Objective: To investigate treatment strategies for chronic periapical periodontitis in prematurely erupted premolars and provide guidance for managing pulp and periapical diseases in young permanent teeth with immature roots. Methods: A regenerative endodontic procedure (REP) was performed on a prematurely erupted maxillary left first premolar (tooth 24) at Nolla stage Ⅶ with chronic apical periodontitis, following standardized protocols including root canal irrigation, disinfection, and coronal sealing. The case was followed up, and a literature review was conducted. Results: Clinical resolution of symptoms was observed on tooth 24, with sustained root development. After a 20-month follow-up, the tooth had restored biological function. Literature synthesis revealed that periapical infections in prematurely erupted permanent teeth predominently arise from pulp exposure and bacterial infection, with retrograde infection being rare. For young permanent teeth with necrotic pulp, regenerative endodontic procedures has been established as the treatment of choice to promote apical closure and root maturation. The critical steps of regenerative endodontic procedures include thorough disinfection, induced bleeding to form a fibrin scaffold, and coronal sealing to facilitate stem cell recruitment and differentiation. Conclusion Regenerative endodontic procedures represents an effective and viable treatment option for prematurely erupted young permanent teeth with chronic periapical periodontitis.

Background::Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring’s cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring’s cognitive performance during adolescence and young adulthood in China.Methods::We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring’s fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018).Results::Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring’s healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring’s cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring’s overall crystallized intelligence. Conclusions::Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring’s cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the intracranial pressure in patients undergoing laparoscopic hysterectomy by measuring the optic nerve sheath diameter (ONSD) via ultrasound.Methods:Forty-two American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-60 yr, with a body mass index of 18-28 kg/m 2, scheduled for elective laparoscopic hysterectomy, were divided into 2 groups ( n=21 each) using a random number table method: control group (group C) and TEAS group (group T). In group T, TEAS was applied to the Yintang (EX-HN3) and Taiyang (EX-HN5) acupoints at 30 min before anesthesia, the stimulation used alternating dense-disperse waves at a frequency of 2/100 Hz, with the current intensity starting at 1 mA and increasing to the maximum tolerable level just below the pain threshold, and stimulation was maintained at the Hegu (LI4), Quanliao (SI18), and Fengchi (GB20) acupoints during surgery until the procedure was completed. Patients had electrode pads applied to the corresponding acupoints without electrical stimulation in group C. The ONSD was measured upon entry into the operating room (T 0), 3 min after anesthesia induction (T 1), 5 min after trendelenburg position (T 2), 30 min after trendelenburg position (T 3), 60 min after trendelenburg position (T 4), and immediately after the end of operation (T 5). Results:Compared to the baseline at T 0, the ONSD was significantly increased at T 3-5 in group C and at T 4, 5 in group T ( P<0.05). The ONSD was significantly lower at T 4, 5 in group T than in group C ( P<0.05). Conclusions:TEAS can reduce the intracranial pressure to some extent in patients undergoing laparoscopic hysterectomy.

