Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To explore the preventive and therapeutic effects of quercetin(QU)loaded with different nanomate-rials on high altitude cerebral edema(HACE)in rats and their mechanisms.Methods Thirty male SD rats were selected and equally divided into a normoxic group,a HACE group,a HACE+QU group,a HACE+carbon quantum dots(CQDs)-loaded QU(QU@CQDs)group,a HACE+mesoporous silica(MS)-loaded QU(QU@MS)group and a HACE+zeolitic imida-zolate framework-8(ZIF-8)loaded QU(QU@ZIF-8)group.The rats except those in the normoxic group were exposed to a simulated 5 000 m altitude in a low-pressure oxygen chamber,which were orally administered QU at a dose of 5 mg/g body mass 1 h before hypoxic exposure except those in the HACE group.The groups were compared in terms of the effects of the materials on the water content of rat brain tissue,cerebrovascular leakage,hematological changes and NF-κB-related mechanisms.Statistical analysis was performed using SPSS 26.0 software.Results When compared with the rats in the normoxic group,the ones in the HACE group showed significant increases in brain tissue water content,cerebrovascular leakage,leukocytes,erythrocytes,lymphocytes,monocytes,granulocytes,mean erythrocyte volume,hemoglobin,hematocrit,platelets,reactive oxygen species and malondialdehyde and NF-κB protein levels,with obvious oxidative damage and statistically decreased oxidative stress parameters including glutathione peroxidase,glutathione and superoxide dismutase(all P＜0.05).When compared with the HACE+QU@CQDs and HACE+QU@MS groups,the HACE+QU@ZIF-8 group gained advantages with the lowest brain tissue water content,improved cerebrovascular leakage,leukocytes,erythrocytes,lymphocytes,monocytes,granulocytes,mean erythrocyte volume,hematocrit,platelets and hemoglobin,decreased oxidative damagea and oxidative stress,enhanced antioxidant enzyme levels and the statistically lowered NF-κB protein level.Conclusion ZIF-8 loaded QU behaves better than CQDs and MS in reducing inflammation and brain edema formation in HACE rats.[Chinese Medical Equipment Journal,2025,46(5):27-33]

Objective:To compare the efficacy and safety of LY01011,a recombinant anti-RANKL fully human monoclonal antibody injection,versus denosumab in the treatment of bone metastases from solid tumors.Methods:A randomized,double-blind,positive drug parallel-controlled,multicenter clinical trial was conducted.A total of 850 subjects were randomly assigned(1:1)to either the experimental group(424 subjects)or the control group(426 subjects).The experimental group received 13 doses of LY01011,while the control group received 3 doses of denosumab followed by 10 doses of LY01011.Results:The primary efficacy endpoint was the natural logarithmic change from baseline in urinary N-terminal telopeptide of type I collagen corrected by urinary creatinine(uNTX/uCr)at week 13.The change was-1.740(0.042 0)in the experimental group and-1.745(0.042 1)in the control group.The least-squares mean difference between groups was 0.005(90%CI:-0.088 to 0.097),indicating no statistically significant difference(P>0.05).Safety profiles,including treatment-emergent adverse events,laboratory tests,vital signs,physical examinations,and electrocardiograms,were comparable between groups(P>0.05).Conclusions:LY01011 demonstrated biosimilarity to denosumab,with favorable safety profile,tolerability,and potential for clinical application.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To explore the preventive and therapeutic effects of quercetin(QU)loaded with different nanomate-rials on high altitude cerebral edema(HACE)in rats and their mechanisms.Methods Thirty male SD rats were selected and equally divided into a normoxic group,a HACE group,a HACE+QU group,a HACE+carbon quantum dots(CQDs)-loaded QU(QU@CQDs)group,a HACE+mesoporous silica(MS)-loaded QU(QU@MS)group and a HACE+zeolitic imida-zolate framework-8(ZIF-8)loaded QU(QU@ZIF-8)group.The rats except those in the normoxic group were exposed to a simulated 5 000 m altitude in a low-pressure oxygen chamber,which were orally administered QU at a dose of 5 mg/g body mass 1 h before hypoxic exposure except those in the HACE group.The groups were compared in terms of the effects of the materials on the water content of rat brain tissue,cerebrovascular leakage,hematological changes and NF-κB-related mechanisms.Statistical analysis was performed using SPSS 26.0 software.Results When compared with the rats in the normoxic group,the ones in the HACE group showed significant increases in brain tissue water content,cerebrovascular leakage,leukocytes,erythrocytes,lymphocytes,monocytes,granulocytes,mean erythrocyte volume,hemoglobin,hematocrit,platelets,reactive oxygen species and malondialdehyde and NF-κB protein levels,with obvious oxidative damage and statistically decreased oxidative stress parameters including glutathione peroxidase,glutathione and superoxide dismutase(all P＜0.05).When compared with the HACE+QU@CQDs and HACE+QU@MS groups,the HACE+QU@ZIF-8 group gained advantages with the lowest brain tissue water content,improved cerebrovascular leakage,leukocytes,erythrocytes,lymphocytes,monocytes,granulocytes,mean erythrocyte volume,hematocrit,platelets and hemoglobin,decreased oxidative damagea and oxidative stress,enhanced antioxidant enzyme levels and the statistically lowered NF-κB protein level.Conclusion ZIF-8 loaded QU behaves better than CQDs and MS in reducing inflammation and brain edema formation in HACE rats.[Chinese Medical Equipment Journal,2025,46(5):27-33]

