Objective:To retrospectively analyze the pathogenic factors of retrograde peri-implantitis (RPI) and assess the effectiveness of treatment, and to provide clinicians evidence for the prevention and treatment of RPI.Methods:A total of 2 731 patients with missing teeth (4 016 implants) who underwent implant restoration in the Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University between January 2004 and December 2022 were included in the study. According to the diagnostic criteria of RPI, a total of 20 cases (23 implants) of RPI were collected, including 4 female (5 implants) and 16 male (18 implants), and the treatment medical records, intraoral photos and cone beam CT or oral panoramic radiographs records of each patient were collected. Each patient with RPI was treated accordingly and followed up regularly to evaluate its efficacy.Results:After treatment, the follow-up time for 20 patients with clinical symptoms of RPI was 13 (6, 40) months (1 month to 13 years), and the survival rate of the treated implants was 91% (21/23). There were 7 patients (8 implants) with inactive RPI, no clinical symptoms, no loosening of the implant, with normal occlusal load, and the disease was at the inactive stage and was not treated. The pulp vitality of the natural tooth adjacent to the implant was normal, and the implant could function normally. There were 13 patients (15 implants) with infected RPI, 1 patient (1 implant) had no loosening of the implant, and the periapical radiolucency of the implant disappeared after endodontic treatment of the natural tooth adjacent to the implant; 12 patients (14 implants) had clinical symptoms such as implant loosening, pus discharge, etc. Among them, 10 patients (12 implants) were successfully implanted in situ or in adjacent sites after removing the implants, and were successfully implanted after 3 to 20 months. Two patients(2 implants) were removed and no further implants were placed. Among them, 2 implants with infected RPI had cystic lesions, which was similar to natural root apex cysts.Conclusions:The etiology of RPI is related to inflammation of adjacent tooth root tips or bacterial residues from inflammatory lesions in the alveolar bone and bone augmentation. RPI can be treated by perfect root canal treatment of adjacent teeth, removal of inflammatory tissue, or simultaneous guided bone regeneration techniques.

Objective:To retrospectively analyze the pathogenic factors of retrograde peri-implantitis (RPI) and assess the effectiveness of treatment, and to provide clinicians evidence for the prevention and treatment of RPI.Methods:A total of 2 731 patients with missing teeth (4 016 implants) who underwent implant restoration in the Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University between January 2004 and December 2022 were included in the study. According to the diagnostic criteria of RPI, a total of 20 cases (23 implants) of RPI were collected, including 4 female (5 implants) and 16 male (18 implants), and the treatment medical records, intraoral photos and cone beam CT or oral panoramic radiographs records of each patient were collected. Each patient with RPI was treated accordingly and followed up regularly to evaluate its efficacy.Results:After treatment, the follow-up time for 20 patients with clinical symptoms of RPI was 13 (6, 40) months (1 month to 13 years), and the survival rate of the treated implants was 91% (21/23). There were 7 patients (8 implants) with inactive RPI, no clinical symptoms, no loosening of the implant, with normal occlusal load, and the disease was at the inactive stage and was not treated. The pulp vitality of the natural tooth adjacent to the implant was normal, and the implant could function normally. There were 13 patients (15 implants) with infected RPI, 1 patient (1 implant) had no loosening of the implant, and the periapical radiolucency of the implant disappeared after endodontic treatment of the natural tooth adjacent to the implant; 12 patients (14 implants) had clinical symptoms such as implant loosening, pus discharge, etc. Among them, 10 patients (12 implants) were successfully implanted in situ or in adjacent sites after removing the implants, and were successfully implanted after 3 to 20 months. Two patients(2 implants) were removed and no further implants were placed. Among them, 2 implants with infected RPI had cystic lesions, which was similar to natural root apex cysts.Conclusions:The etiology of RPI is related to inflammation of adjacent tooth root tips or bacterial residues from inflammatory lesions in the alveolar bone and bone augmentation. RPI can be treated by perfect root canal treatment of adjacent teeth, removal of inflammatory tissue, or simultaneous guided bone regeneration techniques.

