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.

Objective To investigate the risk factors associated with necrosis in interstitial oedematous pancreatitis(IOP)and to develop a nomogram model for the early prediction of necrosis in IOP.Methods A retrospective analysis was conducted on 306 patients diagnosed with IOP.Patients were stratified into necrosis and edema groups based on the presence or absence of pancreatic necrosis through follow-up CT-enhanced examinations.Logistic regression analysis was employed to identify independent predictive factors for necrosis in IOP.Subsequently,a nomogram model was developed,and its discriminative ability,accuracy,and practicality were assessed through receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA).Results Balthazar computed tomography severity index(CTSI),gender,lactate dehydrogenase(LDH),and triglyceride(TG)were finally identified as four independent predictors for constructing the nomogram model.The area under the curve(AUC)of the nomogram model was 0.800[95％confidence interval(CI)0.731-0.869].The calibration curve indicated good consistency between the predicted probabil-ity and the actual probability of necrosis in IOP(P=0.737).DCA suggested high practicality of the nomogram model within the threshold probability range of 3％to 66％and 75％to 96％.Conclusion The nomogram model based on Balthazar CTSI,gender,LDH,and TG demonstrates good efficacy in early prediction of necrosis in IOP.

Objective:To explore the change trend of disease burden in laryngeal cancer attributable to smoking in China from 1990 to 2019.Methods:Based on data from the 2019 Global Burden of Disease Study database, the changes of death cases, mortality, disability adjusted life years (DALY) and DALY rate of laryngeal cancer attributable to smoking among people with different gender and age in China from 1990 to 2019 were analyzed. Joinpoint software was used to evaluate the annual percentage change (APC) and average annual percentage change (AAPC) of attributable mortality and DALY rate. The change trend of laryngeal cancer death attributable to smoking and DALY was analyzed.Results:From 1990 to 2019, the mortality rate and DALY rate of laryngeal cancer attributable to smoking in China showed an overall upward trend (AAPC of mortality was 1.6%, P < 0.05;AAPC of DALY rate was 1.26%, P < 0.05). In 2019, 75.64% of laryngeal cancer deaths in China were attributable to smoking, with 15 336 attributable deaths, 1.08/100 000 attributable mortality rates, 376 143 person-year attributable DALY and 26.45/100 000 attributable DALY rates, respectively. The population attributable fraction, death number, mortality rate, DALY and DALY rate of laryngeal cancer attributable to smoking in males were higher than those in females. In China, the number of laryngeal cancer deaths and DALY attributable to smoking peaked in the age group of 50-69 years old, and the attributable mortality and DALY rate peaked in the age group of ≥70 years old. Conclusions:The disease burden of laryngeal cancer attributable to smoking is high in China from 1990 to 2019, and there are differences in gender and age.

ObjectiveBy observing the impact of Bevacizumab injection on the speed of wound healing and the expression of CD34 in cynomolgus monkeys, to verify its delayed wound healing mechanism, and to provide clinical reference for the dosage and frequency of Bevacizumab treatment for oncology surgery patients. MethodsSix male cynomolgus monkeys underwent full-thickness skin resection on the back to establish a wound healing evaluation model. Three cynomolgus monkeys were randomly selected as the saline group, and the other three cynomolgus monkeys were allocated to the Bevacizumab treatment group. The monkeys of Bevacizumab group were administrated with Bevacizumab injection (30 mg/kg, i.v.) on day 0, day 4, day 8, and day 11, respectively. The monkeys of saline group were injected with the same volume of saline as the group receiving Bevacizumab. The blood routine test was conducted, and the wound healing of each group of cynomolgus monkeys was observed 28 days after operation. The wound healing rate was analyzed by software Image J, and the severity of the wound was assessed by scoring method. Wound healing skin samples of 6 cynomolgus monkeys were obtained after 4 weeks, and the expression level of CD34 in the wound skin tissues was detected using immunohistochemistry. ResultsA skin excision wound model has already been established in cynomolgus monkeys. The number of white blood cells and neutrophils in the blood of cynomolgus monkeys increased significantly on the 3^rd day after operation (P<0.05), and the number of white blood cells gradually returned to normal on the 7^th day, while the number of red blood cells, hemoglobin and hematocrit did not change significantly, suggesting that the animals were in good nutritional status. The Bevacizumab injection group wound healing rate was significantly slower than that of the saline group on day 7, and day 28 (P<0.01, P<0.001). Microvessel density in the wound skin of Bevacizumab group appeared to be significantly lower than that of the saline group (P<0.01). ConclusionThe injection of Bevacizumab may delay the wound healing by inhibiting the angiogenesis in the new skin tissue of the cynomolgus monkey. In clinical practice, the timing of giving a tumor patient a bevacizumab injection after surgery should be based on the pros and cons, and the duration, dosage, and frequency of the intervention should be chosen in a rational way.

