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

Objective:To summarize the clinical characteristics and the features of electroencephalograph (EEG) of children with DEPDC5 gene variants related epilepsy.Methods:The clinical data, gene variation, EEG and head magnetic resonance image (MRI) of 20 epileptic children with DEPDC5 gene variants admitted to Department of Pediatrics, Peking University First Hospital from May 2017 to November 2020 were retrospectively analyzed.Results:Twenty patients with heterozygous DEPDC5 gene variants were enrolled, 8 of 20 patients were nonsense variants, 6 were missense variants, 3 were frame-shift variants, 2 were splicing variants, and 1 was large fragment deletion. Sixteen cases had hereditary variation and 4 had de novo variation. Fifteen of variations were novel. Nine were male, while 11 were female. Their latest follow-up age ranged from 10 months to 13 years and one month.The epilepsy onset age ranged from 3 hours to 11 years and 3 months, the median age was 10.5 months. Twelve (60%) patients had developmental delay. Nineteen patients had focal seizures, 7 had epileptic spasms, 1 had multiple seizure types including tonic, atypical absence, dystonic and myoclonic seizures. Epileptic form discharges were observed in 18 patients during the interictal phase, and 11 were focal discharges, 7 were multifocal discharges. Ten (50%) patients had abnormal brain MRI, including focal cortical dysplasia in 5 patients, undefined malformation of cortical development in 4 patients, hemimegalencephaly in 1 patient. Four patients were diagnosed as West syndrome and one patient was diagnosed as Lennox-Gastaut syndrome. Fourteen (70%) patients were diagnosed as drug-resistant epilepsy. Four patients became seizure-free by treatment with anti-epileptic drugs. Three children were treated with surgery, and 2 of them became seizure-free, 1 had more than 75% reduction in seizures.Conclusions:DEPDC5 gene variant epilepsy is inherited with incomplete penetrance and focal seizure is the major seizure type. However, epileptic spasms, generalized seizures can also be observed. Half of the patients brain malformations. Most of the patients are drug-resistant epilepsy. Patients with clear epileptogenic zones can be treated with surgery. Treatment-resistant patients are more likely to be complicated with developmental delay.

The Zika virus (ZIKV) and dengue virus (DENV) flaviviruses exhibit similar replicative processes but have distinct clinical outcomes. A systematic understanding of virus–host protein–pro-tein interaction networks can reveal cellular pathways critical to viral replication and disease patho-genesis. Here we employed three independent systems biology approaches toward this goal. First, protein array analysis of direct interactions between individual ZIKV/DENV viral proteins and 20,240 human proteins revealed multiple conserved cellular pathways and protein complexes, including proteasome complexes. Second, an RNAi screen of 10,415 druggable genes identified the host proteins required for ZIKV infection and uncovered that proteasome proteins were crucial in this process. Third, high-throughput screening of 6016 bioactive compounds for ZIKV inhibition yielded 134 effective compounds, including six proteasome inhibitors that suppress both ZIKV and DENV replication. Integrative analyses of these orthogonal datasets pinpoint proteasomes as crit-ical host machinery for ZIKV/DENV replication. Our study provides multi-omics datasets for fur-ther studies of flavivirus–host interactions, disease pathogenesis, and new drug targets.

Objective:To explore the feature of impaired sustaind attention in the stable patients with bipolar disorder and their first degree relatives.Methods:Totally 76 patients with bipolar disorder meeting with, 83 first degree relatives of patients and 81 healthy controls, were employed and evaluated with continuous performance test (CPT).Results:In reaction time task (a simple performance), all of CPT parameters were higher in patients group than in the first degree relatives group and controlled group (Ps＜0.01), while all of CPT parameters in the first degree relatives group were similar to those in healthy controls (Ps＞0.05).In X task (a complex performance), the results of CPT in the first degree relatives group were between the patients and the normal controls, and the differences were statistically significant (Ps＜0.05).Conclusion:The sustained attention function may have a certain hereditary apparent in stable patients with bipolar disorder.

