1.Prevalence and molecular characterization of Shiga toxin-producing Esch-erichia coli in domestic goats in the Chengkou District of Chongqing
Jing-jing PENG ; Bin HU ; Xi YANG ; Yi LI ; Hai HUANG ; Wen-shuang LIU ; Yu MENG ; Li-jun WANG ; Yan-wen XIONG ; Yi YUAN ; Pei-bin HOU
Chinese Journal of Zoonoses 2025;41(5):529-536
This study investigated the infection status,drug resistance,and molecular characteristics of Shiga toxin-producing Escherichia coli(STEC)in domestic goats in Chengkou county,Chongqing.In August 2023,283 fecal samples were collected from households in Chengkou county.After enrichment with EC broth and inoculation onto selective media,samples that tested positive for stx1/stx2 were selected for further isolation.The positive strains were investigated with antimicrobial susceptibility testing and whole genome sequencing.According to the whole genomic sequences,the stx subtypes,serotypes,multi-locus sequence types,virulence genes,drug resistance genes,and phylogenetic relationships of the STEC strains were analyzed.Forty-six strains of STEC were isolated from 283 goat fecal samples,thus resulting in a detection rate of 16.25%.The 46 STEC strains were categorized into 12 O∶H serotypes,among which O76∶H19 and O8∶H7 predominated,each represented by 9 strains.Five STEC strains were identified as serotype O157∶H7.The 46 STEC strains were categorized into 11 sequence types(STs),among which ST675 and ST196 predominated,each represented by nine strains,accounting for a 19.57%proportion.The strains were categorized into 7 stx subtypes,among which stx1c(26/46,56.52%),followed by stx2k(9/46,19.57%)predominated.All nine Stx2k-STEC strains were identified as serotype O8∶H7 and sequence type ST196.In antimicrobial susceptibility testing,2 STEC strains were resistant to ampicillin,one strain was resistant to ampicillin/sulbactam,one strain was resistant to cefazolin,and one strain was resistant to cefoxitin.Nine Stx2k-STEC strains were found to carry the beta-lactam resistance gene blaEC-18.Antimicrobial sensitivity tests revealed that the nine Stx2k-STEC strains were sensitive to all 15 tested antibiotics.Moreover,phylogenetic analysis indicated that the 9 Stx2k-STEC strains were remarkably similar but showed high genetic diversity with respect to that of the Stx2k-STEC strains isolated from other regions in China.Goatsare an important animal reservoir for STEC in theChengkou district of Chongqing,and novel sequence type Stx2k-STEC strains distinct from those found in other regions of China were identified in this region.
2.Mechanism of action of hispidulin on cervical cancer based on network pharmacology and in vitro cell experiments
Hui-jun MENG ; Wen-jie HUANG ; Xiao-tong YU ; Hai YANG ; Ye WANG
Chinese Pharmacological Bulletin 2025;41(7):1367-1375
Aim To explore the mechanism of hispidu-lin in the treatment of cervical cancer by using network pharmacology and molecular docking methods and veri-fy it by in vitro experiments.Methods Cervical canc-er HeLa and SiHa cells were cultivated in vitro,and CCK-8 assay,cloning assay,scratch assay,transwell as-say,and flow cytometry were used to detect the effects of hispidulin on cell proliferation,migration,invasion,and apoptosis.SwissTarget Prediction was used to ob-tain predicted targets for hispidulin.Potential targets for cervical cancer were screened in GeneCards disease database.R software Venn package was used to obtain the intersection target genes of hispidulin and cervical cancer,STRING website and Cytoscape software were used to obtain protein-protein interaction(PPI)net-work,and the core targets were screened.The GEIPA data analysis platform was employed to analyze the dif-ferential gene expression levels of core targets in cervi-cal cancer.Gene Ontology(GO)and Kyoto Encyclo-pedia of Genes and Genomes(KEGG)enrichment a-nalysis were performed,and molecular docking was car-ried out on key targets.Western blot was used to detect the regulatory effects of hispidulin on the expression of key proteins PI3K,p-Akt,as well as core target pro-teins MMP9 and RARP1 in the PI3K/Akt signaling pathway.Results Cell experiments showed that after treatment with hispidulin,the proliferation and colony formation abilities of HeLa and SiHa cells significantly decreased in a concentration-and time-dependent man-ner.At the same time,the lateral and longitudinal mi-gration and invasion abilities of HeLa cells decreased,and the level of apoptosis significantly increased.A to-tal of 87 intersection targets between hispidulin and cervical cancer were obtained,and eight core targets,namely,Akt1,EGFR,SRC,ESR1,PTGS2,GSK3β,MMP9,and PARP1,were selected based on the degree values in network topology analysis.KEGG enrichment screening identified PI3K/Akt signaling pathway,canc-er pathway,and other signaling pathways.The molecu-lar docking results showed that hispidulin had strong affinity activity with AktⅠ,P13K,MMP9,and RARP1.Western blot results showed downregulation of PI3K,p-Akt expression,as well as MMP9 and RARP1 expres-sion.Conclusions Hispidulin can inhibit the prolif-eration,migration,invasion,and promote apoptosis of cervical cancer cells by downregulating the PI3K/Akt signaling pathway and the expression of MMP9 and RARP1.
