Objectives This study aimed to investigate the mechanism of successful autologous pulp transplantation through semi- in situ pulp regeneration in animal experiments and three case reports of autologous pulp transplantation protocols using concentrated growth factor (CGF)-enriched pulp. Material and methods Wisdom tooth pulp was removed, placed in the anterior molar canal, and implanted in the subcranial space of the cranial apex of SD rats to establish an animal model of hemi- in situ pulp regeneration. Postoperative histological observations were performed. Three patients diagnosed with chronic periapical inflammation in a single canal of the anterior teeth and satisfied with the presence of wisdom teeth were recruited, and the CGF-rich autologous pulp transplantation protocol was selected after obtaining informed consent. Result Animal experiments showed no detachment of all SD rat grafts after surgery, a large amount of neovascularization by HE staining, and positive vascular expression by immunohistochemistry for both human CD31 and murine CD31. The three patients were followed at 3 and 6 months after surgery, and all teeth showed improvement in periapical lesions and positive pulp electrical vitality tests. Conclusion The results of animal experiments indicate that isolated pulp can survive and establish a blood supply with the host, and the addition of CGF facilitates regenerative pulp formation. The clinical results also demonstrated that CGF-rich autologous pulp transplantation protocols are a good regenerative pulp therapy (RET) for the treatment of chronic apical periodontitis in anterior teeth.

BACKGROUND An extra tooth in the normal tooth sequence in any region of the dental arch is regarded as a supernumerary tooth (SNT). Due to the large variation in location and morphology, the extraction of impacted SNTs is an extensive and complex procedure with high risks of several complications. This report presents a rare case of seven impacted SNTs in the bilateral upper and lower arch that were successfully extracted with the use of digital positioning guide plates. CASE SUMMARY In January 2022, a 21-year-old male was referred to our department with a chief complaint of pain in relation to tooth #36. Clinical examination showed a deep carious lesion with pulpal involvement in tooth #36 and lingual swelling of the bilateral mandibular posterior area. Radiographic examination revealed seven deeply impacted SNTs in the bilateral posterior area and bilateral impacted mandibular third molars. Based on these findings, the patient was diagnosed with bilateral, multiple impacted SNTs and tooth #36 chronic pulpitis. A root canal treatment and an all-ceramic crown restoration for tooth #36 were performed. An individualized digital positioning guide plate was designed by computer-aided design/computer-aided manufacturing technology and cone-beam computed tomography for extraction of the impacted SNTs. During the operation, the digital positioning guide plate allowed rapid positioning and exposure of the SNTs while avoiding adjacent important anatomical structures. At 3-month follow-up, regeneration of bone and soft tissues was visible. CONCLUSION The application of digital positioning guide plates is useful for the individualized and minimalized extraction of impacted supernumerary teeth.

1 临床病例 男性,24岁,战士,缘于5月中旬参与野外训练,半月后日出现发热,随队医生给予退烧针肌肉注射,稍缓解后继而反复发热,辗转两家当地医院治疗效果欠佳,体温最高达42℃,为持续性发热,偶有咳嗽、咯少量白色黏痰.7月2日晚转入医院呼吸内科,自感胸闷、呼吸困难,伴痰中带血,全身肌肉酸痛,尤以下肢腓肠肌明显.7月4日出现极度烦躁,严重呼吸困难,给予经鼻高流量吸氧无法缓解呼吸困难,频繁咯鲜红色血,因病情危重转入医院重症医学科救治,7月14日患者病情基本控制转回呼吸内科继续治疗,于8月11日痊愈出院.

护理是一门理论与实践相结合的学科,国内各类护理培训正大力开展,目前已取得一定的成果和经验,但仍处于探索阶段,存在很多需要探讨和解决的问题,如护理人员培训的内容、方法及其评价方式.目前,柯氏模型应用广泛,是大家熟知的培训评估模型之一 [1],应用柯氏模型对护理相关培训进行系统、有效的评估已成为研究趋势.笔者系统回顾柯氏模型在护理培训评估中的应用现状,为护理培训内容设置及全面评价提供参考.

结合某院野战医疗所参加跨区基地化实践训练,发现训练中存在的问题,分析原因,并总结分类后送组对批量伤病员快速检伤分类的流程和方法,针对不足提出一些思考与建议,以期为卫勤训练提供参考.

To sum up and discuss the nursing personnel participating in the Sino US joint disaster medical rescue drill. In the exercise, the two sides participated in nursing personnel mixed grouping, participated in water rescue, ruins search and other aspects of treatment drills. During the exercise, we have enhanced the cooperation ability of both military and nursing personnel participating in international humanitarian assistance and disaster re-duction. At the same time, we should learn the advanced military medical care support mode and the training mechanism of military nursing personnel through exercises. In the mixed exercises between the two militaries, there are differences in the modes of health care support between Chinese and American nurses, the attendance of the nurses in this international rescue drill has been well accomplished, but there are still deficiencies, and it is neces-sary to continuously improve the overall quality of nursing staff.