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

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Background Stroke has become a main cause of death in China. With global warming, the studies on temperature and stroke have attracted much attention. Objective To analyze he relationships between heatwave and the years of life lost (YLL) by different subtypes of stroke by controlling temporal and spatial effects with Bayesian spatio-temporal model, and to study the modifiers of the health effect of heatwave. Methods The daily information of stroke deaths, meteorological data, and air pollutant data in 40 districts and counties of Guangdong Province were collected during the warm seasons (from May to October) in the years from 2014 to 2017. The individual YLL was first calculated by matching age and gender according to the life table, and then the daily YLL rate (person-years/100 000 people) was obtained by summarizing the daily YLL and correcting it with the population of each district or county. Bayesian spatio-temporal model was used to fit a proposed exposure-response relationship between heatwave and the YLL rates of different subtypes of stroke. Finally, stratified analyses were conducted by age (<65 years, ≥65 years), gender (male, female), and region (Pearl River Delta and non-Pearl River Delta regions) to identify the major modifiers for the association between heatwave and stroke mortality. Results During the warm seasons from 2014 to 2017, a total of 23 heatwave events occurred in the 40 districts or counties of Guangdong Province, cumulatively lasting for 145 d. A total of 30 852 stroke deaths were recorded in the same time periods. The average daily YLL rate of total stroke was (2.39±3.63) person-years/100 000 people, and those for hemorrhagic stroke and ischemic stroke were (1.54±2.99) person-years/100 000 people and (0.84±1.85) person-years/100 000 people, respectively. Heatwave was associated with increased YLL rate of stroke in residents, and it had a greater impact on ischemic stroke with a lag effect. The largest cumulative effect of heatwave was at lag 0-1 day, which was associated with an increased YLL rate of total stroke and ischemic stroke by 0.17 (95%CI: 0.03-0.29) person-years/100 000 people and 0.13 (95%CI: 0.06-0.20) person-years/100 000 people, respectively. The results of stratified analyses showed that heatwave had a larger effect on ischemic stroke in residents of aged 65 years or older, male, and non-Pearl River Delta regions, and the rates of YLL increased by 1.11 (95%CI: 0.58-1.55), 0.13 (95%CI: 0.03-0.23), and 0.20 (95%CI: 0.07-0.32) person-years/100 000 people, respectively; Heatwave only had an effect on hemorrhagic stroke in residents aged 65 years or older with an increased YLL rate of 0.79 (95%CI: 0.26-1.31) person-years/100 000 people. Conclusion Heatwave could elevate the level of years of life lost associated with stroke in Guangdong residents, with greater impacts on ischemic stroke of the aged, men, and residents in non-Pearl River Delta regions, and on hemorrhagic stroke in the elderly.

