Radiotherapy is a crucial treatment modality for head and neck tumors. However, while effectively killing tumor cells, it significantly disrupts the homeostasis of the oral microecology, which is closely associated with various complications such as radiation-induced oral mucositis. Literature review indicates that as radiotherapy doses accumulate and treatment durations extend, the richness and diversity of the oral microbiota show a declining trend, with the genus Streptococcus decreasing most markedly. In contrast, radiotherapy selectively promotes the proliferation of bacterial phyla such as Proteobacteria and Bacteroidetes, which are rich in opportunistic pathogens. Mechanistically, radiotherapy activates the nuclear factor-kappa B pathway, triggering chronic inflammation and oxidative stress, damaging the epithelial barrier, suppressing local immunity, and causing damage to organs such as the salivary glands. It can also induce systemic diseases via the oral-gut axis, forming a multi-level, interconnected pathogenic network. In terms of interventions, treatment strategies including probiotics and prebiotics have shown promising efficacy against side effects such as radiation-induced oral mucositis. Saliva-based oral microbiota transplantation is an emerging strategy that is expected to become widely utilized for restoring oral microecological balance. Existing interventions provide preliminary pathways for clinical practice, but this field still faces several key scientific questions. The association between oral microecology and systemic diseases remains largely correlative, lacking causal evidence. Furthermore, critical parameters for oral microbiota transplantation, such as donor screening criteria, transplantation protocols, and long-term safety, are not yet well-defined. Therefore, future research should focus on conducting large-scale clinical trials to establish standardized protocols and safety evaluation systems for oral microecological interventions, and explore combined treatment therapies such as probiotics, prebiotics, and microbiota transplantation to advance the development of personalized precision modulation. These will enable more effective management of radiotherapy-induced oral microecological dysbiosis and improve treatment outcomes and quality of life for patients with head and neck tumors.

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*

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*

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Quality marker (Q-Marker) is an innovative concept and model for quality control of Traditional Chinese medicines (TCMs), which will navigate the new direction of quality development of TCMs. Yet, how to characterize the overall quality attributes of TCMs and their biological effects is still debating. In view of this key scientific issue, this paper proposes a research method based on mass spectrometry imaging (MSI) technology for the discovery and confirmation of TCMs Q-Marker. MSI is powerful in investigating the spatial distribution of molecules in a variety of samples, and visualizing the information obtained from MS. On this basis, combine with the five principles of TCMs Q-Marker validation, i.e., specificity, transmission and traceability, testability, prescription compatibility, and validity, were applied to confirm the finalized Q-Marker. It will lead the new direction of quality development of TCMs.

Diabetic nephropathy(DN)is a chronic complication that leads to the high mortality of diabetes mellitus(DM)patients.Many researchers are devoted to the diagnosis,etiology,process and molecular mechanism of treatment of DN.At present,the regulation of small molecular lipids on renal function and the role in the pathogenesis of DN are gradually becoming clear,and lipidomics has also become a powerful tool in DN research.DN is characterised by disorders of lipid metabolism,and lipidomics plays an important role in the characterisation of lipid metabolic profiles,diagnosis,mechanistic investigation and treatment of DN because of its unique relevance.But at the same time,the lipids in the body are complex,which brings great challenges to the detection and analysis of lipids.In the future,multidisciplinary crossover and multi-omics association is the direction of lipidomics breakthrough.This article outlines the progress of the application of lipidomics in DN research strategies,lipid metabolic profiling,early diagnosis,drug efficacy and mechanism exploration,and histological co-analysis,and further discusses the opportunities and challenges of the future application of lipidomics in DN,with the aim of providing a clear picture of the current status of the research and the prospects for researchers in the relevant directions.

Objective:To explore the risk assessment and intervention effect of WeChat platform-based health management in high-risk populations for cardiovascular diseases (CVD).Methods:It was a randomized controlled trial. A total of 480 individuals at high risk of CVD who underwent physical examinations at the Health Management Center of Sichuan Provincial People′s Hospital from February to April in 2023 were selected using a simple random sampling method. The participants were randomly assigned to either the intervention group or the control group (240 cases each) using a random number table. The control group received routine follow-up and health assessments, while the intervention group received an additional 12-month WeChat-based health management intervention. During the study, 28 participants were lost to follow-up, resulting in 227 participants in the intervention group and 225 in the control group being included in the final analysis. The 10-year CVD risk was assessed using the prediction for atherosclerotic cardiovascular disease risk in China (China-PAR) model, and psychological status was evaluated using the self-rating anxiety Scale (SAS) and the self-rating depression scale (SDS). Changes in health behaviors, adherence, life style, blood pressure, metabolic indicators, psychological status, and CVD risk were compared before and after the intervention in both groups to evaluate the intervention′s effectiveness.Results:Among the 452 high-risk participants analyzed, the intervention group included 227 individuals [mean age: (53.16±10.81) years; 117 males and 110 females], and the control group included 225 individuals [mean age: (52.60±10.25) years; 118 males and 107 females]. There was no significant differences in baseline characteristics between the two groups (all P>0.05). After 12 months of intervention, the intervention group showed significant improvements in medication adherence, intake of vegetables and fruits, exercise duration, sleep time, proportion of regular lifestyle, and high density lipoprotein cholesterol (HDL-C) levels, all of which were all higher than both the baseline values and those in the control group (all P<0.05). Conversely, the intervention group showed reductions in medical visit rate, smoking and drinking rates, high-salt diet, meat intake, body mass index (BMI), fasting blood glucose, systolic and diastolic blood pressure, low density lipoprotein cholesterol (LDL-C), total cholesterol, triglycerides, SAS and SDS scores when compared to the baseline values and those in the control group (all P<0.05). The proportions of participants with 10-year CVD risk levels of 10%-<20%, 20%-<30%, 30%-<40%, and ≥40% significantly decreased in the intervention group after intervention (18.94% vs 36.12%, 12.78% vs 26.43%, 7.93% vs 19.82%, 3.96% vs 17.63%), and were also significantly lower than those in the control group (18.94% vs 40.45%, 12.78% vs 30.67%, 7.93% vs 22.67%, 3.96% vs 16.89%) (all P<0.001). After 12 months, the intervention group showed significantly higher improvement rates in both medication adherence and non-medication-related compliance behaviors, including smoking, alcohol consumption, meat and salt intake, fruit and vegetable intake, exercise duration, sleep duration, and lifestyle regularity, when compared to those in the control group (16.74% vs -3.11%, 14.54% vs -0.89%, 16.74% vs -0.44%, 57.71% vs 8.44%, 21.15% vs -0.44%, 56.83% vs -6.67%, 51.54% vs -3.56%, 60.79% vs -7.11%, 26.87% vs -13.78%, 22.91% vs -1.78%) (all P<0.001). Conclusion:The WeChat platform-based health management intervention can effectively improve the behavioral patterns, compliance, control of CVD risk factors and psychological status of high-risk populations for CVD, and help reduce their 10-year risk of CVD.