Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

The key pathogenesis of coronary heart disease （CHD） is spleen deficiency and phlegm stasis， and dysfunctional high-density lipoprotein （dys-HDL） may be the biological basis for the occurrence of CHD due to spleen deficiency and phlegm stasis. Considering the biological properties and effects of high-density lipoprotein （HDL）， it is believed that the structure and components of HDL are abnormal in the state of spleen deficiency which led to dys-HDL； and dys-HDL contributes to the formation of atherosclerotic plaques through two major pathways， namely， mediating the dysfunction of endothelial cells and mediating the foaminess of macrophages and smooth muscle cells， thus triggering the development of CHD. It is also believed that dys-HDL is a microcosmic manifestation and a pathological product of spleen deficiency， and spleen deficiency makes foundation for the production of dys-HDL； dys-HDL is also an important biological basis for the phlegm-stasis interactions in CHD. The method of fortifying spleen， resolving phlegm， and dispelling stasis， is proposed as an important principle in the treatment of CHD by traditional Chinese medicine， which can achieve the therapeutic purpose by affecting the changes in the structure and components of dys-HDL， thus revealing the scientific connotation of this method， and providing ideas for the diagnosis and treatment of CHD by traditional Chinese medicine.

OBJECTIVE: To quantify the purine concentrations of the acupoints along the pericardium and nonpericardium meridians under healthy and myocardial ischemia conditions to investigate the relationship between acupoint purine change and body functional status in rats. METHODS: A total of 70 rats underwent an operation for myocardial ischemia, while 40 of them survived. They were randomly assigned to the following 5 subgroups: Neiguan (PC 6), Quze (PC 3), Tianquan (PC 2), Quchi (LI 11), and Jianyu (LI 15). Simultaneously, another 40 healthy rats were also randomized into the same 5 subgroups as the control group. The tissue fluids at the acupoints were collected by microdialysis for 30 min. Subsequently, the concentration of adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), and adenosine (ADO) were quantified using the high-performance liquid chromatography method. RESULTS: Compared with the healthy group, the ADO at PC 6 (P=0.012), PC 3 (P=0.038), PC 2 (P=0.024), and LI 15 (P=0.042) obviously increased in the model group, while no significant difference was observed at LI 11 (P=0.201). However, ATP, ADP, and AMP manifested no significant changes in these areas, except for ATP at LI 15 (P=0.036). CONCLUSIONS Myocardial ischemia could induce an increase in ADO at acupoints of the upper arm and shoulder area, suggesting that the body functional status could affect the responsiveness of acupoints. The status of these acupoints could be pathogenically activated by disease, and distribution following some specific courses.

OBJECTIVETo investigate the effect of premature rupture of the membrane (PROM) on neonatal complications in premature infants.

METHODSThe registration information of 7684 preterm infants with gestational age <37 weeks were collected from the cooperative units in the task group between January 1, 2014 to December 31, 2014. Specially trained personnel from each cooperative units filled in the unified form in a standardized format to record the gender, gestational age, birth weight, PROM, placental abruption, antenatal corticosteroid, Apgar score, amniotic fluid pollution, and complications of the infants. The data were analyzed comparatively between the cases with PROM and those without (control).

RESULTSThe preterm mortality rate was significantly lower but the incidences of ICH, NEC, ROP and BPD were significantly higher in PROM group than in the control group (P<0.05). The 95% confidence interval of the OR value was <1 for mortality, and was >1 for ICH, NEC, ROP and BPD. After adjustment for gestational age, birth weight, gender, mode of delivery, placental abruption, placenta previa, prenatal hormones, gestational diabetes mellitus (GDM), gestational period hypertension and 5-min Apgar score <7, the incidences of NEC, ROP and BPD were significantly different between the two groups (P<0.05) with 95% confidence interval of OR value >1, but the mortality rate and incidence of ICH were not significantly different between the two groups (P>0.05).