Objective:To observe the effect of local retinal laser photocoagulation (local photocoagulation) on Coats disease.Methods:A retrospective clinical study. From January 1, 2006 to August 1, 2020, 48 patients (48 eyes) who were diagnosed as Coats disease and received focal photocoagulation at The Eye Hospital Affiliated to Wenzhou Medical University were included in the study. Among them, there were 40 males (40 eyes) and 8 females (8 eyes). The average age was 32.46±22.41 years old. Nine eyes were in stage 2A, and 39 eyes were in stage 2B. All affected eyes underwent best corrected visual acuity (BCVA), color fundus photography and fluorescein fundus angiography (FFA).The BCVA was carried out using a standard logarithmic visual acuity chart, which was converted into the logarithmic minimum angle of resolution (logMAR) visual acuity during statistics. According to age, patients were divided into the adolescent group (age≤ 20 years old) and the adult group (age> 21 years old), with 18 eyes in 18 cases and 30 eyes in 30 cases, respectively. In the adolescent group, 18 eyes of 18 cases were all male; the average age was 11.17±3.31 years; the average logMAR BCVA was 0.83±0.60. Among the 30 patients in the adult group, 22 patients were male and 8 patients were female. the average age was 49.26±15.26 years old; the average logMAR BCVA was 0.82±0.59. All the affected eyes were treated with focal photocoagulation. Laser parameters were as followed: wavelength 577 nm, spot diameter 500 μm, exposure time 0.5 to 0.7 s, spot intensity level Ⅲ. FFA was FFA was performed 3 to 4 months after the first laser photocoagulation, and laser treatment was repeated as needed. The average follow-up after first treatment was 36.88±36.92 months. The changes in BCVA, abnormal blood vessels in the fundus, and hard exudation were observed.Results:Among 48 eyes, 36 eyes (75.00%, 36/48) received multiple local photocoagulation treatments. At the last follow-up, 36 eyes (75.00%, 36/48) had an improved or stable vision, and 17 eyes (35.42%, 17/48) had BCVA ≤ 0.32 logMAR units (≥ 0.5). The average logMAR BCVA of eyes in the adolescent group was 0.66±0.54, which was higher than the baseline, but the difference was not statistically significant ( Z=-1.126, P=0.260). The average logMAR BCVA of the eyes in the adult group was 0.96±0.79, which was lower than the baseline, but the difference was not statistically significant ( Z=-0.482, P=0.630). Among 48 eyes, abnormal blood vessels were completely or partially occluded in 42 eyes (87.50%, 42/48); of which, 29 eyes were completely occluded (60.42%, 29/48), and 13 eyes were partially occluded (27.08%, 13/48)). The hard exudation at macula or peripheral retina were completely absorbed or obviously absorbed in 40 eyes (83.33%, 40/48); among them, the complete and obvious absorption were 11 (22.92%, 11/48) and 29 (60.42%, 29/48) eyes. Conclusion:The treatment of focal photocoagulation with a larger spot, long exposure and weak level Ⅲ spot can effectively seal abnormal blood vessels in the eyes of Coats disease,reduce hard exudation and improve or stabilize vision.

Objective:To investigate the relationship between the changes of serum lipoprotein associated phospholipase A2 (Lp-PLA2), human Parkinson′s protein 7 (PARK7), erythropoietin (EPO) and neurological deficit score (NIHSS) and carotid intima-media thickness (CIMT) in patients with acute ischemic stroke (AIS).Methods:150 patients with AIS diagnosed in our hospital from January 2016 to January 2018 (AIS group) and 80 healthy subjects were selected as the control group. The Lp-PLA2, PARK7, EPO levels were compared between the two groups according to NIHSS score (mild, moderate and severe), carotid atherosclerotic plaque (unstable plaque, stable plaque, no plaque).Results:The serum level of Lp-PLA2, PARK7, EPO and CIMT values in the AIS group were significantly higher than those in the control group ( P<0.05). The Lp-PLA2 and PARK7 levels in the mild, moderate and severe AIS patients were gradually increased among the three groups, with statistically significant difference ( P<0.05). There was no significant difference in EPO levels between the different NIHSS groups ( P>0.05); The levels of Lp-PLA2, PARK7 and EPO of AIS patients in non plaque group, stable plaque group and unstable plaque group were gradually increased among the groups, and the difference between the two groups was statistically significant ( P<0.05). The level of Lp-PLA2 and PARK7 in patients with AIS and the NIHSS scores showed a significant positive correlation ( P<0.05). There was a significant positive correlation between Lp-PLA2, PARK7, EPO and CIMT in patients with AIS ( P<0.05). Conclusions:The serum levels of Lp-PLA2, PARK7 and EPO were significantly increased in AIS patients. Lp-PLA2, PARK7 were related to the aggravation of neurological deficits in potential patients. Lp-PLA2, PARK7 and EPO were related to the increase of carotid intima-media thickness in potential patients.

