Aberrant expression of Colgalt1 is closely associated with tumorigenesis and tumor progres-sion;however,the mechanism by which it regulates macrophages to influence tumor development remains poorly understood.This study aimed to establish a macrophage-specific Colgalt1 gene knockout mouse model to delve into the mechanisms through which Colgalt1 modulates macrophage function and subse-quently affects the occurrence and progression of tumor-related diseases.Initially,Colgalt1flox+mice were generated using gene editing techniques,followed by crossing with Lyz2-Cre+mice,which exhibit tissue-specific expression in the myeloid lineage(including monocytes and mature macrophages).Through this strategy,mice with the genotype Colgalt1-/-Lyz2-Cre+were successfully obtained,achieving conditional knockout of the Colgalt1 gene in macrophages.Colgalt1flox/flox Lyz2-Cre-mice were used as control.PCR and agarose gel electrophoresis were employed to identify the Flox and Cre genotypes of the knockout mice.RT-qPCR and Western Blot techniques were utilized to detect the expression levels of Colgalt1 in BMDMs from knockout mice at both the mRNA and protein levels,respectively.Western Blot results re-vealed a significant downregulation of Colgaltl expression in BMDMs from knockout mice compared to controls(P＜0.01).RT-qPCR results demonstrated a significant reduction in Colgalt1 mRNA levels in BMDMs from knockout mice compared to contro1s(P＜0.001),while no significant differences in Col-galt1 mRNA expression were observed in liver,lung,or spleen tissues between the two groups.Addition-ally,immunohistochemistry was employed to detect Colgalt1 expression in liver-specific macrophages,re-vealing an absence of Colgalt l-positive staining in liver macrophages from knockout mice.HE staining was used to observe cellular morphology in liver tissues from both groups of mice,showing no significant differences in cellular morphology or obvious pathological changes in tissues and organs.Moreover,the o-verall survival of the mice was not affected.Finally,RT-qPCR was used to assess the expression of mac-rophage-related inflammatory factors in BMDMs from both groups of mice.The results indicated that com-pared to controls,knockout mice exhibited downregulated expression of TNF-α(P＜0.05)and signifi-cantly upregulated expression of IL-10(P＜0.01),Arginase1(P＜0.001),and CD206(P＜0.001)in BMDMs,suggesting an anti-inflammatory trend and M2 polarization of macrophages following Colgalt 1 knockout.In summary,this study successfully established a macrophage-specific Colgalt1 gene knockout mouse model,providing a more reliable experimental animal model for in-depth exploration of the specific roles of Colgalt1 in macrophage functional regulation and the pathogenesis of tumor-related diseases.This model holds promise for identifying novel therapeutic targets and strategies for tumors and other diseases.

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*

OBJECTIVE: To describe a novel arthroscopic technique of modified tri-anchor double-pulley suture-bridge in repairing medium-sized supraspinatus tendon tears and evaluate the early effectiveness. METHODS: Between June 2021 and January 2024, 26 patients with medium-sized supraspinatus tendon tears who underwent arthroscopic modified tri-anchor double-pulley suture-bridge repair and met the selective criteria were included. There were 11 males and 15 females with an average age of 61.4 years (range, 43-74 years). Five patients had a significant history of trauma, while the remaining 21 patients had no apparent cause. The time from symptom onset to hospitalization was 3-25 months (mean, 7.9 months). The effectiveness was evaluated during follow-up, including the scores of University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), visual analogue scale (VAS), the range of forward flexion, abduction, external rotation, and internal rotation, and patient's satisfaction. Either MRI or ultrasound examination were used to evaluate structural integrity of the tendon. RESULTS: The operation time was 65-110 minutes (mean, 81.8 minutes). All patients were followed up 12-43 months (mean, 23.0 months). At 3 and 12 months after operation, the shoulder range of flexion, abduction, external rotation, and internal rotation, and the scores of VAS, UCLA, and ASES significantly improved when compared with those before operation ( P<0.05). The improvement was further observed at 12 months compared to 3 months ( P<0.05). At last follow-up, 13 patients were very satisfied with the effectiveness, 11 patients were satisfied, 1 was relatively satisfied, and 1 was dissatisfied. During follow-up, 15 patients underwent imaging examination and imaging reexamination showed that the re-tear rate of tendon was 6.6%(1/15). The remaining 11 patients refused imaging examination. Complications included partial anchor withdrawal in 1 case, shoulder stiffness in 5 cases, and mild pain in shoulder joint in 2 cases in physical activity or heavy physical activity. CONCLUSION Arthroscopic modified tri-anchor double-pulley suture-bridge technique is a novel surgical technique that uses double-loaded suture anchors as medial- and lateral-row anchors. In repairing medium-sized supraspinatus tendon tears, 6 sets of double-pulley suture-bridges can be created from one medial-row anchor; knotless medial-row can reduce re-tear rate of the tendon; good early effectiveness is obtained.
Humans ; Female ; Male ; Middle Aged ; Arthroscopy/methods* ; Adult ; Rotator Cuff Injuries/surgery* ; Aged ; Suture Techniques ; Treatment Outcome ; Suture Anchors ; Rotator Cuff/surgery* ; Range of Motion, Articular ; Tendon Injuries/surgery* ; Patient Satisfaction

