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*

In this experiment, self-assembled nanoparticles(SANs) were prepared by the pH-driven method, and Her-HCP SAN was constructed by using herpetrione(Her) and Herpetospermum caudigerum polysaccharides(HCPs). The average particle size and polydispersity index(PDI) were used as evaluation indexes for process optimization, and the quality of the final formulation was evaluated in terms of particle size, PDI, Zeta potential, and microstructure. The proposed Her-HCP SAN showed a spheroid structure and uniform morphology, with an average particle size of(244.58±16.84) nm, a PDI of 0.147 1±0.014 8, and a Zeta potential of(-38.52±2.11) mV. Her-HCP SAN significantly increased the saturation solubility of Her by 2.69 times, with a cumulative release of 90.18% within eight hours. The results of in vivo unidirectional intestinal perfusion reveal that Her active pharmaceutical ingredient(API) is most effectively absorbed in the jejunum, where both K_a and P_(app) are significantly higher compared to the ileum(P<0.001). However, the addition of HCP leads to a significant reduction in the P_(app) of Her in the jejunum(P<0.05). Furthermore, the formation of the Her-HCP SAN results in a notably lower P_(app) in the jejunum compared to Her API alone(P<0.001), while both K_a and P_(app) in the ileum are significantly increased(P<0.001, P<0.05). The absorption of Her-HCP SAN at different concentrations in the ileum shows no significant differences, and the pH has no significant effect on the absorption of Her-HCP SAN in the ileum. The addition of the transporter protein inhibitors(indomethacin and rifampicin) significantly increases the absorption parameters K_a and P_(app) of Her-HCP SAN in the ileum(P<0.05,P<0.01), whereas the addition of verapamil has no significant effect on the intestinal absorption parameters of Her-HCP SAN, suggesting that Her may be a substrate for multidrug resistance-associated protein 2 and breast cancer resistance proteins but not a substrate of P-glycoprotein.
Nanoparticles/metabolism* ; Polysaccharides/pharmacokinetics* ; Intestinal Absorption/drug effects* ; Animals ; Rats ; Particle Size ; Drugs, Chinese Herbal/pharmacokinetics* ; Male ; Rats, Sprague-Dawley ; Drug Carriers/chemistry* ; Drug Compounding ; Cucurbitaceae/chemistry*

OBJECTIVE: To assess the independent and combined effects of air pollutants, meteorological factors, and greenspace exposure on new tuberculosis (TB) cases. METHODS: TB case data from Shanghai (2013-2018) were obtained from the Shanghai Center for Disease Control and Prevention. Environmental data on air pollutants, meteorological variables, and greenspace exposure were obtained from the National Tibetan Plateau Data Center. We employed a distributed-lag nonlinear model to assess the effects of these environmental factors on TB cases. RESULTS: Increased TB risk was linked to PM _2.5, PM ₁₀, and rainfall, whereas NO ₂, SO ₂, and air pressure were associated with a reduced risk. Specifically, the strongest cumulative effects occurred at various lags: PM _2.5 ( RR = 1.166, 95% CI: 1.026-1.325) at 0-19 weeks; PM ₁₀ ( RR = 1.167, 95% CI: 1.028-1.324) at 0-18 weeks; NO ₂ ( RR = 0.968, 95% CI: 0.938-0.999) at 0-1 weeks; SO ₂ ( RR = 0.945, 95% CI: 0.894-0.999) at 0-2 weeks; air pressure ( RR = 0.604, 95% CI: 0.447-0.816) at 0-8 weeks; and rainfall ( RR = 1.404, 95% CI: 1.076-1.833) at 0-22 weeks. Green space exposure did not significantly impact TB cases. Additionally, low temperatures amplified the effect of PM _2.5 on TB. CONCLUSION Exposure to PM _2.5, PM ₁₀, and rainfall increased the risk of TB, highlighting the need to address air pollutants for the prevention of TB in Shanghai.
China/epidemiology* ; Humans ; Air Pollutants/analysis* ; Tuberculosis/epidemiology* ; Incidence ; Meteorological Concepts ; Particulate Matter/adverse effects* ; Environmental Exposure ; Male ; Female ; Adult ; Air Pollution ; Middle Aged

Dental hygienists are medical personnel who work with dentists and provide patients with oral health services. Dental hygienists possess professional licenses, and they can prevent oral diseases and cooperate in the treatment, helping individuals or groups maintain optimal oral health situations with methods like clinical services, education, consulting and planning, evaluation, etc. The education and development of dental hygienists in European countries and America have gone through many years and have formed a relatively mature system. This article introduces the history of development, educational patterns, and scope of practice of dental hygienists in Europe and America, providing references on future career planning and development for dental hygienists in China.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.

