Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
Child ; Child, Preschool ; Consensus ; Dental Caries/prevention & control* ; Dental Caries Susceptibility ; Humans ; Oral Health

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective To study and analyze value of the hemodynamic monitoring in the differential diagnosis of severe sepsis and acute heart failure.Methods A total of 86 patients with severe sepsis and acute heart failure treated with hemodynamic monitoring of PICCO were selected as the research subjects,among whom 55 patients were severe sepsis,and 31 patients were acute heart failure.The cardiac index (CI),the right atrial pressure (RAP),the pulmonary artery wedge pressure (PAWP),the mean arterial pressure (MAP),the heart rate (HR) of the patients were detected and compared.Results The RAP,PAWP levels of the patients with acute heart failure were significantly higher than that of the patients with severe sepsis.The CI level was significantly lower than that of the patients with severe sepsis,and the differences between the two groups were statistically significant (P ＜ 0.05).The area of the receiver operating characteristics curve (AUC) of CI in the differential diagnosis of severe sepsis and acute heart failure was the highest,which was 0.893.At the optimal screening limit value (Cut off value),the sensitivity and the specificity were 0.764 and 1.000.The AUC of RAP or PAWP in the differential diagnosis of severe sepsis and acute heart failure were lower than that of CI,the sensitivities at Cut off value were relatively lower,which were 0.323 and 0.484,respectively.Conclusion The invasive hemodynamic monitoring indicators of the patients with severe sepsis and acute heart failure have certain differences.Monitoring indicators can provide the basis for the early differential diagnosis and the development of treatment strategy,which is beneficial to improve the therapeutic effects and the prognosis of the patients.

Objective To study and analyze value of the hemodynamic monitoring in the differential diagnosis of severe sepsis and acute heart failure.Methods A total of 86 patients with severe sepsis and acute heart failure treated with hemodynamic monitoring of PICCO were selected as the research subjects,among whom 55 patients were severe sepsis,and 31 patients were acute heart failure.The cardiac index (CI),the right atrial pressure (RAP),the pulmonary artery wedge pressure (PAWP),the mean arterial pressure (MAP),the heart rate (HR) of the patients were detected and compared.Results The RAP,PAWP levels of the patients with acute heart failure were significantly higher than that of the patients with severe sepsis.The CI level was significantly lower than that of the patients with severe sepsis,and the differences between the two groups were statistically significant (P ＜ 0.05).The area of the receiver operating characteristics curve (AUC) of CI in the differential diagnosis of severe sepsis and acute heart failure was the highest,which was 0.893.At the optimal screening limit value (Cut off value),the sensitivity and the specificity were 0.764 and 1.000.The AUC of RAP or PAWP in the differential diagnosis of severe sepsis and acute heart failure were lower than that of CI,the sensitivities at Cut off value were relatively lower,which were 0.323 and 0.484,respectively.Conclusion The invasive hemodynamic monitoring indicators of the patients with severe sepsis and acute heart failure have certain differences.Monitoring indicators can provide the basis for the early differential diagnosis and the development of treatment strategy,which is beneficial to improve the therapeutic effects and the prognosis of the patients.

BACKGROUND:Previous studies have shown that bone marrow mesenchymal stem cels in the treatment of neurological diseases have achieved some success, which can promote neurological alterations; however, there is no breakthrough on gene and drug regulation. OBJECTIVE:To investigate the influence of ginsenosides-induced differentiation of bone marrow mesenchymal stem cels on nerve regeneration after traumatic brain injury. METHODS: A traumatic brain injury model was built in rats using hydraulic shock method, and then rat models were randomly divided into model group (traumatic brain injury group), bone marrow mesenchymal stem cel group, ginsenosides group (ginsenosides induced differentiation of bone marrow mesenchymal stem cels). At 2 weeks after transplantation, western blot assay was used to detect protein expression levels of nerve growth factor and brain-derived neurotrophic factor, immunohistochemistry assay used to detect the number of BrdU-positive cels. At 1, 3 days and 1, 2 weeks after transplantation, modified neurological severity scores were recorded. RESULTS AND CONCLUSION: The expression levels of nerve growth factor and brain-derived neurotrophic factor protein were significantly higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). The number of BrdU positive nerve cels was also higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). At 3 days and 1, 2 weeks after transplantation, the modified neurological severity scores in the ginsenosides group were lower than those in the bone marrow mesenchymal stem cel group and model group (P< 0.05). These findings indicate that ginsenoside-induced bone marrow mesenchymal stem cel transplantation can promote nerve regeneration in rats with traumatic brain injury, which has better outcomes than bone marrow mesenchymal stem cel transplantation alone.

BACKGROUND:Bone marrow mesenchymal stem cels (BMSCs) can promote nerve regeneration, but there are no better results because of the limitations of treatment methods. BMSC transplantation alone is not enough to achieve desired therapeutic effects. OBJECTIVE:To investigate the effect of fibroblast growth factor (FGF)-modified BMSC transplantation on functional recovery and expression of glial fibrilary acidic protein after traumatic brain injury. METHODS:Animal models of traumatic brain injury were established in Sprague-Dawley rats using hydraulic shock method, and then randomized into control group (traumatic brain injury group), BMSC group and FGF-BMSC group (FGF-modified BMSC group). After isolation and culture, BMSCs were modified by adenovirus vector-mediated FGF gene. Western blot assay was used to detect transfection efficiency and glial fibrilary acidic protein expression; immunohistochemical detection was used to detect distribution and number of BrdU positive cels in the brain; Longa score was used to evaluate the neurologic function of rats at 1, 3 days, 1, 2 weeks after transplantation; TUNEL assay was used to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:Western blot results showed that FGF gene was successfuly transferred to the adenovirus vector, and capable of expressing in BMSCs; moreover, the glial fibrilary acidic protein expression of FGF-BMSC group was significantly higher than that in the other two groups (P < 0.05). The number of BrdU positive cels in the brain was significantly higher in the FGF-BMSC group than the other two groups (P < 0.05). Two weeks after transplantation, the Longa scores in the FGF-BMSC group were significantly lower than those in the other two groups (P < 0.05). TUNEL results showed that the number of apoptotic cels in the FGF-BMSC group was significantly lower than that in the other two groups (P < 0.05). These findings indicate that FGF-modified BMSCs transplantation is able to improve neurological damage after traumatic brain injury and promote neurological recovery, which is better than BMSC transplantation alone.