3.Frontalis sling surgery using polypropylene non-absorbable sutures: a novel approach for the treatment of senile ptosis
Yi YANG ; Xueyong MENG ; Jun ZHANG ; Jinlong HUANG
Chinese Journal of Plastic Surgery 2025;41(1):8-14
Objective:To investigate the effect of a new method of utilizing frontalis sling with polypropylene non-absorbable sutures for the treatment of senile ptosis.Methods:A retrospective analysis was conducted on the clinical data of senile patients with blepharoptosis who were treated with frontalis sling surgery with polypropylene non-absorbable sutures at the Department of Plastic Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine between January 2022 and December 2023. The palpebral fissure height and margin reflex distance (MRD1) of the upper eyelid margin were measured and recorded before and after the operation, and the operation time and postoperative detumescence time were recorded. Postoperative complications and recurrence of ptosis were followed up. Patients’ satisfaction with the postoperative effect was investigated and divided into three levels: very satisfied, satisfied, and dissatisfied. Normal distribution measurement data were expressed as Mean±SD; counting data were expressed as frequency.Results:A total of 8 patients were enrolled, including 3 males and 5 females, with an age of (68.8±6.1) years. Six patients underwent bilateral ptosis correction surgery, and two underwent unilateral ptosis correction surgery. The ptosis was graded as follows: 1 case was mild, 2 cases were moderate, and 5 cases were severe. There were 2 cases of aponeurotic ptosis, 3 cases of congenital ptosis and 3 cases of traumatic ptosis (1 of which was prosthetic eye). The operative time of 8 patients (14 eyes) with unilateral ptosis was (43.9±4.9) min. The swelling resolved in (9.4±1.7) days. One patient still had symptoms of lagophthalmos and corneal irritation 7 days after the operation. The symptoms gradually relieved after wearing corneal protective goggles and applying eye ointment. The postoperative follow-up lasted from 2 to 15 months (mean 6.3 months). Palpebral cleft height [(9.8±0.6) mm vs. (3.3±1.2) mm] and MRD1[(4.1±0.5) mm vs. (-1.1±0.8) mm] in 8 patients (14 eyes) after surgery were significantly higher than those before the operation( P<0.01). There was no recurrence of ptosis after the operation. There were 2 cases of upper eyelid hysteresis, of which 1 case was mild upper eyelid hysteresis, and the other case had relatively obvious upper eyelid hysteresis on prosthetic side. Satisfaction survey showed that 7 patients were very satisfied with the result of the operation, and 1 patient was satisfied. Conclusion:Frontal muscle suspension with polypropylene non-absorbable suture is a feasible method for the treatment of ptosis in elderly patients with simple operation, little tissue damage, positive effect, rapid postoperative recovery and acceptable complications.