Objective:To investigate the diagnostic value of gastroenteroscopic narrow band imaging(NBI)combine with serum amyloid A(SAA),C-reactive protein(CRP),D-Dimer(D-D)in children with abdominal henoch schonlein purpura(HSP).Methods:90 children with HSP who were admitted to our hospital from September 2022 to September 2024 were prospectively selected as the research objects,of which 50 children with abdominal HSP were included in the observation group and 40 children with other types of HSP were included in the control group.All children underwent gastroenteroscopic NBI examination and serum CRP,SAA and D-D levels were detected,and serum CRP,SAA and D-D levels were compared between the two groups,and the results of gastroenteroscopic NBI examination were analyzed in the two groups.Then the receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of gastroenteroscopic NBI and serum CRP,SAA,D-D alone or in combination in children with abdominal HSP.Results:Serum CRP,SAA and D-D levels in the observation group were significantly higher than those in the control group(P＜0.05);The results of gastroenteroscopic NBI showed that most of the children with abdominal HSP had some degree of changes in the gastric and duodenal mucosa,with mucosal congestion,edema,erosion,ulceration,and scattered bright or dark red bleeding spots as the main manifestations.Under gastroenteroscopic NBI,41 of 50 children with abdominal HSP were diagnosed as abdominal HSP,and 11 of 40 children with other types of HSP were diagnosed as abdominal HSP;the area under curve(AUC)of serum CRP,SAA,and D-D in the diagnosis of children with abdominal HSP were 0.668,0.720 and 0.771,respectively,and the AUC of the combination diagnosis of serum CRP,SAA and D-D in the diagnosis of children with abdominal HSP was 0.815;The AUC of the diagnosis of gastroenteroscopic NBI and serum CRP,SAA and D-D in children with abdominal HSP was 0.801 and 0.815,respectively,and the AUC of the combination diagnosis of gastroenteroscopic NBI in children with abdominal HSP was 0.867.Conclusion:Serum CRP,SAA and D-D in children with abdominal HSP were significantly increased,and the main manifestations under gastroenteroscopic NBI were mucosal congestion,edema,erosion,ulceration and scattered bright or dark red bleeding spots as the main manifestations.Gastroenteroscopic NBI combine with serum CRP,SAA and D-D could significantly improve the diagnostic efficiency of children with abdominal HSP.

Dental hygienists are medical personnel who work with dentists and provide patients with oral health services. Dental hygienists possess professional licenses, and they can prevent oral diseases and cooperate in the treatment, helping individuals or groups maintain optimal oral health situations with methods like clinical services, education, consulting and planning, evaluation, etc. The education and development of dental hygienists in European countries and America have gone through many years and have formed a relatively mature system. This article introduces the history of development, educational patterns, and scope of practice of dental hygienists in Europe and America, providing references on future career planning and development for dental hygienists in China.

Objective:To investigate the diagnostic value of gastroenteroscopic narrow band imaging(NBI)combine with serum amyloid A(SAA),C-reactive protein(CRP),D-Dimer(D-D)in children with abdominal henoch schonlein purpura(HSP).Methods:90 children with HSP who were admitted to our hospital from September 2022 to September 2024 were prospectively selected as the research objects,of which 50 children with abdominal HSP were included in the observation group and 40 children with other types of HSP were included in the control group.All children underwent gastroenteroscopic NBI examination and serum CRP,SAA and D-D levels were detected,and serum CRP,SAA and D-D levels were compared between the two groups,and the results of gastroenteroscopic NBI examination were analyzed in the two groups.Then the receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of gastroenteroscopic NBI and serum CRP,SAA,D-D alone or in combination in children with abdominal HSP.Results:Serum CRP,SAA and D-D levels in the observation group were significantly higher than those in the control group(P＜0.05);The results of gastroenteroscopic NBI showed that most of the children with abdominal HSP had some degree of changes in the gastric and duodenal mucosa,with mucosal congestion,edema,erosion,ulceration,and scattered bright or dark red bleeding spots as the main manifestations.Under gastroenteroscopic NBI,41 of 50 children with abdominal HSP were diagnosed as abdominal HSP,and 11 of 40 children with other types of HSP were diagnosed as abdominal HSP;the area under curve(AUC)of serum CRP,SAA,and D-D in the diagnosis of children with abdominal HSP were 0.668,0.720 and 0.771,respectively,and the AUC of the combination diagnosis of serum CRP,SAA and D-D in the diagnosis of children with abdominal HSP was 0.815;The AUC of the diagnosis of gastroenteroscopic NBI and serum CRP,SAA and D-D in children with abdominal HSP was 0.801 and 0.815,respectively,and the AUC of the combination diagnosis of gastroenteroscopic NBI in children with abdominal HSP was 0.867.Conclusion:Serum CRP,SAA and D-D in children with abdominal HSP were significantly increased,and the main manifestations under gastroenteroscopic NBI were mucosal congestion,edema,erosion,ulceration and scattered bright or dark red bleeding spots as the main manifestations.Gastroenteroscopic NBI combine with serum CRP,SAA and D-D could significantly improve the diagnostic efficiency of children with abdominal HSP.