【Objective】  To study the composition and function of tongue coating (TC) and gastrointestinal tract (GIT) microbiota in participants with yellow-greasy tongue coating (YGTC), and to explore the representative metabolite markers and pathways in this group. 【Methods】  Subjects with YGTC or thin-white tongue coating (TWTC) were recruited from December 1, 2021 to October 30, 2022, and the TC and fecal samples were collected. Samples were subjected to both whole-genome shotgun (WGS), and 16S rRNA gene sequencing. The α-diversity analysis, principal component analysis (PCA), and Spearman correlation analysis were performed for two groups. Ultra-performance liquid chromatography combined with tandem mass spectrometry (UPLC–MS/MS) analysis was used to analyze metabolomics and enrichment of metabolic pathways. 【Results】  The results revealed 20 YGTC participates and 19 TWTC participates. At the genus level, the dominant bacterial species of TC flora and intestinal flora in the two groups were roughly the same, but the relative kurtosis difference was marked, and the abundance of potentially pathogenic bacteria in TC and fecal samples of YGTC subjects was higher. There were 9 down-regulated microorganisms in the TC samples, 26 down-regulated microorganisms, and 6 up-regulated microorganisms in YGTC subjects. The α-diversity analysis indicated that the Chao and abundance-based coverage estimator (ACE) indices of TC bacteria in the YGTC subjects showed a decreasing trend, but the difference was not statistically significant (P > 0.05). The α-diversity of fecal samples and the Chao and ACE indices decreased significantly (P < 0.05). PCA showed that the microflora structure of TC and fecal samples were significantly different between the two groups. Spearman correlation analysis showed that there was no correlation between TC and fecal microorganisms at phyla and genus levels in the same subjects (P > 0.05). The metabolomics results demonstrated that fumarate reductase, V/A ATPase, and phosphatidylethanolamine were increased, and glycerate-3p, UDP-glucose, and quinone oxidoreductase metabolites were decreased in YGTC TC samples. Inosine monophosphate (IMP), uridine monophosphate (UMP), and gamma-aminobutyric acid(GABA) were increased in YGTC fecal samples, while the contents of ribo-5P, histidine, biotin,and cobalamin were decreased. Metabolic pathway analysis indicated that the abundance of the TC and fecal samples of the YGTC subjects was relatively low in various metabolic pathways, including amino acid metabolism, carbohydrate metabolism, nitrogen metabolism, and energy metabolism. 【Conclusion】  Structural and functional changes in TC and GIT microbiota or metabolite markers could be potential biological bases of YGTC formation.

Objective: To investigate the clinicopathological and radiological features of benign fibro-osseous lesion (BFOL). Methods: Sixty-five cases of craniofacial BFOL, eight cases of peripheral ossifying fibroma (POF) and one case of low-grade central osteosarcoma diagnosed at Sichuan Provincial People′s Hospital between January 2010 and March 2019 were collected. The clinicopathologic features, hematoxylin-eosin and immunohistochemical (IHC) staining and radiographic features were analyzed. MDM2 gene amplification was detected by FISH in difficult borderline cases. Results: This cohort of BFOLs included 50 cases of fibrous dysplasia (FD), 12 cases of ossifying fibroma (OF), and three cases of juvenile psammomatoid ossifying fibroma (JPOF). The average ages of patients with FD,OF and JPOF were 31.7, 39.2 and 26.0 years respectively. The male to female ratio was 1.0∶1.8.The average age of POF was 47.0 years, with male to female ratio of 1∶7. Patient of low-grade central osteosarcoma was a 48-year-old man. Twenty-seven cases of FD were located in the jaw, and 23 cases were in other craniofacial bones. Nine cases of OF were located in the jaw, and three cases were in the nasal cavity. Two cases of JPOF were in the nasal sinus, and one was in the jaw. All POF were located in the gingiva, and low-grade central osteosarcoma was located in the mandible. The imaging features of FD were luffa-like or ground-glass like signal shadows with poorly defined borders with expansion. OF had clear borders or sclerosing margins. Both JOF and low-grade central osteosarcoma were expansile intraosseously and with focally invasive nodular masses with ground-glass like signal shadows; and POF showed soft tissue mass with bone formation. Histological features of BFOLs showed mixed fibrous and irregular osteoid lesions. FD had no clear relationship with the host bone and no osteoblasts surrounded the bone trabeculae. Osteoblasts rimming was found in OF, and the boundaries of the host bone were clear. JPOF and low-grade central osteosarcoma infiltrated the host bone focally, and the latter showed mild cellular atypia. MDM2 amplification was detected in low-grade central osteosarcoma. Conclusions BFOLs are a group of fibro-osseous lesions with similar morphology in the head and neck and face, but their clinical features and prognosis are different; and their imaging and histological characteristics are also slightly different. Attentions should be given to the combination of clinical, imaging and pathologic features of BFOLs, especially the differential diagnosis between BFOLs and low-grade central osteosarcoma. Molecular detection could be used to assist the diagnosis in difficult cases.