4.Frontalis sling surgery using polypropylene non-absorbable sutures: a novel approach for the treatment of senile ptosis
Yi YANG ; Xueyong MENG ; Jun ZHANG ; Jinlong HUANG
Chinese Journal of Plastic Surgery 2025;41(1):8-14
Objective:To investigate the effect of a new method of utilizing frontalis sling with polypropylene non-absorbable sutures for the treatment of senile ptosis.Methods:A retrospective analysis was conducted on the clinical data of senile patients with blepharoptosis who were treated with frontalis sling surgery with polypropylene non-absorbable sutures at the Department of Plastic Surgery, Affiliated Hospital of Nanjing University of Chinese Medicine between January 2022 and December 2023. The palpebral fissure height and margin reflex distance (MRD1) of the upper eyelid margin were measured and recorded before and after the operation, and the operation time and postoperative detumescence time were recorded. Postoperative complications and recurrence of ptosis were followed up. Patients’ satisfaction with the postoperative effect was investigated and divided into three levels: very satisfied, satisfied, and dissatisfied. Normal distribution measurement data were expressed as Mean±SD; counting data were expressed as frequency.Results:A total of 8 patients were enrolled, including 3 males and 5 females, with an age of (68.8±6.1) years. Six patients underwent bilateral ptosis correction surgery, and two underwent unilateral ptosis correction surgery. The ptosis was graded as follows: 1 case was mild, 2 cases were moderate, and 5 cases were severe. There were 2 cases of aponeurotic ptosis, 3 cases of congenital ptosis and 3 cases of traumatic ptosis (1 of which was prosthetic eye). The operative time of 8 patients (14 eyes) with unilateral ptosis was (43.9±4.9) min. The swelling resolved in (9.4±1.7) days. One patient still had symptoms of lagophthalmos and corneal irritation 7 days after the operation. The symptoms gradually relieved after wearing corneal protective goggles and applying eye ointment. The postoperative follow-up lasted from 2 to 15 months (mean 6.3 months). Palpebral cleft height [(9.8±0.6) mm vs. (3.3±1.2) mm] and MRD1[(4.1±0.5) mm vs. (-1.1±0.8) mm] in 8 patients (14 eyes) after surgery were significantly higher than those before the operation( P<0.01). There was no recurrence of ptosis after the operation. There were 2 cases of upper eyelid hysteresis, of which 1 case was mild upper eyelid hysteresis, and the other case had relatively obvious upper eyelid hysteresis on prosthetic side. Satisfaction survey showed that 7 patients were very satisfied with the result of the operation, and 1 patient was satisfied. Conclusion:Frontal muscle suspension with polypropylene non-absorbable suture is a feasible method for the treatment of ptosis in elderly patients with simple operation, little tissue damage, positive effect, rapid postoperative recovery and acceptable complications.
5.Regulation of methyltransferase METTL3 on radiotherapy sensitivity of oral squamous cell carcinoma cells
Qingzhe MENG ; Junhong HUANG ; Xinjie YANG ; Huan LI ; Zihui YANG ; Jun WANG ; Yahui LI ; Rong LIU ; Jianhua WEI
Journal of Practical Stomatology 2025;41(2):206-213
Objective:To study the influence of methyltransferases like 3(METTL3)on the radiosensitivity of oral squamous cell carcinoma cells(OSCCs).Methods:The apoptosis level of OSCCs CAL27,SCC9 and SCC15 treated with X-ray radiation doses of 2,4 and 8 Gy respectively was compared by flow cytometry,the expression of methylated gene RNA and protein in the cells were examined by qRT-PCR and Western blot.m6A in the cells was quantified by LC/LC-MS method.qRT-PCR and Western blot were used to investigate the expression of methylated gene RNA and protein in the cells.Flow cytometry was used to examine the cell apoptosis level of CAL27 and SCC15 cells treated with METTL3 overexpression and knockdown respectively.The clone forma-tion of CAL27 and SCC15 cells after knockdown and overexpression of target genes followed by radiation treatment was observed by clonogenic assays.Results:The apoptosis rate of all the cell lines increased with the increase dose of radiation at each dose,CAL27 cells showed the highest and SCC15 showed the lowerst apoptosis rate.The RNA and protein expression levels of METTL3 in CAL27 were significantly lower than those of SCC15.m6A quantification showed that the methylation modification in CAL27 cells was lower than that in SCC15.The expression of METTL3 was increased in CAL27 and SCC15 cells after radiation treatment.Knockdown of METTL3 increaced the apoptosis rate and decreased the clonogenesity,overession of METTL3 the decreaced the ap optosis rate and increased the clonogenecity of the cells.Conclusion:Regulation of METTL3 can affect the radiotherapy sensitivity of OSCCs,METTL3 may become a new target for radiosensitization of OSCCs.