Objective:To observe the short-term efficacy of sub-Tenon’s triamcinolone acetonide (TA) in the treatment of cystoid macular edema (CME) after cataract surgery.Methods:A retrospective study. From October 1, 2013 to October 1, 2018, 21 patients (21 eyes) with CME after cataract surgery diagnosed at The Affiliated Eye Hospital of Wenzhou Medical University were included in this study. All eyes underwent BCVA, intraocular pressure, frequency domain OCT examination. The standard logarithmic visual acuity chart was used for BCVA examination, which was converted into logMAR visual acuity when recorded. A frequency domain OCT instrument was used to measure the foveal retinal thickness (CRT). Among 21 eyes of 21 patients, 9 eyes were male and 12 eyes were female; the average age was 66.38±10.88 years. The average logMAR BCVA was 0.46±0.23; the average CRT was 519.90±131.59 μm; the average intraocular pressure was 11.01±3.97 mmHg (1 mmHg=0.133 kPa). All eyes underwent a single treatment of 100 mg/ml TA suspension 0.4 ml (containing TA 40 mg) under Tenon's capsule. The average follow-up time after treatment was 32.86±20.2 days. The changes of BCVA, CRT and intraocular pressure were observed 1 month after treatment. The BCVA, CRT and intraocular pressure before and after treatment were compared by paired t test. Results:One month after treatment, the average logMAR BCVA, CRT, and intraocular pressure of the CME eyes were 0.29±0.22, 307.71±35.82 μm and 14.19±6.30 mmHg, respectively. Compared with those before treatment, the differences were statistically significant ( t=5.252, 8.166, 4.128; P=0.000, 0.000, 0.001). Among 21 eyes, 13 eyes (61.90%) of the retinal cysts in the macular area completely disappeared; 8 eyes (38.1%) were still visible between the retinal layers. Three eyes with intraocular pressure over than 21 mmHg were treated with lowering intraocular pressure and returned to normal. Conclusion:Sub-Tenon’s capsular injection of TA to treat CME after cataract surgery can reduce CRT and improve vision in a short time.

Diabetic retinopathy (DR) is a major and irreversible blinding eye disease in working aged adults. Diabetic macular edema (DME) is a complication of the further development of DR, and it is one of the main causes of vision loss in DR patients. The emergence of anti-VEGF drugs has changed the treatment model of DR and DME. Firstly, for the treatment of DME, the previous focal/grid-like laser photocoagulation is converted to anti-VEGF drugs as the first-line treatment. Secondly, for the treatment of proliferative DR (PDR), panretinal photocoagulation (PRP) was the gold standard in the past, and now anti-VEGF drugs have become an alternative treatment for some PDR patients. In varying degrees of DR and DME, the option of treatment, anti-VEGF drug therapy replacing PRP, and the era of anti-VEGF drug therapy on DR treatment modes are worthy questions for consideration by clinicians. In-depth study of the clinical study of PRP and anti-VEGF drugs in the treatment of DR, the changes attention in clinical guidelines and expert consensus, the gradual establishment of treatment of DR and DME suitable, and the personalized treatment of DR patients may help improve the level of DR treatment in China.

Objective To assess the imported risk of COVID-19 in Guangdong province and its cities, and conduct early warning. Methods Data of reported COVID-19 cases and Baidu Migration Index of 21 cities in Guangdong province and other provinces of China as of February 25, 2020 were collected. The imported risk index of each city in Guangdong province were calculated, and then correlation analysis was performed between reported cases and the imported risk index to identify lag time. Finally, we classified the early warming levels of epidemic by imported risk index. Results A total of 1 347 confirmed cases were reported in Guangdong province, and 90.0% of the cases were clustered in the Pearl River Delta region. The average daily imported risk index of Guangdong was 44.03. Among the imported risk sources of each city, the highest risk of almost all cities came from Hubei province, except for Zhanjiang from Hainan province. In addition, the neighboring provinces of Guangdong province also had a greater impact. The correlation between the imported risk index with a lag of 4 days and the daily reported cases was the strongest (correlation coefficient: 0.73). The early warning base on cumulative 4-day risk of each city showed that Dongguan, Shenzhen, Zhongshan, Guangzhou, Foshan and Huizhou have high imported risks in the next 4 days, with imported risk indexes of 38.85, 21.59, 11.67, 11.25, 6.19 and 5.92, and the highest risk still comes from Hubei province. Conclusions Cities with a large number of migrants in Guangdong province have a higher risk of import. Hubei province and neighboring provinces in Guangdong province are the main source of the imported risk. Each city must strengthen the health management of migrants in high-risk provinces and reduce the imported risk of Guangdong province.