Objective To investigate the gestational weight gain and quality of life in women with gestational diabetes mellitus(GDM) who used Free-Style Libre Flash Glucose Monitoring System. Methods From August of 2017 to January of 2019, the GDM patients diagnosed in the Department of Endocrinology in 3 ClassⅢ Grade A hospitals in Guangzhou were selected and divided into the observation group(n=39) and control group(n=43) according to their glucose monitoring willingness. The Free-Style Libre Flash Glucose Monitoring System was used for the observation group(sensor changed every 14 days) combined with the fingertip blood glucose monitor, it was necessary to monitor fingertip blood glucose contrast when hypoglycemia was identified by sensors. Pregnant women at other monitoring points could selectively monitor fasting and postprandial blood glucose. In the control group, after assigned into the group patients only monitored their fingertip blood glucose(at lease 2 times/d, including fasting and 2h postprandial blood glucose). The two groups were all instructed by self-management on diet, exercise etc according to the result of blood glucose monitor, the Wechat management was included to instruct them of the daily life diary recording method. World Health Organization-5 Well-Being Index (WHO-5) was adopted at the beginning of the study and the second week of follow-up to investigate the well-being index score of the patients in the two groups; at the end of pregnancy, the average perinatal blood sugar level, incidence of hypoglycemia events and the eligible rate of weight gain in different BMI patients were recorded. Results At the 2nd week, the score of well-being index in the observation group was higher than that in the control group with statistical significance(P=0.037).There was no statistically significant difference in fasting and 2 h postprandial glucose between the two groups (P＞0.05). There was no significant difference in blood sugar control (fasting and 2 hours after meal) between the two groups (P＞0.05), but the detection rate of hypoglycemia in the group using Free-style Libre glucose monitoring system was higher than that in the control group (P=0.042). By the end of pregnancy, stratified analysis showed that the qualified rate of weight gain in the observation group with BMI between 18.5 and 24.9 kg/m2 before pregnancy was higher than that in the control group with statistical significance(P=0.035). Conclusions The use of Free- Style Libre Flash Glucose Monitoring System in GDM patients makes gestational weight control more reasonable and painless, and improves the well-being index of patients.

Many factors contribute to a successful total knee arthroplasty, and postoperative coronal lower limb alignment has always been a focus of joint surgeons. Previous researches have suggested that neutral alignment can bring higher prosthesis survival rate and better knee function. However, the theory has been challenged in recent years.In this article, the author introduces the axis, alignment and osteotomy of total knee arthroplasty briefly and reviews the studies on the neutral alignment and kinematic alignment of recent years in order to provide some advice for the clinical operation.

BACKGROUND:Fast track surgery, also cal ed enhanced recovery after surgery, is a series of optimal measures adopted during the perioperative period on the basis of evidence-based medicine, to reduce the physical and mental trauma brought to the patient and accelerate their recovery. It has become the research focus of orthopedic clinic as the surgery and anesthesia skil s are improved a lot in recent years, especial y the articular surgery, which has been widely used in clinics. OBJECTIVE:To summarize the clinical study of the application of optimal measures in joint replacement surgery both at home and abroad in recent years. METHODS:The first author searched related articles in PubMed and Chinese Journal Ful-text Database from January 1997 to September 2016. The key words were“joint replacement, enhanced recovery after surgery, multi-mode analgesia, diet management, steroid hormones”. 81 articles were found at last and one monograph was included. RESULTS AND CONCLUSION:(1) We found that the recovery plan reduced the hospital stays of the patients from 4-12 days to 1-3 days, including pre-operative health education, shortening fasting and water-depriving duration before surgery, super-anesthesia before surgery and do not place catheter;adopting general anesthesia and appropriate adductor canal to relieve the pain, and stopping bleeding using tranexamic acid during operation;multi-mode analgesia, faster function exercise after anesthesia recovery, and drinking water in early phase after surgery during the perioperative period of joint replacement surgery conducted by the cooperation of surgeon, anesthetist, nurse and nutritionist. There were no significant improvements of postoperative complications rate and rehospitalization rate. (2) The research found that, enhanced recovery after surgery is suitable for most of the patients receiving joint replacement surgery, including those in advanced age, combined heart and lung disease before surgery, type 2 diabetes and smoking and drinking before surgery.

OBJECTIVETo investigate the distribution and proportion of subtypes of pol gene in HIV-1 epidemic strains in Guangxi Autonomous Region.

METHODS152 HIV-1 patients were enrolled from 11 cities in Guangxi Autonomous Region from 2010 to 2012 by convenient sampling. Inclusion criterias were listed as the fdlowing: HIV-1 infection was confirmed by Western blot, HIV-1 viral load >1 000 copies/ml, > 18 year-old, and without any serious illnesses. 5 ml of peripheral blood samples were obtained from each patient. The viral RNA was isolated from plasma and used for amplification of full-length pol gene by nested RT-PCR. The amplified products were sequenced. After editing and modification, all sequences were characterized for preliminary subtyping by genotyping and confirmed with phylogenetic tree constructed by MEGA 5.03 software. The recombinant identification of 2 unknown recombinant strains was determined by RIP and jpHMM at GOBICS.

