASSO regression and 10-fold cross-validation method, 20 optimal radiomics features were finally selected. The area under ROC curve of clinical model, R-score model, and clinical-radiomics combined model were 0.650, 0.860, and 0.870, respectively. The calibration curve showed that the prediction accuracy of clinical-radiomics combined model in early HE had good consistency with the actual occurrence probability. Conclusion:The clinical-radiomics combined model could effectively predict early HE with good calibration, which is helpful in individualized clinical assessment of risk of early HE in SICH patients.