Objective:To compare the clinical outcomes and costs in arthroscopic repair of small and medium-sized supraspinatu tendon tears between double-pulley suture-bridge (DPSB) and traditional suture bridge (SB).Methods:A retrospective study was conducted at Department of Joint Surgery, The Second Hospital Affiliated to Hengyang Medical School to analyze the data of 26 patients with small and medium-sized supraspinatus tendon tears who had been treated by SB repair from May 2018 to December 2020 (SB group) and those of 35 patients with small and medium-sized supraspinatus tendon tears who had been treated by DPSB repair from January 2021 to December 2022 (DPSB group). There were 61 patients in the 2 groups, including 44 males and 17 females, with an age of (59.1±7.5) years. The left shoulder was affected in 26 patients and the right shoulder in 35 patients. The tear size was small in 25 cases and medium in 36 ones. The total number of anchors used, total anchoring costs, and surgical time were recorded and compared between the 2 groups. Visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score and shoulder range of motion were used to evaluate the clinical outcomes of the 2 groups before surgery and at the last follow-up. Comparisons were made within and between the 2 groups. Tendon integrity was assessed using MRI or ultrasound at 3, 6, 12 months or at the last follow-up.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). DPSB and SB groups were followed up for (28.1±3.5) and (27.1±1.8) months, respectively. There was no statistically significant difference between DPSB group and SB group in surgical time or total number of anchors ( P>0.05). The total costs of anchoring in DPSB group [(6,028.6±173.4) yuan] were significantly lower than those in SB group [(13,257.1±554.2) yuan] ( P<0.05). At the last follow-up, the anterior flexion, abduction, external rotation and internal rotation of the shoulder, as well as VAS pain score, ASES score and UCLA score, were significantly better in both DPSB group and SB group than their preoperative values ( P<0.05), but there were no statistically significant differences between DPSB group and SB group ( P>0.05). There was no significant difference either in tendon retear between DPSB group (2 cases) and SB group (1 case) ( P>0.05). No such complication as wound infection or nerve damage was found in either group. Conclusions:In arthroscopic repair of small and medium-sized supraspinatu tendon tears, both DPSB and SB techniques can achieve satisfactory and comparable clinical outcomes. However, DPSB leads to lower total costs of anchoring.

Aberrant expression of Colgalt1 is closely associated with tumorigenesis and tumor progres-sion;however,the mechanism by which it regulates macrophages to influence tumor development remains poorly understood.This study aimed to establish a macrophage-specific Colgalt1 gene knockout mouse model to delve into the mechanisms through which Colgalt1 modulates macrophage function and subse-quently affects the occurrence and progression of tumor-related diseases.Initially,Colgalt1flox+mice were generated using gene editing techniques,followed by crossing with Lyz2-Cre+mice,which exhibit tissue-specific expression in the myeloid lineage(including monocytes and mature macrophages).Through this strategy,mice with the genotype Colgalt1-/-Lyz2-Cre+were successfully obtained,achieving conditional knockout of the Colgalt1 gene in macrophages.Colgalt1flox/flox Lyz2-Cre-mice were used as control.PCR and agarose gel electrophoresis were employed to identify the Flox and Cre genotypes of the knockout mice.RT-qPCR and Western Blot techniques were utilized to detect the expression levels of Colgalt1 in BMDMs from knockout mice at both the mRNA and protein levels,respectively.Western Blot results re-vealed a significant downregulation of Colgaltl expression in BMDMs from knockout mice compared to controls(P＜0.01).RT-qPCR results demonstrated a significant reduction in Colgalt1 mRNA levels in BMDMs from knockout mice compared to contro1s(P＜0.001),while no significant differences in Col-galt1 mRNA expression were observed in liver,lung,or spleen tissues between the two groups.Addition-ally,immunohistochemistry was employed to detect Colgalt1 expression in liver-specific macrophages,re-vealing an absence of Colgalt l-positive staining in liver macrophages from knockout mice.HE staining was used to observe cellular morphology in liver tissues from both groups of mice,showing no significant differences in cellular morphology or obvious pathological changes in tissues and organs.Moreover,the o-verall survival of the mice was not affected.Finally,RT-qPCR was used to assess the expression of mac-rophage-related inflammatory factors in BMDMs from both groups of mice.The results indicated that com-pared to controls,knockout mice exhibited downregulated expression of TNF-α(P＜0.05)and signifi-cantly upregulated expression of IL-10(P＜0.01),Arginase1(P＜0.001),and CD206(P＜0.001)in BMDMs,suggesting an anti-inflammatory trend and M2 polarization of macrophages following Colgalt 1 knockout.In summary,this study successfully established a macrophage-specific Colgalt1 gene knockout mouse model,providing a more reliable experimental animal model for in-depth exploration of the specific roles of Colgalt1 in macrophage functional regulation and the pathogenesis of tumor-related diseases.This model holds promise for identifying novel therapeutic targets and strategies for tumors and other diseases.