Objective:To explore the effect of the non-suicidal self-injury (NSSI) management plan for hospitalized adolescents with mood disorders based on hazard analysis and critical control point (HACCP) theory.Methods:From February to July 2023, convenience sampling was used to select 76 adolescents with mood disorders and NSSI from two closed full care wards of the Affiliated Brain Hospital of Nanjing Medical University as the research subject. Adolescents were randomly divided into a control group and an experimental group. The control group received the routine diagnosis, treatment, nursing, and risk management plan, while the experimental group implemented the management plan based on the HACCP theory. This study compared the incidence of NSSI, Adolescent Non-suicidal Self-injury Assessment Questionnaire (ANSSIQ), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Accompanying Family Member Satisfaction Questionnaire scores before and after intervention between two groups of adolescents.Results:The control group included 35 patients, while the experimental group included 32 patients. After intervention, the anxiety and depression scores of the experimental group patients were lower than those of the control group, and the difference was statistically significant ( P<0.05). The incidence of NSSI in the experimental group was lower than that in the control group with a statistical difference ( P<0.05). The satisfaction of accompanying family members in the experimental group was better than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The management plan based on the HACCP theory is beneficial for reducing the occurrence of NSSI in hospitalized adolescents with mood disorders, improving their negative emotions, enhancing the satisfaction of accompanying family members, and ensuring the safety of the ward.

Objective:To explore the protective effect and safety of RotaTeq vaccine on children with rotavirus gastroenteritis (RVGE) in high mortality areas in the world and guide the correct use of RotaTeq vaccine.Methods:The literature on RotaTeq vaccine in high mortality areas in the world published from February 2006 to December 2021 was searched, screened and sorted out according to the exclusion and inclusion criteria, and the data were analyzed by RevMan 5.3, Stata 14.0 and SPSS 26.0 softwares.Results:A total of 5 reports were enrolled, including 63 974 subjects, including 32 092 subjects in the vaccine group and 31 882 subjects in the placebo group. In high mortality areas, the protection rates of RotaTeq vaccine against RVGE, severe rotavirus gastroenteritis (SRVGE) and very severe rotavirus gastroenteritis (VSRVGE) were VE RVGE=35% (95% CI: 28%-41%), VE SRVGE=51% (95% CI: 33%-65%) and VE VSRVGE=64% (95% CI: 41%-78%). The protection rates of SRVGE in Asia and Africa are VE SRVGE=43% (95% CI: 28%-55%) and VE SRVGE=57% (95% CI: 17%-77%), respectively. There was no significant difference in the incidences of serious adverse events (SAEs) between RotaTeq vaccine group and placebo group ( χ2=2.05, P=0.152). Conclusions:RotaTeq vaccine has a certain protective effect on severe and above RVGE with good safety in high mortality areas in the world.

Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
Consensus ; Dental Care ; Dental Caries/prevention & control* ; Humans ; Prevalence

Objective:To understand the epidemiological characteristics of group A rotavirus (RVA) infection in hospitalized children under 5 years of age with diarrhea in 2019, and to provide reference for the surveillance of RVA.Methods:Stool samples and clinical information of hospitalized children under 5 years of age with diarrhea were collected from sentinel hospitals in 20 provinces in 2019. RVA nucleic acid detection and genotyping were performed according to the rotavirus detection method in the National Viral Diarrhea Surveillance Program.Results:A total of 5 395 viral diarrhea samples were collected, 5 038 were tested, and 1 247 diarrhea samples showed RVA positive results (1 247/5 038, 24.75%). The positive rate of RVA in Fujian province was the lowest (30/319, 9.40%), and the positive rate of RVA was the highest in Henan province (182/338, 53.85%). The positive rate of RVA in male and female children was 25.24%(762/3 019)and 24.02%(485/ 2 019), respectively. There was no significant gender distribution of RVA infection ( χ2 = 0.96, P=0.326). Children aged 12 to 17 months were mainly susceptible to RVA (342/1 033, 33.11%), and the positive rate of RVA in children aged 48 to 59 months was lower (35/227, 15.42%). RVA infection showed significant age distribution characteristics ( χ2 = 86.78, P<0.001). RVA infection had significant difference between urban and rural areas ( χ2 = 20.92, P<0.001) and seasonal characteristics ( χ2 =411.42, P<0.001). RVA genotyping showed that G9P[8] type (994/1 122, 88.59%) was the dominant epidemic strain. Conclusions:In 2019, the main genotype of RVA infection in hospitalized children under 5 years of age with diarrhea was G9P[8], and RVA infection had significant age, region and season characteristics.

Objective:To analyze the evolutionary characteristics of the approximate whole genome of rotavirus G2P[4] type 2020BJ strain.Methods:The rotavirus genome was amplified by reverse transcription-polymerase chain reaction (RT-PCR), the amplified products were sequenced, and the sequences were subjected to phylogenetic analysis and homology analysis.Results:The approximate full-length 11 segments of human rotavirus G2P[4] type 2020BJ strain were obtained. Sequence analysis showed that the strain was G2-P[4]-I2-R2-C2-M2-A2-N2-T2-E2-H2 genotype (DS-1-Like); evolutionary analysis shows that it is closely related to strains in Japan, India, Bangladesh, Italy and other countries; there are differences in the amino acids of antigenic epitopes between the closely related strains.Conclusions:There are differences in the amino acids of the epitopes of VP7 and VP4 of the five G2P[4] rotavirus strains that are closely related to 2020BJ, which may lead to different epidemic characteristics, and rotavirus surveillance should be strengthened.

