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

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Objective: To investigate the epidemiological characteristics and the transmission chain of a family clustering of COVID-19 cases caused by severe acute respiratory 2019-nCoV Delta variant in Changping district of Beijing. Methods: Epidemiological investigation was conducted and big data were used to reveal the exposure history of the cases. Close contacts were screened according to the investigation results, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: On November 1, 2021, a total of 5 COVID-19 cases caused by 2019-nCoV Delta variant were reported in a family detected through active screening. The infection source was a person in the same designated isolation hotel where the first case of the family cluster was isolated from 22 to 27, October. The first case was possibly infected through aerosol particles in the ventilation duct system of the isolation hotel. After the isolation discharge on October 27, and the first case caused secondary infections of four family members while living together from October 27 to November 1, 2021. Conclusion: 2019-nCoV Delta variant is prone to cause family cluster, and close attention needs to be paid to virus transmission through ventilation duct system in isolation hotels.
Aerosols ; COVID-19 ; Epidemics ; Humans ; SARS-CoV-2

Objective: To investigate the source and the transmission chain of a cold-chain product associated COVID-19 epidemic caused by 2019-nCoV Delta variant in Beijing. Methods: Epidemiological investigation were used to verify the exposure points of the cases. Close contacts were traced from the exposure points, and human and environmental samples were collected for nucleic acid tests. Positive samples were analyzed by gene sequencing. Results: A total of 112 cases of COVID-19 were reported in the epidemic from January 18 to February 6, 2022 in Beijing. Except for 1 case was uncertain, there were epidemiological links among 111 cases. The source of infection was the packages of imported cold-chain products from Southeast Asia, which were harvested and stored in a local cold-storage in January 2021, and packaged and sent to the cold-storage A in A district in June 2021, and then sold in batches in cold-storage B in B district from January 2022. The first case was infected in the handling of positive frozen products, and then 77 cases occurred due to working, eating and living together with the index case in the cold-storage B, cold-storage C and restaurant D. Besides the cold-storage B, C and the restaurant D, there were 16 sub-transmission chains, resulting in additional 35 cases. Conclusion: The epidemic indicated that the risk of 2019-nCoV infection from imported cold-chain products contaminated by package and highlighted the importance to strengthen the management of cold-chain industry in future.
Beijing/epidemiology* ; COVID-19/epidemiology* ; Epidemics ; Humans ; SARS-CoV-2

OBJECTIVE: To investigate the mechanism of Tojapride, a Chinese herbal formula extract, on strengthening the barrier function of esophageal epithelium in rats with reflux esophagitis (RE). METHODS: Ten out of 85 SD rats were randomly selected as the sham group (n10), and 75 rats were developed a reflux esophagitis model (RE) by the esophageal and duodenal side-to-side anastomosis. Fifty successful modeling rats were divided into different medicated groups through a random number table including the model, low-, medium-, and high-dose of Tojapride as well as omeprazole groups (n10). Three doses of Tojapride [5.73, 11.46, 22.92 g/(kg•d)] and omeprazole [4.17 mg/(kg•d)] were administrated intragastrically twice daily for 3 weeks. And the rats in the sham and model groups were administered 10 mL/kg distilled water. Gastric fluid was collected and the supernatant was kept to measure for volume, pH value and acidity. Esophageal tissues were isolated to monitor the morphological changes through hematoxylin-eosin (HE) staining, and esophageal epithelial ultrastructure was observed by transmission electron microscopy. The expressions of nuclear factor kappa-light-chain-enhancer of activated B cells p65 (NF-KBp65), κB kinase beta (IKKß), occludin, and zonula occludens-1 (ZO-1) in the esophageal tissues were measured by immunohistochemistry and Western blot, respectively. RESULTS: The gastric pH value in the model group was significantly lower than the sham group (P<0.05). Compared with the model group, gastric pH value in the omeprazole and medium-dose of Tojapride groups were significantly higher (P<0.05). A large area of ulceration was found on the esophageal mucosa from the model rats, while varying degrees of congestion and partially visible erosion was observed in the remaining groups. Remarkable increase in cell gap width and decrease in desmosome count was seen in RE rats and the effect was reversed by Tojapride treatment. Compared with the sham group, the IKKß levels were significantly higher in the model group (P<0.05). However, the IKKß levels were down-regulated after treatment by all doses of Tojapride (P<0.01 or P<0.05). The occluding and ZO-1 levels decreased in the model group compared with the sham group (Ps0.01 or Ps0.05), while both indices were significantly up-regulated in the Tojapride-treated groups (P<0.01 or P<0.05). CONCLUSIONS Tojapride could improve the pathological conditions of esophageal epithelium in RE rats. The underlying mechanisms may involve in down-regulating the IKKß expression and elevating ZO-1 and occludin expression, thereby alleviating the inflammation of the esophagus and strengthening the barrier function of the esophageal epithelium.

Aim To investigate the effects of oridonin on proliferation, migration and apoptosis of U87 glioma cells and to explore the involvement of the mechanism in the inhibition of Yes-associated protein (YAP)-c - Myc signaling pathway. Methods The effect of oridonin on U87 viability was measured by MTT assay; the migration and invasiveness of cells were measured by transwell assays; the apoptotic rates of cells were assessed by flow cytometry; the caspase-3, B c l - 2, Bax, YAP, c - MycmRNA expression in U87 glioma cells was detected by real-time quantitative P C R; the caspase-3, Bcl-2, Bax, YAP, p-YAP (Seri 27), c-Myc protein expressions were detected by Western blot. Results The proliferation of U87 cells was significantly inhibited by oridonin in a dose-dependent manner (P < 0. 05), and the ability of cell migration and invasion was weakened (P <0. 01), cell apoptosis rate in flow cytometry analysis increased significantly (P <0. 01), the protein and mRNA expression of caspase-3 increased (P < 0. 05), the mRNA and protein expression of Bcl-2/Bax decreased (P < 0. 05), the mRNA and protein expression of Y A P and c-Myc decreased (P < 0. 05), and the protein expression of p - Y A P increased (P < 0. 05). Conclusions Oridonin can significantly inhibit the proliferation and migration of U87 glioma cells and promote the transformation apoptosis of glioma cells; the mechanism may be related to the inhibition of YAP-c-Myc signaling pathway.