Objective:To compare the clinical outcomes and costs in arthroscopic repair of small and medium-sized supraspinatu tendon tears between double-pulley suture-bridge (DPSB) and traditional suture bridge (SB).Methods:A retrospective study was conducted at Department of Joint Surgery, The Second Hospital Affiliated to Hengyang Medical School to analyze the data of 26 patients with small and medium-sized supraspinatus tendon tears who had been treated by SB repair from May 2018 to December 2020 (SB group) and those of 35 patients with small and medium-sized supraspinatus tendon tears who had been treated by DPSB repair from January 2021 to December 2022 (DPSB group). There were 61 patients in the 2 groups, including 44 males and 17 females, with an age of (59.1±7.5) years. The left shoulder was affected in 26 patients and the right shoulder in 35 patients. The tear size was small in 25 cases and medium in 36 ones. The total number of anchors used, total anchoring costs, and surgical time were recorded and compared between the 2 groups. Visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score and shoulder range of motion were used to evaluate the clinical outcomes of the 2 groups before surgery and at the last follow-up. Comparisons were made within and between the 2 groups. Tendon integrity was assessed using MRI or ultrasound at 3, 6, 12 months or at the last follow-up.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). DPSB and SB groups were followed up for (28.1±3.5) and (27.1±1.8) months, respectively. There was no statistically significant difference between DPSB group and SB group in surgical time or total number of anchors ( P>0.05). The total costs of anchoring in DPSB group [(6,028.6±173.4) yuan] were significantly lower than those in SB group [(13,257.1±554.2) yuan] ( P<0.05). At the last follow-up, the anterior flexion, abduction, external rotation and internal rotation of the shoulder, as well as VAS pain score, ASES score and UCLA score, were significantly better in both DPSB group and SB group than their preoperative values ( P<0.05), but there were no statistically significant differences between DPSB group and SB group ( P>0.05). There was no significant difference either in tendon retear between DPSB group (2 cases) and SB group (1 case) ( P>0.05). No such complication as wound infection or nerve damage was found in either group. Conclusions:In arthroscopic repair of small and medium-sized supraspinatu tendon tears, both DPSB and SB techniques can achieve satisfactory and comparable clinical outcomes. However, DPSB leads to lower total costs of anchoring.

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.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Objective To explore the effectiveness of different intervention strategies in response to outbreaks of emerging highly pathogenic respiratory infectious diseases(RIDs)in mega-city in China,and provide decision-ma-king basis for effective response to emerging RIDs.Methods A susceptible-exposed-infectious-recovered(SEIR)transmission dynamics model was constructed,referencing to and combining the pathogenicity and infectivity para-meters of previous emerging RIDs.The outbreak of emerging highly pathogenic RIDs with low,moderate,and high infectivity in a mega-city with a population of 10 million in China was simulated,the development of the epidemic within 100 days after implementing different combinations of non-pharmaceutical interventions(NPIs)in response to the outbreak was compared.Results When highly pathogenic RIDs outbreak occurred,and if its infectivity was low(R0 was about 1.5),it was unnecessary to adopt strict NPIs to control epidemic.If its infectivity was moderate(R0 was about 6),different intensities of NPIs were needed based on its existing infection scale.When the initial num-ber of infected cases was 50,moderate-intensity NPIs could keep the infection and death at a low level within 100 days,and the required bed number in hospital for cases could be kept below the national average reserve level.But when the scale of infection exceeded 100 cases,high-intensity NPIs were needed to control the development of the epidemic.In the case of extremely strong infectivity(R0 was about 10),regardless of the scale of infection,only immediate high-intensity NPIs could control the epidemic,infection and death scale.Conclusion In case of out-breaks of highly pathogenic RIDs,adopting appropriate NPIs as early as possible based on their epidemiological characteristics and infection scale is necessary to minimize the harm to the population.