The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

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.

Objective To construct the machine learning models based on the radiomic features of non-contrast and enhanced CT and to evaluate the predictive value in the risk stratification of gastrointestinal stromal tumor(GIST).Methods A total of 182 patients with pathologically confirmed GIST were randomly divided into a training set and a validation set at a ratio of 7∶3.The volume of interest(VOI)was outlined in the non-contrast phase,arterial phase and venous phase,and its radiomic features were extracted.The most valuable radiomic features were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.The logistic regression(LR)classifier was used to construct the prediction models based on single-phase or multi-phase images.The predictive efficacy of the different models was compared by using receiver operating characteristic(ROC)curves.Results Four,three,and four radiomic features were selected in the non-contrast phase,arterial phase and venous phase,and 4 models were constructed in total.Among the single-phase models,the venous phase had better predictive efficacy,with the area under the curve(AUC)of 0.932[95％confidence interval(CI)0.873-0.969]and 0.924(95％CI 0.819-0.979)in the training and validation sets.The predictive efficacy of the combined model was improved,with the AUC of 0.946(95％CI 0.891-0.978)and 0.938(95％CI 0.838-0.986).Conclusion The venous phase model can predict the risk stratification of GIST accurately,and the prediction efficacy can be improved by combining the non-contrast and arterial phases.

Objective:To analyze the clinical application value of serum heme oxygenase (HO)-1expression level in non-alcoholic fatty liver disease (NAFLD) and, based on that, establish a diagnostic model combined with glucose regulatory protein 78 (GRP78) so as to clarify its diagnostic effectiveness and application value.Methods:A total of 210 NAFLD patients diagnosed by abdominal B-ultrasound and liver elastography were included, and at the same time, 170 healthy controls were enrolled. The general clinical data, peripheral blood cell counts, and biochemical indicators of the research subjects were collected. The expression levels of HO-1 and GRP78 were detected using an enzyme-linked immunosorbent assay. Multivariate analysis was used to screen independent risk factors for NAFLD. Visual output was performed through nomogram diagrams, and the diagnostic model was constructed. Receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the diagnostic effectiveness of NAFLD. Measurement data were analyzed using a t-test or Mann-Whitney U rank sum test to detect data differences between groups. Enumeration data were analyzed using the Fisher's exact probability test or the Pearson χ2 test. Results:Compared with the healthy control group, the white blood cell count, aspartate aminotransferase (AST), alanine aminotransferase, gamma-glutamyl transferase (GTT), fasting blood glucose (Glu), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), serum HO-1, and GRP78 levels were significantly increased in the NAFLD group patients ( P ?

Gap junction is a necessary channel structure composed of connexin proteins, which can form direct communication to exchange material and information between mammal cells. Connexin 43(Cx43)is the most abundant connexin protein expressed in the central nervous system. There is emerging evidence that Cx43 has a wide regulatory effect on the occurrence and development of glioma and play an important role in malignant biological behaviors of glioma. Temozolomide is a currently first-line chemotherapeutic drug for glioma. However, with the prolong of treatment period, the therapy effect of temozolomide is attenuated in some patients because of drug resistance. And the abnormal expression of Cx43 in glioma may be one of the important reasons for temozolomide resistance. In this review, we summarized the structure and function of Cx43, several mechanism of temozolomide resistance and the research progress of Cx43-mediated temozolomide resistance, as well as anti-tumor compounds targeting Cx43 in recent years, in order to provide new evidence for glioma therapy.

Objective: To evaluate recent prognosis of patients with acute ST elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI), and explore related risk factors.Methods: Clinical data of 168 STEMI patients undergoing primary PCI were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE) within 30d or not, they were divided into poor prognosis group (n=40) and good prognosis group (n=128).Clinical data were compared between two groups.Logistic regression analysis was used to analyze independent risk factors for MACE.Results: Incidence rate of MACE was 23.81% among the 168 STEMI patients.Logistic regression analysis indicated that age (OR=1.326, 95%CI 1.168~1.505), family history of coronary heart disease (OR=1.852, 95%CI 1.369~2.505), number of diseased vessels ≥2 (OR=1.682, 95%CI 1.382~2.047), Killip′s class Ⅲ~Ⅳ (OR=1.693, 95%CI 1.428~2.007) and onset-to-PCI time (OR=1.785, 95%CI 1.425~2.236) were the independent risk factors, P<0.01 all;TIMI grade 3 (OR=0.623, 95%CI 0.518~0.749) and tirofiban application (OR=0.452, 95%CI 0.367~0.557) were independent protective factors for MACE, P<0.01 both.Conclusion: Advanced aged, family history of coronary heart disease, number of diseased vessels ≥2, poor cardiac function and long onset-to-PCI time are independent risk factors, while TIMI grade 3 and tirofiban application are independent protective factors for MACE.