Objective:To explore the pattern of pulmonary vascular remodeling in patients with chronic obstructive pulmonary disease (COPD) using artificial intelligence technology based on chest CT images.Methods:This was a cross-sectional study. The clinical and imaging data of 257 patients with stable COPD who underwent chest high resolution CT (HRCT) and pulmonary function tests (PFT) from January 2018 to October 2022 at Shanxi Bethune Hospital were retrospectively analyzed. In addition, 28 healthy individuals with normal HRCT and PFT were collected in the same period as a control group. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) grading criteria, COPD patients were classified into 31 cases of GOLD 1, 116 cases of GOLD 2, 82 cases of GOLD 3, and 28 cases of GOLD 4. FACT digital lung software was used to automatically segment the pulmonary arteries and pulmonary veins of all the cases, and to calculate the relevant pulmonary vascular parameters, including total lung volume (TLV), vessel volumes at all levels [cross-sectional area less than 5 mm 2 (CSA <5), between 5 and 10 mm 2 (CSA 5-10), and more than 10 mm 2 (CSA >10)], number of vascular branches, and vascular density (pulmonary vascular volume/TLV). Percentage of emphysema (%LAA) and pulmonary artery diameter/aortic diameter (PAD/AD) were calculated for all cases. ANOVA or Kruskal-Wallis H test was used for multiple intergroup comparisons, and LSD test or Bonferroni correction was used for within-group pairwise comparisons. Spearman correlation test was conducted to examine the relationship between CT pulmonary vascular parameters and pulmonary function parameters, as well as %LAA, in both the control group and the COPD group. Results:Differences in age, body mass index, pulmonary function parameters, %LAA and PAD/AD were statistically significant among the 5 groups ( P<0.001). Differences in overall pulmonary vascular density parameters were statistically significant among the 5 groups ( P<0.05). Differences in pulmonary arterial density parameters among the 5 groups with CSA <5, CSA 5-10, and CSA >10 were statistically significant ( P<0.05). The pulmonary arterial density values of GOLD 1 CSA <5, CSA 5-10 and CSA >10 were higher than those of the control group, and then showed a decreasing trend with the increase of COPD severity. The differences in pulmonary venous density parameters among the 5 groups with CSA< 5, CSA 5-10, and CSA >10 were statistically significant ( P<0.001), and the CSA 5-10 pulmonary venous density was higher in GOLD 1 patients than in the control group, and the remaining pulmonary venous densities showed a gradual decreasing trend with the increase in the severity of COPD. The number of arterial and venous vascular branches/TLV tended to decrease in the control group, GOLD 1, GOLD 2, GOLD 3, and GOLD 4 patients ( P<0.001). Pulmonary vascular density parameters were positively correlated with all PFT parameters ( r=0.138-0.510, P<0.05), and negatively correlated with %LAA ( r=-0.340--0.671, P<0.001); PAD/AD was negatively correlated with PFT parameters ( r=-0.208--0.286, P<0.001) and positively correlated with %LAA ( r=0.131, P<0.05). Conclusion:Various pulmonary vascular density parameters can be quantitatively analyzed by artificial intelligence technology based on chest CT images, which can reveal the changing pattern of pulmonary vascular remodeling in COPD patients.

OBJECTIVE: To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN). METHODS: A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014. RESULTS: A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer. CONCLUSIONS No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.
Humans ; Retrospective Studies ; Incidence ; Carcinoma, Hepatocellular ; Liver Neoplasms/epidemiology* ; Kidney Diseases/chemically induced* ; Aristolochic Acids/adverse effects*

Objective To explore the value of vesical imaging reporting and data system(VI-RADS)combined with absolute tumor-wall contact length(ABTCL)and actual tumor-wall contact length(ACTCL)in diagnosing muscle invasive bladder cancer(MIBC).Methods The MRI data of 113 patients with pathologically confirmed bladder cancer(BCa)were analyzed retrospectively.All patients underwent conventional MRI,diffusion weighted imaging(DWI)and dynamic contrast enhanced(DCE)MRI before sur-gery.Two radiologists independently evaluated MRI images based on VI-RADS score,and measured quantitative parameters,inclu-ding ABTCL and ACTCL.The Chi-square test was used to compare the difference of VI-RADS scores between MIBC and non-mus-cle invasive bladder cancer(NMIBC).Quantitative parameters between MIBC and NMIBC were compared by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of VI-RADS,quantitative parameters and VI-RADS combined with quantitative parameters in the diagnosis of MIBC.Results VI-RADS,ABTCL and ACTCL had significant differences between MIBC and NMIBC(P＜0.05).The area under the curve(AUC)for VI-RADS,ABTCL and ACTCL in diagno-sing MIBC were 0.89,0.76 and 0.77,respectively.There was no significant difference between the AUC for ABTCL and ACTCL(P＞0.05).The AUC for VI-RADS combined with ABTCL or ACTCL in diagnosing MIBC was 0.93,higher than that of only VI-RADS(P＜0.05).Conclusion The combination of VI-RADS with either ABTCL or ACTCL can effectively improve the diagnostic performance of MIBC.ABTCL obtainedby linear measurement is easier to implement in clinical practice than ACTCL obtained by curved measurement.