OBJECTIVE: To analyze the risk factors for incomplete endoscopic submucosal resection of rectal neuroendocrine neoplasms(r-NENs) and offer clinical experience after incomplete endoscopic submucosal resection. METHODS: From February 2012 to February2018, 62 cases of rectal carcinoid tumors resected by endoscopic submucosal dissection(ESD) were enrolled, and the factors associated with incomplete endoscopic resection were retrospectively analyzed by univariate and multivariate analysis. RESULTS: Univariate analysis demonstrated that depth of infiltration(P<0.05) and central depression of the surface mucosa(P<0.05) were risk factors for incomplete resection of ESD in rectal neuroendocrine neoplasms. Multivariate analysis revealed that central depression of the surface mucosa(P= 0.031) and infiltration of the lesion into the submucosa(P= 0.014) were independent risk factors for incomplete resection of rectal neuroendocrine neoplasms. CONCLUSION: Depth of infiltration into submucosa and the central depression of surface are associated with incomplete resection of rectal neuroendocrine neoplasm. After an incomplete ESD resection of rectal neuroendocrine neoplasm, without evidence of lympho-vascular invasion, a periodic follow-up examination may be considered.

OBJECTIVE: The objective of this study is to determine whether coronary atherosclerotic plaque composition is associated with cardiovascular disease (CVD) risk in Chinese adults. METHODS: We performed a cross-sectional analysis in 549 subjects without previous diagnosis or clinical symptoms of CVD in a community cohort of middle-aged Chinese adults. The participants underwent coronary computed tomography (CT) angiography for the evaluation of the presence and composition of coronary plaques. CVD risk was evaluated by the Framingham risk score (FRS) and the 10-year atherosclerotic cardiovascular disease (ASCVD) risk score. RESULTS: Among the 549 participants, 267 (48.6%) had no coronary plaques, 201 (36.6%) had noncalcified coronary plaques, and 81 (14.8%) had calcified or mixed coronary plaques. The measures of CVD risk including FRS and ASCVD risk score and the likelihood of having elevated FRS significantly increased across the groups of participants without coronary plaques, with noncalcified coronary plaques, and with calcified or mixed coronary plaques. However, only calcified or mixed coronary plaques were significantly associated with an elevated ASCVD risk score [odds ratio (OR) 2.41; 95% confidence interval (CI) 1.09-5.32] compared with no coronary plaques, whereas no significant association was found for noncalcified coronary plaques and elevated ASCVD risk score (OR 1.25; 95% CI 0.71-2.21) after multivariable adjustment. CONCLUSION Calcified or mixed coronary plaques might be more associated with an elevated likelihood of having CVD than noncalcified coronary plaques.
Asian Continental Ancestry Group ; Cardiovascular Diseases ; epidemiology ; Computed Tomography Angiography ; Female ; Humans ; Male ; Middle Aged ; Odds Ratio ; Plaque, Atherosclerotic ; diagnostic imaging ; epidemiology ; Risk Factors

Asian Continental Ancestry Group ; genetics ; China ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; Humans ; Parkinson Disease ; genetics ; Polymorphism, Single Nucleotide

Spermatozoa are not mature until they transit the epididymis where they acquire motility and the ability to fertilize an egg through sequential modifications. The epididymis has three functional regions, caput, corpus, and cauda, and the luminal proteins of the epididymis play important roles in the above modifications. However, the proteins with differential enrichment between the caput and cauda are still largely unknown. To reveal the functions of the caput and cauda during sperm maturation, luminal proteins from caput and cauda of mice were analyzed by isobaric tag for relative and absolute quantitation (iTRAQ). Overall, 128 differentially enriched proteins were found, of which 46 were caput enriched and 82 were cauda enriched. Bioinformatic analysis showed that lipid metabolism was active in the caput; while anion- and cation-binding activity and phosphorus and organophosphate metabolism were active in the cauda. A new epididymal luminal protein, the caput-enriched PDZ domain containing 1 (Pdzk1), also named Na⁺/H⁺ exchange regulatory cofactor 3 (NHERF3), which plays a critical role in cholesterol metabolism and carnitine transport, was found in the lipid metabolism. Western blotting and immunofluorescence analyses showed that Pdzk1 was expressed in the epididymis but not in the testis, and localized at the middle piece of the sperm tail. Pdzk1 protein level was also reduced in the spermatozoa in case of asthenozoospermic patients compared with that in normozoospermic men, suggesting that Pdzk1 may participate in sperm maturation regulation and may be associated with male infertility. These results may provide new insights into the mechanisms of sperm maturation and male infertility.
Adult ; Animals ; Asthenozoospermia/metabolism* ; Carrier Proteins/metabolism* ; Case-Control Studies ; Epididymis/metabolism* ; Humans ; Intracellular Signaling Peptides and Proteins/metabolism* ; Male ; Membrane Proteins ; Mice ; Sperm Maturation ; Sperm Tail/metabolism* ; Spermatozoa/metabolism* ; Testis/metabolism*