CONCLUSIONPROM is a risk factor for NEC, ROP and BPD in preterm infants, and adequate intervention of PROM can reduce the incidences of such complications as NEC, ROP and BPD in the infants.

Apgar Score ; Birth Weight ; Female ; Fetal Membranes, Premature Rupture ; pathology ; Gestational Age ; Humans ; Incidence ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Infant, Premature ; Pregnancy ; Risk Factors

With the universal two-child policy implementation, the birth rate increased, posing challenges to pediatrician allocation. Based on the birth rate, we calculated pediatrician demands and gaps during the period from 2016 to 2020 by the method of health service demand. The results showed that except Beijing and Shanghai, the ped-iatrician supply and demand ratios are less than 0 . 80 and additional numbers of pediatricians ranging from 191 981 to 198 287 are needed to meet the service demands. We recommend increasing the number of pediatricians taking both national supply-demand ratios and gaps by rationally using reasonable enrolment quota and improving the treatment and other reasonable ways to increase pediatricians. In addition, we should enhance information disclosure and guid-ance, and improve the hierarchical hospital visit system to alleviate the pressure of big cities.

With the universal two-child policy implementation, the birth rate increased, posing challenges to the maternity beds resource allocation. Based on the birth rate and the method of health service demand, we calculat-ed the maternity beds demands and gaps during the period from 2016 to 2020 . Results showed that numbers between 73 478 and 99 004 of maternity beds are needed annually and mainly allocated to eastern and central areas as well. In addition, the maternity beds of different delivery institutions should be adjusted and the hierarchical diagnosis system should be improved in order to alleviate the pressure of the obstestric acceepts in big cities like Beijing and Shanghai.

Genome editing tools such as the clustered regularly interspaced short palindromic repeat (CRISPR)-associated system (Cas) have been widely used to modify genes in model systems including animal zygotes and human cells, and hold tremendous promise for both basic research and clinical applications. To date, a serious knowledge gap remains in our understanding of DNA repair mechanisms in human early embryos, and in the efficiency and potential off-target effects of using technologies such as CRISPR/Cas9 in human pre-implantation embryos. In this report, we used tripronuclear (3PN) zygotes to further investigate CRISPR/Cas9-mediated gene editing in human cells. We found that CRISPR/Cas9 could effectively cleave the endogenous β-globin gene (HBB). However, the efficiency of homologous recombination directed repair (HDR) of HBB was low and the edited embryos were mosaic. Off-target cleavage was also apparent in these 3PN zygotes as revealed by the T7E1 assay and whole-exome sequencing. Furthermore, the endogenous delta-globin gene (HBD), which is homologous to HBB, competed with exogenous donor oligos to act as the repair template, leading to untoward mutations. Our data also indicated that repair of the HBB locus in these embryos occurred preferentially through the non-crossover HDR pathway. Taken together, our work highlights the pressing need to further improve the fidelity and specificity of the CRISPR/Cas9 platform, a prerequisite for any clinical applications of CRSIPR/Cas9-mediated editing.
Blastocyst ; CRISPR-Cas Systems ; Hemoglobins, Abnormal ; genetics ; metabolism ; Humans ; Zygote

OBJECTIVETo study the efficacy and safety of Naoxintong capsule treatment of stroke recovery with Qi-deficiency and blood-stasis syndrome (cerebral infarction), and to compared the non-inferiority analysis with the positive drug Tongxinluo capsule.

METHODTaking Tongxinluo capsules as control, randomized, double-blind, controlled, multi-center clinical experiments were studied. The evaluating indexes included the decrease of integral value of stroke patients, changes in traditional Chinese medicine, the improvement of the patient viability status (disability level), Chinese stroke scale (CSS), activities of daily living (DAL) scale and barthel index (BI ) points.

RESULTThe total effect of the two groups, Chinese and other symptoms, showed no significant statistical significance.

