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.

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.

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

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective To investigate the mRNA and protein expressions of Nav 1.1 and Nav 1.2 in hippocampus following traumatic brain injury ( TBI) in rats.Methods After the lateral fluid percussion model was established in adult male Sprague Dawley rats,the rats were sacrificed at 2,12,24 and 72 hours after percussion and collected ipsilateral hippocampus for detecting mRNA and protein expressions of Nav 1.1 and Nav 1.2 by means of fluorescent quantitation RT-PCR,Western blot and immunofluo rescence staining.Results The mRNA expressions of Nav 1.1 and Nav 1.2 were significantly down-regulated (P<0.01) in hippocampus and reached the lowest level at 2 hours following TBI.The protein expression of Nav 1.1 was significantly down-regulated (P<0.01) but recovered near to level of control group at 72 hours after TBI.While there was no statistical difference on protein expression of Nav 1.2 in hippocampus after TBI compared with control group (P>0.05).Conclusion TBI induces significant down-regulated mRNA and protein expressions of Nav 1.1 in the hippocampus,which may be one of molecular mechanisms for functional alternation of sodium channels and excitotoxic action following TBI.

OBJECTIVE To study the infectivity of the Vibrio parahaemolyticus isolated from the brine. METHODS Virulence test group: to divide 35 Kunbai mice into 4 subgroups at random: to inject V. parahaemolyticus into the mice′ abdominal cavity of the test group, Staphylococcus aureus or Escherichia coli into those of the positive control groups and aseptic physiological saline into those of negative control group. Wound infection group:to divide 35 SPF mice into 4 subgroups at random after the legs injured: test subgroup (soaked in artificial brine with bacteria ), two positive control subgroups(with S.aureus or E.coli), negative control subgroup(soaked in aseptic physiological saline). To observe the general condition, blood routine, hemoculture, viscera culture of the mice, after 4 days the mice were sacrificed and examined the viscera with pathological analysis. RESULTS Virulence test group: the hemoculture of one mouse was positive after injected the bacteria into its abdominal cavity for 12 hours, and viscera bacterial culture was positive. Wound infection test group:the ratio of wound infection was 100%,the positive ratio of both the hemoculture and the viscera bacteria culture were 10% after the wound soaked in bacteria solution. There were a great deal of neutrophilic granulocytes infiltration and cellulitis in the striated muscles of wound limbs through pathological examination. The infection of severe degree corresponded with the positive control groups, there was no inflammatory reaction in negative control group. CONCLUSIONS The V. parahaemolyticus isolated from the brine has infectivity and makes the wound of the mice be infected and hematoseptic when the concentration reached 10~6 CFU/ml .

OBJECTIVETo explore the effect of seawater immersion on serum osmotic pressure and electrolytes balance following chest trauma in dogs.

METHODSTwenty-five healthy adult dogs were used in the experiment. A canine model of right open pneumothorax was established by chest puncturing on all animals. Animals were divided into three groups: a control group (n=10) with chest trauma without any immersion; a seawater group (n=10) immersed in seawater after chest trauma and a normal saline group (n=5) immersed in normal saline solution following chest trauma. Blood samples were taken at different time intervals to determine plasma osmotic pressure and electrolytes. The hemodynamic changes were also recorded.

RESULTSMortality in the seawater group was much higher than that of the control group and the normal saline group. The mean survival time in the seawater group lasted only 45 minutes, while in the control group and the normal saline group the average survival time was more than 4 hours (P<0.01). One of the most important causes of death was hypernatremia and high osmolality. Severe electrolytes imbalance was observed in seawater group. Hypernatremia and high osmolality were the most significant factors of high mortality in the seawater group.

CONCLUSIONSSeawater immersion after chest trauma appears to be associated with severe electrolyte imbalance as well as high osmotic pressure. These may be the risk factors leading to fatal outcome.

Animals ; Dogs ; Hemodynamics ; Osmotic Pressure ; Risk Factors ; Seawater ; adverse effects ; Thoracic Injuries ; physiopathology ; Water-Electrolyte Balance ; physiology

Objective To evaluate the effect of various rewarming regimes on rectal temperature and hemodynamic parameters of dogs after open abdominal injury and seawater immersion. Method 30 healthy dogs were subjected to open abdominal injury and 2-hour seawater immersion. Then dogs were divided into three groups: group A (n=10) received no special warming treatment, in group B(n=10) electric blanket was used to warm up to 42℃, in group C (n=10) animals were warmed by 1/3 saline solution in 42℃ for 20 minutes and continuous perfusion of the abdominal cavity with 1/2 saline solution for 2 hours. The changes in body temperature, heart rate, MAP, CVP and CO were observed before and after rescue. Results The results of group A were not satisfactory. The rectal temperature, MAP, HR and CO were not recovered to normal after 6 hours of treatment. and the rectal temperature was 34.8℃ after 6 hours. The rectal temperature rose to 36.9℃ after being rewarmed with an electric blanket in group B. The result was better than that of group A. But there was tachycardia. The effects of rewarming from hypothermia in group C was satisfied. All hemodynamic parameters and rectal temperature recovered after 4 hours treatment. Conclusion Cold seawater immersion after open abdominal injury would result to hypothermia, and intra-corporeal rewarming should be the optional treatment.

Objective To evaluate the effect of seawater immersion on hemodynamics and pathological changes in dogs with perforating injury of the intestine. Methods Thirty healthy adult dogs were subjected to perforating injury of the intestine. Ten injured dogs were immersed in artificial seawater after the injury. An equal number of injured dogs were immersed in normal saline solution. Control group dogs (n=10) were not subjected to salt water immersion. Hemodynamical and pathological changes were observed at different time intervals after injury. Results Obvious hemodynamic disorder and serious pathological changes were found after seawater immersion. Normal saline solution group and control group dogs did not show obvious disorders in hemodynamics and pathology. Conclusion Seawater immersion is one of the main factors leading to the disturbance in hemodynamic and pathological changes after perforating injury of the intestine.

The war injuries with seawater immersion has become one of the most common in the naval battle. These injuries are quite different on characteristics from simple war injuries because of the low temperature, high osmotic pressure and bring a large number of bacterial of seawater. The characteristics and early treatment of war injuries with seawater immersion were introduced on research results of army medicine order task. The significance of making a thorough investigation and study was discussed.