The conventional treatment for periapical periodontitis faces challenges,especially in the cases with immature roots.This article reports a case of periapical periodontitis in an adult permanent tooth with an immature root,where erbium-doped yttrium aluminum garnet(Er:YAG)laser-activated root canal disinfection was employed to induce apical bleeding and pulp revascularization.A 22-month postoperative follow-up showed healing of the periapical lesion,narrowing of the apical foramen,and positive pulp vitality test results.

Objective To identify the feasibility of amide proton transfer-weighted imaging(APTw)and T2 mapping parameters in assessing microsatellite instability(MSI)in endometrial adenocarcinoma(EA). Methods Patients with clinically suspected endometrial cancer were prospectively enrolled and underwent MRI before the operation,which mainly included APTw and T2 mapping.Two radiologists independently performed regions of interest and measured the quantitative parameters.The intraclass correlation coefficients were used to assess the interobserver agreement,the independent samples t-test and Mann-Whitney U test were applied to compare quantitative variables between the MSI and microsatellite stable(MSS)groups,the receiver operator characteristic(ROC)curve was conducted to evaluate the predictive performances of different parameters,the Delong test was implemented to compare the area under the curve(AUC)between single parameters and their combination. Results Twenty-one patients in the MSI group and 37 patients in the MSS group were finally enrolled in this study.The results showed excellent observer agreements between two observers in assessing MRI parameters.APTw values[(2.72±0.52)% vs.(2.08±0.39)%,P<0.001]in the MSI group were significantly higher than those in the MSS group, T2 values [92.25(90.82, 99.91) ms vs.101.80(96.15, 112.13)ms, P<0.001]were significantly lower in the MSI group than those in the MSS group.The ROC curves showed that the AUCs of APTw and T2 values were 0.821 and 0.793,respectively,and no significant difference was observed between the two sequences(P＞0.05).The combination of APTw and T2 mapping yielded the highest AUC of 0.897,which was significantly higher than APTw and T2 mapping alone(both P＜0.05). Conclusion APTw and T2 mapping were valuable in assessing the MSI of EA,and the combination of the two parameters showed a higher diagnostic efficacy,thus providing an efficient basis for the selection of preoperative therapeutic modalities for the patients.

Objective To explore the contemporary prevalence,cumulative incidence,distribution characteristics,and correlates of social isolation among middle-aged and older adults aged 45 years and older in China. Methods This study utilized data from the China Health and Retirement Longitudinal Study.Cross-sectional studies with stratified analysis were conducted to investigate the prevalence of social isolation and its age,gender,and regional differences in 2018 and 2020.A cohort study and binary logistic regression models were employed to analyze the cumulative incidence of social isolation and its correlates from 2018 to 2020.Multiple imputation based on chained equations and sensitivity analyses based on complete-case data were employed to ensure the reliability of the analysis. Results In 2018,the weighted prevalence of social isolation among middle-aged and older adults was 16.48%(95%CI=15.67%-17.32%).In 2020,the weighted prevalence of social isolation among middle-aged and older adults was 18.84%(95%CI=17.93%-19.74%).Weighted stratified analyses indicated that the prevalence of social isolation was significantly higher among older adults,individuals residing in rural areas,and females.The weighted cumulative incidence of social isolation during 2018-2020 was 9.24%(95%CI=8.47%-10.02%).The analysis revealed that 34.02%(95%CI=32.85%-35.19%)of middle-aged and older adults exhibited depressive symptoms.Depressive symptoms(OR=1.38,95%CI=1.07-1.78,P=0.013)were significantly associated with an elevated risk of social isolation. Conclusion The study reveals the epidemiology of social isolation among middle-aged and older adults in China,identifying advanced age,female gender,rural residence,and depressive symptoms as key correlates.These findings emphasize the need for early health management strategies to address social isolation in these high-risk populations.

Objective This study aims to assess the coverage of human papillomavirus(HPV)testing and the prevalence of HPV infection among men who have sex with men(MSM)using geosocial networking apps in China.It also explores the related influencing factors to provide evidence for designing effective prevention and control strategies for this population. Methods The study was conducted from July to August 2024 and recruited participants via the Blued app.Univariate and multivariate logistic regression models were used to analyze factors associated with HPV testing and infection among MSM. Results Among the 1,080 participants,23.3% had undergone HPV testing,and 43.3% of those tested were positive for HPV. The main reason for HPV testing was the presence or suspicion of HPV-related symptoms(n=224,58.9%).Logistic regression analysis showed that MSM with higher levels of HPV knowledge,higher income,and those who self-identified as homosexuals were more likely to undergo HPV testing.Additionally,MSM with higher HPV knowledge,those who self-identified as homosexuals,those who had sex with women in the past six months,and HIV-positive MSM were identified as high-risk groups for HPV infection. Conclusions In China,the HPV testing rate among MSM using geosocial networking apps is low.However,the prevalence of HPV infection remains relatively high.Therefore,the government and community should enhance HPV knowledge dissemination,promote HPV testing,and improve the accessibility and quality of HPV testing services.By doing so,they can increase the testing coverage and effectively control the spread of HPV among MSM.