Rotavirus is the most important pathogen of severe diarrhea in infants and young children in the world. According to the World Health Organization, about 185 000 children die from rotavirus each year. The related deaths mainly occur in low-income countries in Asia and Africa. Rotavirus infections are common even in areas with better sanitary conditions, indicating that rotavirus has a high transmission capacity. At present, there is no specific treatment for rotavirus diarrhea, only symptomatic treatment is available. Therefore, safe and effective vaccines are of great significance in reducing the incidence and mortality of rotavirus diarrhea. The World Health Organization also recommends that oral rotavirus vaccines should be included in the immunization program of all countries. At present, China’s oral rotavirus vaccine LLR has been on the market in China since 2001. The vaccines available on the market in most countries are Rotarix (RV1) and Rotateq (RV5). The vaccine is useful for preventing diarrhea caused by rotavirus infection. The vaccination to prevent rotavirus disease is very cost-effective. This article reviews the current situation of rotavirus vaccines in order to provide a scientific evidences for the prevention and control of rotavirus.

Objective To explore the related risk factors of anastomotic leakage after low rectal cancer anterior resection op-eration .Methods The clinical data of 158 patients with low rectal cancer anterior resection operation in this hospital from January 2011 to June 2016 were retrospectively analyzed .The clinical features and treatment factors were performed the univariate and mult-ivariate correlation analysis .Results The total incidence rate of anastomotic leakage was 5 .7% (9/158) .The univariate analysis showed that the age ,sex ,body mass index(BMI) ,preoperative concurrent disease ,tumor stage ,location ,pathological type ,preopera-tive intestinal obstruction and surgical mode (laparoscopy and laparotomy) had no significant correlation with postoperative anasto-motic leakage (P>0 .05) .Preventive ileostomy did not affect the incidence rate of anastomotic leakage (P=0 .694) .Postoperative placement of anorectal decompression tube could reduce the incidence rate of anastomotic leakage (P=0 .047) .The univariate and multivariate analysis showed that postoperative diarrhea was an independent risk factor for anastomotic leakage occurrence (OR=10 .522 ,P=0 .001) .Conclusion Postoperative early diarrhea is an independent risk factor for anastomotic leakage occurrence after rectal cancer anterior resection operation .Postoperative placement of anorectal decompression tube can reduce the incidence rate of anastomotic leakage .

Objective To investigate the clinical value of continuously detecting serum and pelvic drainage fluid C-reactive protein (CRP) and drainage fluid matrix metalloproteinase-9 (MMP-9) in the early diagnosis of anastomotic leakage after anterior resection of low rectal cancer.Methods The levels of CRP and MMP-9 in serum and pelvic drainage fluid were measured on postoperative 1,3,5,7 d in 158 patients with low rectal cancer anterior resection.The patients were divided into the anastomotic group (n=9) and non-anastomotic leakage group (n=149).The differences in the detection values between the two groups were compared and analyzed statistically.Results Among 158 cases,anastomotic leakage occurred in 9 cases.The correlation analysis of serum and drainage fluid CRP detection value and postoperative days (POD) in the two groups showed the POD 3,POD 5 and POD 7 difference was statistically significant (P＜0.05).The ROC curve analysis showed that the accuracy of the serum and drainage fluid CRP continuous detection for diagnosing the anastomotic leakage on postoperative 3 d was middle,which on postoperative 5,7 d was higher.The patients with CRP detection value ＞ 128.23 mg/L and drainage fluid CRP ＞89.93 mg/L on postoperative 5 d and those with CRP detection value＞113.71 mg/L and drainage fluid CRP＞81.75 mg/L on postoperative 7 d developed the anastomotic leakage.The drainage fluid MMP-9 detection value had no statistical difference between the anastomotic leakage group and the non-anastomotic leakage group (P＞0.05).Conclusion Continuous detection of serum and drainage fluid CRP level can be used for early diagnosing postoperative anastomotic leakage in low rectal cancer anterior resection.The drainage fluid MMP-9 continuous detection has no relation with early diagnosis of anastomotic leakage after low rectal cancer anterior resection.