6.Cross-sectional survey of healthcare-associated infection in 5 736 medical institutions across China in 2024
Cui ZENG ; Wuqiang GAO ; Fu QIAO ; Hui ZHAO ; Xu FANG ; Linping LI ; Xiuwen CHEN ; Jiansen CHEN ; Dan LI ; Yuan ZHOU ; Lingli YU ; Qinglan MENG ; Xia MOU ; Lijuan XIONG ; Weiguang LI ; Ding LIU ; Jiaqing XIAO ; Limei OU ; Baozhen LI ; Jun YIN ; Haojun ZHANG ; Qiang FU ; Qun LU ; Biao WU ; Ya-wei XING ; Shumei SUN ; Shuncai WANG ; Longmin DU ; Jingping ZHANG ; Wen-ying HE ; Gui CHENG ; Nan REN ; Xun HUANG ; Anhua WU
Chinese Journal of Infection Control 2025;24(11):1572-1583
Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27%.The number of HAI episodes was 38 032,and case prevalence rate was 1.38%.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66%to 2.35%.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65%.The most common infection site was the lower respiratory tract(44.66%),followed by the urinary tract(12.94%),surgical site(9.32%),upper respiratory tract(7.02%),and bloodstream infection(5.78%).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02%),department of neurosurgery(5.51%),and department(group)of hematology(5.34%).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10%)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76%),Pseudomonas aeruginosa(13.33%),Escherichia coli(12.79%),Acinetobacter baumannii(9.23%),and Staphylococcus aureus(7.88%).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71%.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18%.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46%.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.
7.Cross-sectional survey of healthcare-associated infection in 5 736 medical institutions across China in 2024
Cui ZENG ; Wuqiang GAO ; Fu QIAO ; Hui ZHAO ; Xu FANG ; Linping LI ; Xiuwen CHEN ; Jiansen CHEN ; Dan LI ; Yuan ZHOU ; Lingli YU ; Qinglan MENG ; Xia MOU ; Lijuan XIONG ; Weiguang LI ; Ding LIU ; Jiaqing XIAO ; Limei OU ; Baozhen LI ; Jun YIN ; Haojun ZHANG ; Qiang FU ; Qun LU ; Biao WU ; Ya-wei XING ; Shumei SUN ; Shuncai WANG ; Longmin DU ; Jingping ZHANG ; Wen-ying HE ; Gui CHENG ; Nan REN ; Xun HUANG ; Anhua WU
Chinese Journal of Infection Control 2025;24(11):1572-1583
Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27%.The number of HAI episodes was 38 032,and case prevalence rate was 1.38%.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66%to 2.35%.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65%.The most common infection site was the lower respiratory tract(44.66%),followed by the urinary tract(12.94%),surgical site(9.32%),upper respiratory tract(7.02%),and bloodstream infection(5.78%).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02%),department of neurosurgery(5.51%),and department(group)of hematology(5.34%).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10%)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76%),Pseudomonas aeruginosa(13.33%),Escherichia coli(12.79%),Acinetobacter baumannii(9.23%),and Staphylococcus aureus(7.88%).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71%.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18%.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46%.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.
8.N 6-Methyladenosine modification of circDcbld2 in Kupffer cells promotes hepatic fibrosis via targeting miR-144-3p/Et-1 axis.
Sai ZHU ; Xin CHEN ; Lijiao SUN ; Xiaofeng LI ; Yu CHEN ; Liangyun LI ; Xiaoguo SUO ; Chuanhui XU ; Minglu JI ; Jianan WANG ; Hua WANG ; Lei ZHANG ; Xiaoming MENG ; Cheng HUANG ; Jun LI
Acta Pharmaceutica Sinica B 2025;15(1):296-313
Kupffer cells (KCs), as residents and sentinels of the liver, are involved in the formation of hepatic fibrosis (HF). However, the biological functions of circular RNAs (circRNAs) in KCs to HF have not been determined. In this study, the expression levels of circRNAs, microRNAs, and messenger RNAs (mRNAs) in KCs from a mouse model of HF mice were investigated using microarray and circRNA-Seq analyses. circDcbld2 was identified as a candidate circRNA in HF, as evidenced by its up-regulation in KCs. Silver staining and mass spectrometry showed that Wtap and Igf2bp2 bind to cirDcbld2. The suppression of circDcbld2 expression decreased the KC inflammatory response and oxidative stress and inhibited hepatic stellate cell (HSCs) activation, attenuating mouse liver fibrogenesis. Mechanistically, Wtap mediated the N 6-methyladenosine (m6A) methylation of circDcbld2, and Igf2bp2 recognized m6A-modified circDcbld2 and increased its stability. circDcbld2 contributes to the occurrence of HF by binding miR-144-3p/Et-1 to regulate the inflammatory response and oxidative stress. These findings indicate that circDcbld2 functions via the m6A/circDcbld2/miR-144-3p/Et-1 axis and may act as a potential biomarker for HF treatment.