Objective: To investigate the prevalence of oral mucosal diseases (OMD) in patients with cerebrovascular disease. Methods: A total of 182 patients with cerebrovascular disease and 166 controls were examined for OMD to compare the differences of prevalence rates. Results: The prevalence of OMD in patients with cerebrovascular disease appeared higher than that in the control group. Oral candidiasis was most commonly seen (11.1%, 20/182), followed by fissured tongue (5.0%, 9/182), traumatic ulcer (2.8%, 5/182), herpes labialis (2.2%, 4/182), recurrent oral ulcer (1.6%, 3/182), chronic cheilitis (1.6%, 3/182) and oral leukokeratosis (1.6%, 3/182). Conclusion Patients with cerebrovascular diseases were susceptible to OMDs, especially to oral candidiasis that called for more attention.

Objective To explore the experience and needs on clinical practice training for interventional therapy specialized nurses of Hu'nan Province, so as to provide a reference for reasonably setting up the training practical courses for interventional therapy specialized nurses and a basis for further perfecting the system of interventional therapy specialized nurses training. Methods From 10th June to August 6th 2017, the semi-structured in-depth interview was used to 14 nurses attending the training for interventional therapy specialized nurses of Hu'nan Province by purposive sampling. The results were analyzed and themes were refined with the Colaizzi seven-step analysis. Results A total of five themes were refined in training experiences including that the practical ability of interventional therapy was improved, the time of clinical practice was too short, clinical rotating department was arranged unreasonably, quality of clinical teachers was uneven, the forms of clinical practice assessment needed to be standardized. Conclusions Interventional therapy specialized nurses training can improve trainees' quality of clinical practice. However, course offered should be adjusted based on trainees' actual situation and the model of interventional therapy specialized nurses training should be perfected so as to improve training effects.

Objective To study the impact of Xingnaojing (XNJ) injection (a preparation of Chinese herb medicine) on the permeability of blood-brain barrier and Caveolin-1 in cortex of brain after global ischemia-reperfusion.Methods Modified Pulsinelli method for four-vessel occlusion was employed to establish the global ischemia reperfusion model in rats.Male Wistar rats were randomly (random number) divided into three groups,namely sham group,model group and XNJ group.Each group was observed at 24 h,48 h and 72 h after ischemia reperfusion.The water content of brain tissue was determined by dry/wet weight ratio,while the Evans blue (EB) concentration in brain tissue was detected by spectrophotometer.Western blot was used to detect caveolin-1 level in the cerebral cortex.Results The water contents of brain tissue in model group and XNJ group were significantly higher than that in sham group 24 hour after ischemia-reperfusion (P ＜ 0.05).But at 48 h and 72 h after ischemia-reperfusion,the brain water content in model group was significantly higher than that in XNJ group and sham group (P ＜ 0.05).The EB concentrations in brain tissue in model group and XNJ group were higher than that in sham group 24 h after ischemia-reperfusion (P ＜ 0.05).EB levels in sham group and XNJ group were significantly lower than that in model group 48 h and 72 h after ischemia-reperfusion (P ＜ 0.05).Caveolin-1 levels in cerebral cortex in sham group and XNJ group were significantly higher than that in model group 24 h,48 h and 72 h after ischemia-reperfusion (P ＜ 0.05).Conclusions After global ischemia-reperfusion,Xingnaojing (XNJ) injection could protect blood-brain barrier in virtue of regulating caveolin-1 protein level.

Objective To investigate the role of Wnt/β-Catenin signaling pathway in the endotoxin induced acute lung injury (ALI) during the treatment by mesenchymal stem cells (MSCs).Methods Six SPF male SD rats were isolated and bone marrow mesenchymal stem cells were cultured.A total of 72 SPF male SD rats with 6-week-old were randomly (random number) divided into 4 groups:control group (n =18) in which phosphate buffered solution (PBS) used instead of lipopolysaccharide (LPS);LPS group (n =18) in which LPS used to induce acute lung injury;LPS + MSCs group (n =18) in which MSCs directly transplanted after injection of LPS;Control + MSCs group (n =18) in which MSCs transplanted after injection of PBS.And then 6 rats of each group were sacrificed at 6 h,24 h,and 48 h separately after injection of LPS.At 24 h after the modeling,lung tissue was taken and the levels of Wrnt signaling pathway components were detected by using immunohistochemistry and Western blot.In addition,quantitative realtime PCR was used to detect the expression of Wnt signaling pathway target genes.Results Compare with the PBS control group,significant decrease in lung dry-to-wet ratio and increase in arterial oxygen partial pressure (PaO2) were found in MSCS transplantation groups.According the immunohistological results,Wnt 5a was significantly increased in the LPS-induced ALI rats and decreased after MSCs transplantation.Moreover,decrease in levels of GSK-3β phosphorylation and β-catenin was found in the lung tissue after MSCs transplantation.In addition,the expressions of Wnt signaling target genes Vegf,Axin2 and Klf4 were decreased significantly after MSCs transplantation.Conclusions In the setting of ALI,the therapeutic effect of MSCs was exerted by decreasing the expressions of Wnt 5a,GSK-3β phosphorylation,β-catenin,and Wnt signaling target genes Vegf,Axin2 and Klf4.Wnt signaling implicated in the therapeutic effect of MSC in the setting of ALI.