Objective To evaluate the role of fetal brainstem-vermis (BV) and brainstem-tentorium (BT) angles in differential diagnosis of fetal cereballar vermis anomalies by three-dimensional ultrasonography. Methods A total of 335 normally developed fetuses at 18-34 gestational weeks were examined prospectively in Prenatal Ultrasound Center of Suzhou Municipal Hospital from July 2013 to July 2014 by three-dimensional ultrasonography scanning. The BV angles and BT angles were measured at the mid-sagittal sections of fetal heads which were obtained by three-dimensional ultrasonography. Sixteen fetuses with abnormal cerebellar vermis were selected. The BV angles and BT angles were measured and compared with the measurements of normal group. Results In normal fetuses, the mean of BV angles was (3.3±1.7)° , ranging from1.0 to 10.0°;the mean BT angle was (31.5±6.9)° , and ranging from 16.6 to 57.8° . In 16 cases of abnormal cerebellar vermis, 4 cases of Dandy-Walker Malformation (DWM) showed significantly upward rotated cerebellar vermises, the BV angles increased significantly (88.9±18.1)° , the cerebellar tentoriums were superior displaced, the BT angles increased remarkably (89.0±12.8) ° ;6 cases of Dandy-Walker variant (DWV) showed upward rotated cerebellar vermises, with increased BV angles (23.7±5.2) ° , and slightly increased BT angles (54.5±12.0)°;6 cases of Blake′s pouch cyst (BPC) showed upward rotated cerebellar vermises were, mildly increased BV angles (16.7±1.8)° , and slightly increased BT angles (50.3±8.2)° . The comparison results showed:BV angles increased with increasing severity of the condition in BPC, DWV and DWM;BT angles increased significantly in DWM. Conclusions The measurements of BV angles and BT angles are valuable in the differential diagnosis of fetal cereballar vermis anomalies. From 19 gestational weeks, a BV angle>60° is strongly suggestive of a Dandy-Walker malformation, while a measurement>10.0° and<20° favors the diagnosis of Blake′s pouch cyst.

OBJECTIVETo analyze the differences between the oral microbiota of monozygotic and dizygotic twins by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE).

METHODSA total of 20 pairs of twin children were included in this study, in which 10 pairs were monozygotic (MZ) twins, and 10 pairs were dizygotic (DZ) twins. Of the 20 pairs, 10 pairs of twins had primary dentition, and 10 pairs had mixed dentition; 17 children had caries, and 23 children had no caries. Genomic DNA was extracted from saliva samples. The 16s rRNA was amplified and analyzed by PCR-DGGE. The PCR-DGGE band number and Shannon index were calculated.

RESULTSCluster analysis showed high similarity in the oral bacterial community seen in co-twins. However, no significant difference was seen between MZ and DZ twins. In the primary dentition, the PCR-DGGE band number and Shannon index of children with caries (11.00 +/- 1.56, 1.05 +/- 0.36) were lower than those of children without caries (14.00 +/- 2.74, 1.44 +/- 0.37) (P < 0.05). In mixed dentition, the PCR-DGGE band number and Shannon index of children with caries (11.88 +/- 4.05, 1.18 +/- 0.36) were lower than those of children without caries (14.31 +/- 5.71, 1.28 +/- 0.47), but the differences were not statistically significant (P > 0.05).

CONCLUSIONEnvironmental factors may have a stronger effect on the constitution of oral microbiota in children compared with genetic factors. Children without caries may have a richer microbial diversity compared with children with caries.

Bacteria ; Child ; Denaturing Gradient Gel Electrophoresis ; Dental Caries ; Female ; Humans ; Male ; Microbiota ; Mouth ; microbiology ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; Saliva ; Twins, Monozygotic

Objective To analyze the differences between the oral microbiota of monozygotic and dizygotic twins by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE). Methods A total of 20 pairs of twin children were included in this study, in which 10 pairs were monozygotic (MZ) twins, and 10 pairs were dizygotic (DZ) twins. Of the 20 pairs, 10 pairs of twins had primary dentition, and 10 pairs had mixed dentition; 17 children had caries, and 23 children had no caries. Genomic DNA was extracted from saliva samples. The 16s rRNA was amplified and analyzed by PCR-DGGE. The PCR-DGGE band number and Shannon index were calculated. Results Cluster analysis showed high similarity in the oral bacterial community seen in co-twins. However, no significant difference was seen between MZ and DZ twins. In the primary dentition, the PCR-DGGE band number and Shannon index of children with caries (11.00±1.56, 1.05±0.36) were lower than those of children without caries (14.00±2.74, 1.44±0.37) (P<0.05). In mixed dentition, the PCR-DGGE band number and Shannon index of children with caries (11.88±4.05, 1.18±0.36) were lower than those of children without caries (14.31± 5.71, 1.28±0.47), but the differences were not statistically significant (P>0.05). Conclusion Environmental factors may have a stronger effect on the constitution of oral microbiota in children compared with genetic factors. Children without caries may have a richer microbial diversity compared with children with caries.