9.Study on the gene expression and regulation mechanisms of fibroblasts in acute inflammatory response.
Meng DU ; Hanjing LIAO ; Manjing HUANG ; Yaqin WANG ; Zongjie ZHAO ; Zhixiang ZHU ; Jun LI
Chinese Journal of Cellular and Molecular Immunology 2025;41(5):391-397
Objective To investigate the gene expression and regulatory mechanisms of mouse embryonic fibroblasts (MEFs) under inflammatory conditions, aiming to elucidate the role of MEFs in inflammatory responses and provide a foundation for discovering anti-inflammatory drugs that act by modulating MEF function. Methods MEFs cultured in vitro were divided into the following groups: lipopolysaccharides (LPS)-treated group, inflammatory conditioned medium (CM)-treated group, and control group, which were treated with LPS, CM, and equal volume solvent, respectively. Transcriptome sequencing was used to analyze the effects of two stimuli on gene expression profile of MEFs. Real time fluorescence quantitative PCR (RT-qPCR) was employed to verify the transcription levels of highly expressed genes of MEFs induced by CM. ELISA was performed to determine the concentrations of cytokines in cell supernatants. Finally, the regulatory effects of CM on the activation of signaling pathways in MEFs were analyzed by immunoblotting. Results Transcriptome analysis showed that both LPS and CM induced the transcription of a large number of genes in MEFs. Compared with LPS, CM potentiated the mRNA transcription of some acute phase proteins, inflammatory cytokines, chemokines, matrix metalloproteinases (MMP), prostaglandin synthetases, and colony-stimulating factors. The transcriptome analysis was verified by RT-qPCR. The results of ELISA showed that CM treatment significantly increased the secretion of interleukin 6 (IL-6), C-C motif chemokine ligand (CCL2), and C-X-C motif chemokine ligand (CXCL1) by MEFs compared with LPS. Mechanism study showed that both LPS and CM induced the phosphorylation of nuclear factor-κB p65 (NF-κB p65), p38 mitogen-activated protein kinase (p38 MAPK), extracellular regulated protein kinases 1/2 (ERK1/2), and TANK-binding kinase (TBK) in MEFs, and CM strongly stimulated the phosphorylation of signal transducer and activator of transcription 3 (STAT3) in MEFs. Conclusion Both LPS and CM can induce transcription and protein secretion of various inflammation-related genes in MEFs. CM can partly enhance LPS-induced activation of MEFs, and the mechanism may be related to the enhancement effect of CM on the activation STAT3 signaling pathway.
Animals
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Fibroblasts/immunology*
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Mice
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Lipopolysaccharides/pharmacology*
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Inflammation/metabolism*
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Signal Transduction/drug effects*
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Gene Expression Regulation/drug effects*
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Cytokines/genetics*
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Culture Media, Conditioned/pharmacology*
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Cells, Cultured
10.Expert consensus on management of instrument separation in root canal therapy.
Yi FAN ; Yuan GAO ; Xiangzhu WANG ; Bing FAN ; Zhi CHEN ; Qing YU ; Ming XUE ; Xiaoyan WANG ; Zhengwei HUANG ; Deqin YANG ; Zhengmei LIN ; Yihuai PAN ; Jin ZHAO ; Jinhua YU ; Zhuo CHEN ; Sijing XIE ; He YUAN ; Kehua QUE ; Shuang PAN ; Xiaojing HUANG ; Jun LUO ; Xiuping MENG ; Jin ZHANG ; Yi DU ; Lei ZHANG ; Hong LI ; Wenxia CHEN ; Jiayuan WU ; Xin XU ; Jing ZOU ; Jiyao LI ; Dingming HUANG ; Lei CHENG ; Tiemei WANG ; Benxiang HOU ; Xuedong ZHOU
International Journal of Oral Science 2025;17(1):46-46
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
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Root Canal Therapy/adverse effects*
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Consensus
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Root Canal Preparation/adverse effects*

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