RESULTSAmong 152 patients, 137 full-length pol genes were successfully amplified and 127 HIV-1 subtypes were identified. The distribution and proportion of subtypes was summarized as the following 71 cases of CRF01_AE, accounting for 55.9% (71/127), 38 CRF08_BC, 29.9% (38/127), 13 CRF07_BC, 10.2% (13/127), and 3 B (B'), 2.4% (3/127), 2 unknown recombinant strains, 1.6% (2/127). In 11 cites of Guangxi Autonomous Region, subtype CRF01_AE was the dominant strain. Among heterosexual transmitted patients and drug abusers, the proportions of subtype CRF01_AE were 67.4% (58/86) and 34.1% (14/41), respectively. There was a significance different in the distribution of CRF01_AE in different routes of transmission (χ(2)=15.07, P<0.001). In age 21- 35, age 36- 60 and age>60 groups, the proportions of CRF01_AE was 43.6% (17/39), 57.6% (38/66), 77.3% (17/22), and CRF08_BC was 43.6% (17/39), 28.8% (19/66), 9.1% (2/22), respectively, the difference in proportions was significant(χ(2)=8.48, P= 0.014). The patterns of two unknown recombinant strains were found to be CRF01_AE/B (B') and CRF01_AE/C/B(B'), respectively.

CONCLUSIONCRF01_AE was the dominant HIV-1 subtype in Guangxi Autonomous Region from 2010 to 2012, with heterosexual transmission as its main spreading route. The two unknown recombinant strains in Guangxi Autonomous Region were reconstructed by subtype CRF01_AE and CRF_BC.

Blotting, Western ; China ; epidemiology ; Cities ; Drug Users ; Genes, pol ; Genotype ; HIV Infections ; epidemiology ; transmission ; virology ; HIV-1 ; genetics ; Humans ; Phylogeny ; Polymerase Chain Reaction ; RNA, Viral ; blood ; pol Gene Products, Human Immunodeficiency Virus ; genetics

Objective To explore the application effect of laser speckle perfusion imaging (LSPI) in predicting wound healing time of burn patients.Methods LSP1 was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital within post injury hour (PIH) 24 to 72 to detect the blood perfusion values of the wounds.The wound healing time was recorded.The 128 wounds were divided into superficial group (wound healing time shorter than or equal to 14 d,n =57) and deep group (wound healing time longer than 14 d and shorter than or equal to 28 d,n =71) according to the healing time.The blood perfusion values of the two groups were compared.Data were processed with t test or chi-square test.The receiver operating characteristic (ROC) curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups,and the validity of the critical value was assessed by Kappa consistency test.Results (1) The blood perfusion value of woundsin superficial group was (6.8 ± 1.8) perfusion unit (PU),which was significantly higher than (3.5 ± 1.3) PU in deep group (t =11.404,P ＜0.01).(2) The total area under ROC curve of blood perfusion value to predict wound healing time was 0.931 (with 95％ confidence interval 0.887-0.975,P ＜0.01).Combined with Youden index,5.52 PU was chosen as the optimal critical value of wound healing time of the two groups,with sensitivity of 76.9％ and specificity of 94.7％.(3) The healing time of 44 wounds predicted was shorter than or equal to 14 d,and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d,while the actual number of wounds was 57 and 71,respectively.The Kappa coefficient of consistency test was 0.754 (P ＜0.01).Conclusion LSPI is a useful method to predict the healing time of burn wounds.

Objective To study the advantages and disadvantages of the application of complete endoscopic and endoscope assisted small incision in thyroid surgery. Methods From September 2010 to September 2013,279 patients with thyroid diseases in our hospital were selected as the research object. Among them,239 cases of thyroid surgery were grouped according to the surgical method,the complete endo-scopic group with 95 cases,endoscope assisted small incision surgery group with 144 cases. The other 40 cases of parathyroid surgery were grouped according to the surgical method,the complete endoscopic group with 5 cases,endoscope assisted small incision group with 35 cases. The results and indicators related to the surgery with the complete endoscopic and endoscope assisted small incision for the thyroid disease and parathyroid gland were compared. Results About thyroid disease,the proportion of women in the complete endoscopic group,the adeno-ma or unilateral gland leaf proportion,thyroid volume,the tumor nodules longest diameter,adenoma or glandular lobe resection time,double leaf full cut or full cutting time and intraoperative blood loss were significantly higher than that of endoscope assisted small incision group,and the age,double leaf time full cut or full cut rate were significantly lower than that of endoscope assisted small incision group,the differences were statistically significant (P<0. 05). About thyroid disease,proportion of chest discomfort,VAS pain score,length of hospital stay and postoperative cosmetic effect of satisfaction scores in complete endoscopic group were significantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). About parathyroid disease,the age of patients in the complete endo-scopic group was significantly lower than that in endoscopy assisted small incision group,but the operation time and hospital stay were signifi-cantly higher than that of endoscopy assisted small incision group,the differences were statistically significant (P<0. 05). Conclusion The thyroid surgery with complete endoscopic and endoscopy assisted small incision has certain advantages and disadvantages,which should be considered for patients demands,so as to make the best operation program.