Objective:To compare the efficacy and safety of LY01011,a recombinant anti-RANKL fully human monoclonal antibody injection,versus denosumab in the treatment of bone metastases from solid tumors.Methods:A randomized,double-blind,positive drug parallel-controlled,multicenter clinical trial was conducted.A total of 850 subjects were randomly assigned(1:1)to either the experimental group(424 subjects)or the control group(426 subjects).The experimental group received 13 doses of LY01011,while the control group received 3 doses of denosumab followed by 10 doses of LY01011.Results:The primary efficacy endpoint was the natural logarithmic change from baseline in urinary N-terminal telopeptide of type I collagen corrected by urinary creatinine(uNTX/uCr)at week 13.The change was-1.740(0.042 0)in the experimental group and-1.745(0.042 1)in the control group.The least-squares mean difference between groups was 0.005(90%CI:-0.088 to 0.097),indicating no statistically significant difference(P>0.05).Safety profiles,including treatment-emergent adverse events,laboratory tests,vital signs,physical examinations,and electrocardiograms,were comparable between groups(P>0.05).Conclusions:LY01011 demonstrated biosimilarity to denosumab,with favorable safety profile,tolerability,and potential for clinical application.

Objective:The aim of this study is to explore the clinical efficacy and safety of endocrinotherapy combined with Shenqi Pills on hormone-sensitive prostate cancer(HSPC).Methods:Eighty patients who were diagnosed with HSPC and renal-yang deficiency at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine and the Hospital of Traditional Chi-nese Medicine of Mayang Miao Autonomous County from 1st April 2021 to 30th April 2024 were randomly divided into 2 groups.The patients in the control group were treated with androgen deprivation therapy(ADT).And the patients in treatment group were treated with Shenqi Pills orally on the basis of the control group.The baseline data of the two groups were analyzed.After 36 months of treat-ment,the differences between the two groups were compared in terms of overall survival(OS),prostate-specific antigen(PSA)level,PSA response rate,Functional Assessment Scale for Prostate Cancer Therapy(FACT-P),Chinese medicine evidence scores,testoster-one level and safety.Results:A total of 80 study subjects were included in this study,including 42 cases in the treatment group and 38 cases in the control group.There was no statistical difference in the baseline data between the two groups before treatment(P＞0.05).At the end of the observation period,a statistically significant difference in OS was found in the treatment group compared to the control group in the subgroup of patients with a disease duration ranged of 0-6 months(P＜0.05).There was no statistically signif-icant difference in PSA levels in the treatment group at 3 months(P＞0.05).And the differences in the proportion of PSA50(98.1％vs 91.4％),PSA90(92.9％ vs 84.6％)and the proportion of decrease in PSA(56.7％vs 33.8％)in the treatment group were found compared to those in the control group after 6 months of tre atment.After 12 months of treatment,the scores of FACT-4 and re-nal-yang deficiency in the treatment group were(95.28±7.93)and(15.73±5.70)respectively,compared to the scores in the con-trol group([85.46±10.12]and[18.20±4.27](P＜0.05).However,there was no significant difference in serum testosterone([0.60±0.24]nmol/L vs[1.09±2.10]nmol/L)between the two groups(P＞0.05).After 24 months of treatment,there were significant differences in in the FACT-4 total score([97.95±7.54]vs[80.33±8.58]),renal-yang deficiency syndrome score([14.64±5.15]vs[24.94±8.75])between the treatment group and the control group(P＜0.05).However,there was no signifi-cant difference in serum testosterone([0.73±1.01]nmol/L vs[0.59±0.25]nmol/L)between the two groups(P＞0.05).Bet-ter therapeutic results were showed in the treatment group in terms of total FACT-P score,physical situation score,social and family situation score,emotional state score,functional state score,additional score and renal-yang deficiency symptom score(P＜0.05).After treatment,there was no serious adverse reaction in the course of treatment,and no obvious abnormality was found in the liver and kidney function of the patients from two groups.Conclusion:Endocrinotherapy combined with Shenqi Pills is safe and effective in HSPC and can reduce the risk of death in HSPC patients,and the earlier the intervention,the longer the overall survival of the pa-tients.In addition,this treatment regimen can increase the PSA response rate,improve patients'quality of life,and reduce the renal-yang deficiency syndrome score without the risk of elevating serum testosterone levels.