The lentiviral vector was used for construction of a recombinant mediating RNA interference (RNAi) against Beclin1 gene in this study. Recombinant vector plasmid was transfected into non small cell lung cancer (NSCLC) A549 cells by liposome. PCR results showed that three amplified positive fragments were inserted into pRNAT-U6. 2/Lenti vectors. DNA sequencing results showed that the three recombinant lentivirus plasmids, pRNAT-U6. 2/Lenti-si356, pRNAT-U6. 2/Lenti-si423 and pRNAT-U6. 2/ Lenti-si684 were constructed successfully. After transfection with liposome, RT-PCR and Western blot analysis confirmed that the expression of Beclin1 mRNA and protein was inhibited in the three recombinant lentivirus plasmids transfected groups, and gene silencing efficacy was 35.56%, 89.22% and 66.78%, respectively. The results demonstrated that the lentiviral vectors of RNAi targeting Beclin1 gene were successfully constructed, and NSCLC A549 stable cell line with Beclin1 gene knockdown was established. This study finally provided a new cell model to explore the biological behavior of the Beclin1 gene in NSCLC A549 cells.
Apoptosis Regulatory Proteins ; genetics ; Autophagy ; genetics ; Base Sequence ; Beclin-1 ; Carcinoma, Non-Small-Cell Lung ; genetics ; pathology ; Cell Line, Tumor ; Genetic Vectors ; genetics ; Humans ; Lentivirus ; genetics ; Lung Neoplasms ; genetics ; pathology ; Membrane Proteins ; genetics ; Molecular Sequence Data ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To investigate the expression of Dysadherin and analyze its role in renal clear cell carcinoma (RCCC).Methods RT-PCR and immunohistochemical were used to detect the expression of Dysadherin in 60 cases of fresh RCCC and 60 adjacent normal renal tissues(male 35,female 25; age 37-78,median age 61; ＞7 cm 24,≤7 cm 36; Ⅰ/Ⅱ 39,Ⅲ/Ⅳ 21).Results Dysadherin mRNA expression in RCCC tissues (2.0043±0.2890) was higher than that in adjacent normal renal tissues (0.8461 ±0.2479) (t =6.8020,P ＜ 0.05).Dysadherin expression was associated with nuclear grade.The expression of Dysadherin in nucleus grade Ⅲ and Ⅳ tumors were significantly higher than that in nucleus grade Ⅰ and Ⅱ tumors [the mRNA expression were 4.6224±0.3194,2.7780±0.2288,the positive rates of protein were 64.1％ (25/39),95.2 ％ (20/21) (t =6.5750,x2 =5.495,P ＜ 0.05)].There was no association between the expression of Dysadherin with sex (t =1.0530,x2 =0.023),age(t =0.0511,x2 =0.089) and tumor size (t =1.0330,x2 =0.370) (P ＞ 0.05).Conclusion In RCCC,Dysadherin expression is positively associated with tumor aggressiveness based on grading.It seems that Dysadherin may be a valuable prognostic marker in RCCC.

BACKGROUND: At present, the basic underlying molecular mechanism regulating the interactions among venous endothelial cells, platelets, leukocytes, and promoting local deep vein thrombosis microenvironment formation, still remains unclear, and there is no ideal method for early diagnosis of deep vein thrombosis. OBJECTIVE: To study the underlying role of nuclear factor kappa B1 and tissue factor in rats with deep vein thrombosis. METHODS: A total of 67 Sprague-Dawley rats were randomly divided into control group (n=10) and model group (n=57). Deep vein thrombosis model was established by a clamping and sewing method in femoral vein combined with cast fixation. The incidence and serious degree of thrombus were observed by dissecting rat femoral vein in different time points (2.5 and 25 hours after modeling). The model group was further divided into pre-thrombogenesis group (2.5 hours after modeling), thrombogenesis group (25 hours after modeling) and non-thrombogenesis group (25 hours after modeling). Then total RNA was extracted from the localized femoral venous endothelial tissue. The candidate genes, associated inflammation and thrombosis, were screened by a special gene chip. Then the gene expression of nuclear factor kappa B1 and tissue factor was further identified by real-time polymerase chain reaction. RESULTS AND CONCLUSION: Pre-thrombogenesis group had no thrombogenesis, while thrombogenesis group have 23 cases with thrombosis and non-thrombogenesis group have 22 cases without thrombosis. The results of gene chip hybridization analysis and real-time PCR found that the mRNA expression of nuclear factor kappa B1 and tissue factor in rat femoral vein endothelial tissue were significantly up-regulated at 2.5 hours after modeling (pre-thrombogenesis group was higher than control group) (P < 0.05), and continued up-regulating at 25 hours after modeling (thrombogenesis group was higher than the pre-thrombogenesis group, non-thrombogenesis group and control group) (P < 0.05). The results from present study indicate that up-regulating expressions of nuclear factor kappa B1 and tissue factor in local femoral venous endothelial tissue of rat deep vein thrombosis models may play a key role in initiating venous thrombosis.

BACKGROUND: The molecular mechanism and core regulatory network of deep vein thrombosis are not fully clarified yet.OBJECTIVE: To explore the roles of oxidative stress and Rac1/2 in rat deep vein thrombosis.METHODS: Deep vein thrombosis model in SD rats was established by a champing method femoral veins clamping combinedwith fixation of the lower extremity with plaster. The incidence and serious degree of thrombus were observed by dissecting ratfemoral vein at different time points (2.5 and 25 hours after modeling). The model rats were divided into pre-thrombogenesisgroup (2.5 hours after modeling), thrombogenesis group (25 hours after modeling) and non-thrombogenesis group (25 hours aftermodeling). Then total RNA and protein were extracted from the femoral venous wall tissues.RESULTS AND CONCLUSION: Colorimetry results showed that compared with the non-thrombogenesis group, theconcentration of malondiadehyde in rat femoral vein wall tissues of the thrombogenesis group was the highest (P < 0.05), followedby that of the pre-thrombogenesis group (P < 0.05). The concentrations of total superoxide dismutase and glutathione reductasein the thrombogenesis group were the lowest, followed by those in the pre-thrombogenesis group (P < 0.05). The results of genechip hybridization analysis and real-time PCR showed that compared with the non-thrombogenesis group, the expressions ofRac1 and Rac2 in rat femoral vein wall tissues of thrombogenesis group increased the most, followed by that of thepre-thrombogenesis group (P < 0.05). These findings indicate that the up-regulation of malondialdehyde and Rac1/2 as well asthe activity decrease of total superoxide dismutase and glutathione reductase may lead to the formation of deep venousthrombosis.