Objective:To establish the evaluation criteria for the quality of nursing care in orthopaedic trauma specialties, and to provide a basis for scientific evaluation of the quality of nursing care in orthopaedic trauma specialties.Methods:From February to October 2023, John Hopkinson evidence-based method was used to synthesize the evidence, clinical investigation and semi-structured interview were used to draw up the "quality standard of nursing care in orthopaedic trauma specialty", and two rounds of Delphi method of expert inquiry were used to screen, demonstrate and calibrate the evaluation standard of nursing quality in orthopaedic trauma specialty.Results:The questionnaire recovery rate of 2 rounds of expert consultation was 100.00%, the coefficient of familiarity and authority of 2 rounds of expert consultation were 0.92 and 0.93. Through 2 rounds of expert letter consultation, the quality evaluation criteria of orthopaedic trauma specialist care were established, including 3 first-level indicators (structural quality, process quality and outcome quality), 22 second-level indicators and 85 third-level indicators.Conclusions:The process of constructing the evaluation standard of nursing quality in orthopaedic trauma specialty is scientific and reliable, which can provide standard guidance for clinical practice and is conducive to the development of specialized nursing.

【Objective】 To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. 【Methods】 A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. 【Results】 A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ²=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ²=9.403, 14.921,P<0.01). 【Conclusions】 The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.

[Objective]To observe the expression of spinal G protein-gated inwardly-rectifying potassium(GIRK)channel subunits 1 and 2 in spinal dorsal horn of morphine-tolerant rats and investigate the regulatory mechanism.[Methods]Twenty four rats were equally and randomly divided into 4 groups:saline,morphine,morphine+saline and morphine+εV1-2.The morphine-tolerant rat model was established by intrathecal administration of morphine(15 μg/d)for 7 days.Thirty minutes before daily morphine administration,rats received protein kinase C-ε(PKCε)selective inhibitor εV1-2 to test its effect on morphine tolerance and GIRK1-2 expression.All rats received behavioral tests on days 1,3,5 and 7 and thereafter immunofluorescence.[Results]Double fluorescence staining showed that GIRK1 and GIRK2 were expressed primarily in the spinal laminae I-Ⅱ and co-immunostained with μ-opioid receptor(MOR).Seven-day intrathecal administration of morphine induced antinociceptive tolerance and a significant reduction of the spinal GIRK1(22.45±10.58 vs.62.83±20.80,P<0.001)and GIRK2(23.67±8.78 vs.50.17±11.05,P=0.001)fluorescence intensity,as compared with saline control rats.In addition,pretreatment with εV1-2 significantly delayed the reduction of morphine antinociception(P<0.001)and prevented the decrease of GIRK1(54.50±10.37 vs.19.33±9.48,P<0.001)and GIRK2(39.83±6.24 vs.15.83±9.58,P=0.001)expression induced by morphine treatment.[Conclusions]Morphine tolerance is closely related to down-regulation of GIRK1-2 expression and PKCε plays a crucial regulatory role herein.

Objective To investigate the occurrence of adverse events of lurasidone in the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database by using Open Vigil FDA2.1,to enrich the experience and provide the basis for the clinical use of the drug in China.Methods Using Open Vigil FDA2.1,adverse event data were extracted from the FAERS database for a total of 51 quarters from the 4th quarter of 2010 to the 3rd quarter of 2023,and the ratio of reporting ratio(ROR)method and the proportional reporting ratio(PRR)method were used for data mining and analysis.Results A total of 32 728 adverse event reports with lurasidone as the first suspected drug was obtained,with a larger proportion of females(54.26％)and occurring mostly in adults(18 to 59 years).After the screening,326 preferred term(PT)signals were obtained,involving 20 system-organ classifications(injury,poisoning and procedural complications,general disorders and administration site conditions,psychiatric disorders,etc.).Among them,PTs with the higher frequency of occurrence included off label use,feeling abnormal,crying,anxiety,depression,insomnia,etc.PTs with stronger signal strength included activation syndrome,mania,tongue movement disturbance,hypoprolactinaemia,akathisia,etc.Multiple new suspected adverse drug reactions were unearthed,including hypoprolactinaemia,emotional poverty,stiff tongue,etc.Conclusion Lurasidone has a favorable safety profile,and women need to closely monitor prolactin levels when taking this medication.The drug is relatively safe for use in pregnant,puerperal and perinatal women and patients with poor metabolic function.Hypoprolactinaemia and restless leg syndrome are new rare suspected adverse events with lurasidone.