CONCLUSIONNaoxintong capsule stroke recovery, with Qi-deficiency and blood-stasis syndrome (cerebral infarction) has a therapeutic effect, and more secure.

Activities of Daily Living ; Adult ; Aged ; Capsules ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Qi ; Stroke ; drug therapy ; Treatment Outcome

Objective To study the changes of anorectal motility and rectal sensation in the elderly patients with ulcerative colitis (UC). Methods The anorectal motility and rectal sensation were investigated by Medtronic PC-Polygraf HR made by Sweden in 35 non-elderly patients versus 19 elderly patients with UC, and 20 non-elderly healthy subjects (HS) and 28 elderly HS were as control group. Results (1) The static pressure, pressure of anal sphincter and the maximal squeeze pressure of anal sphincter in non-elderly patients and elderly patients with UC showed no significant differences compared with those in non-elderly HS and elderly HS group (elderly patients with uc vs. ederly HA:t= 1.311,1.298,1.401;nonederly patients with uc vs. nonederly HS: t=1.294,1.299,1.322all P＞0.05). When abdominal pressure was increased, the net increased pressure of anal sphincter was (2.8±1.1) kPa in the elderly patients with UC, (2.9±1.3) kPa in the non-elderly patients with UC. The pressures were lower in two UC groups than in HS groups [elderly HS group:(3.8±1.2) kPa; non-elderly HS group:(3.9±1.2) kPa,elderly patients with uc vs. ederly HS:t=2.238,nonelderly patients with us vs. nonederly HS:t=2.243 all P＜0.05]. (2)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance were (85±30) ml, (180±69) ml, (26. 5±8.8) ml/kpa in elderly patients with UC and (65±15) ml, (170±58) ml, (22.6± 10. 3) ml/kPa in non-elderly patients with UC. They were lower than in each HS group [elderly HS group (95±31) ml, (205±78) ml, (32.9±12.9) ml/kPa; non-elderly HS group:(78±38) ml, (190±50) ml, (30.8± 15.2) ml/kpa, all P＜0. 01]. (3)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance in elderly patients with UC were higher than in non-elderly patients with UC (elderly patients with uc vs. elderly HS:t=3. 121,3. 135,3.146,nonederly patients with uc vs. non elderly HS: t= 3.162, 3.141, 3.188 elderly patients with uc vs. nonelderly patients with uc: t = 2. 246,2. 239,2. 240 all P＜ 0. 05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance in elderly HS group were higher than in non-elderly HS group (ederly HS vs. t = 2. 328,2. 301 all P＜0. 05). Conclusions There are some anorectal motility disturbances in UC. Higher sensitivity, lower tolerance, lower compliance of rectum and weakened anal automatic control function in UC may be associated with diarrhea and frequent defecation. The rectal sensation threshold to volume stimulus is higher in elderly HS than in non-elderly HS group. The sensibility to volume ectasis of rectum is weakened and the survivability of rectum is increased in elderly patients with UC.

Objective To study the clinical and laboratory characteristics of adult Japanese encephalitis (JE) patiens in a JE outbreak in Yuncheng, Shanxi province in 2006. Methods All the clinical data from the Second People's Hospital in Yuneheng city were analyzed, part of patients' sera and cerebrospinal fluid were tested by serology and RT-PCR. Results The majority of patients were middle-aged and elderly, 77.8 % (35/45)of the total cases were more than 40 years old. Severe and fulminating type eases accounted for 60.0% (27/45) . Most patients had underlying diseases. IgM antibody to JE virus (JEV) in serum was positive in each of the 45 patients analyzed and 4-fold or greater rise in sera neutralization antibody titer were found in convalescent serum. JEV nucleic acid was positive in part of cerebrospinal fluid specimens. Conclusion Viral encephalitis emerged in Yuncheng city, Shanxi province was Japanese encephalitis B, and most of the eases belonged to elderly group.