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*

Objective To explore the efficacy of bilateral facial muscle training combined with visual electromyography biofeedback on facial nerve function recovery in patients with idiopathic facial nerve palsy. Methods Patients with idiopathic facial nerve palsy admitted to Shanghai Fifth People’s Hospital, Fudan University from July 2022 to July 2024 were selected and randomly divided into a control group and an intervention group. The control group received conventional physical factor therapy, while the intervention group received bilateral facial muscle training combined with visual electromyography biofeedback therapy based on the control group’s regimen. After 20 treatment sessions, the total effective rate, the House-Brackmann (H-B) facial nerve grading system, the Sunnybrook Facial Grading System (SFGS) score, and the average value ratio of maximal amplitudes of bilateral frontalis and zygomaticus muscles were compared between the two groups. Results A total of 90 patients were included, 45 in each group. After 20 treatment sessions, the total effective rate was significantly higher in the intervention group than in the control group (84.4% vs 75.6%, P＝0.003). Compared with the control group, the intervention group demonstrated a significantly lower H-B grade (P＝0.003) and a higher SFGS score (P＝0.001). The average value ratios of maximal amplitudes of the affected versus healthy side frontalis (P＝0.013) and zygomatic (P＝0.022) muscles were higher in the intervention group than in the control group. Conclusions Bilateral facial muscle training combined with visual electromyography biofeedback is an effective approach for treating idiopathic facial nerve palsy, effectively promoting the recovery of facial nerve function, and improving facial symmetry and facial muscle function.

Recent clinical studies have shown that mutation of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) gene in cancer cells may be associated with immunosuppressive tumor microenvironment (TME) and poor response to immune checkpoint blockade (ICB) therapy. Therefore, efficiently restoring PTEN gene expression in cancer cells is critical to improving the responding rate to ICB therapy. Here, we screened an adeno-associated virus (AAV) capsid for efficient PTEN gene delivery into B16F10 tumor cells. We demonstrated that intratumorally injected AAV6-PTEN successfully restored the tumor cell PTEN gene expression and effectively inhibited tumor progression by inducing tumor cell immunogenic cell death (ICD) and increasing immune cell infiltration. Moreover, we developed an anti-PD-1 loaded phospholipid-based phase separation gel (PPSG), which formed an in situ depot and sustainably release anti-PD-1 drugs within 42 days in vivo. In order to effectively inhibit the recurrence of melanoma, we further applied a triple therapy based on AAV6-PTEN, PPSG^@anti-PD-1 and CpG, and showed that this triple therapy strategy enhanced the synergistic antitumor immune effect and also induced robust immune memory, which completely rejected tumor recurrence. We anticipate that this triple therapy could be used as a new tumor combination therapy with stronger immune activation capacity and tumor inhibition efficacy.

Objective: To investigate the expression of INPP4B in gastric cancer and its relationship with clinicopathological features and prognosis. Methods: The expressions of INPP4B mRNA in fresh cancer tissues of 36 patients with gastric cancer and the paracancerous normal gastric mucosa tissues in the Affiliated Cancer Hospital of Shanxi Medical University between July 2014 and December 2014 were detected by using real-time quantitative polymerase chain reaction (RT-qPCR). The expressions of INPP4B protein and its downstream molecule phosphorylation AKT (p-AKT) in paraffin-embedded tumor tissues and the corresponding margin tissues of 49 gastric cancer patients between January 2010 and December 2010 were detected by using immunohistochemistry. The relationship between the expression of INPP4B and clinicopathological features and prognosis was analyzed. Results: RT-qPCR results showed that the expression level of INPP4B mRNA was 0.21±0.04 compared with adjacent cancer normal tissues (t = -2.208, P < 0.05). Immunohistochemistry showed that INPP4B protein was highly expressed in normal margin tissues and lowly expressed in tumor tissues. There was a statistical difference in the positive intensity score between the two groups (u = 4.70, P < 0.01). However, p-AKT protein was overexpressed in tumor tissues and underexpressed in normal margin tissues. There was a statistical difference in the positive intensity score between the two groups (u = 5.77, P < 0.01). The expression of INPP4B and p-AKT protein was negatively correlated (r = -0.644, P < 0.01). The positive expression rate of INPP4B protein in gastric cancer patients was 34.7% (17/49). There were no statistical differences of the positive expression rate of INPP4B protein in gender, age, pathological type, depth of invasion and lymph node metastasis (all P > 0.05). The median overall survival time of patients with INPP4B negative expression was 47 months, and that of patients with INPP4B positive expression was 48 months, and there was no statistical difference (P > 0.05). Conclusion The expression of INPP4B in gastric cancer tissue is low, which may play a role of tumor suppressor in the occurrence and development of gastric cancer by affecting the activity of AKT.

Objectives To compare clinical manifestations and electrophysiological features in patients with chron?ic inflammatory demyelinating polyneuropathy (CIDP) and Type-I Charcot Marie Tooth Disease (CMT-I) for guiding dif?ferential diagnosis. Methods Data including clinical manifestations and electrophysiological indexes was collected from thirty-one CIDP cases and 28 CMT-I cases. Correlation analysis was used to assess the association of the severity of electrophysiology with the severity of clinical symptoms. Results There were statistically significant differences in onset site, sensory dysfunction, foot deformity and cerebrospinal fluid protein between these two groups (P<0.05). There were significant differences in indexes of nerve conduction and needle electromyography between these two groups (P<0.05). The severity of clinical symptoms was not related with the severity of electrophysiology in CMT-I group (r=0.27,P>0.05). Conclusions Differential diagnoses of CIDP and CMT-I can be made based on clinical manifestations and electro?physiological features.

OBJECTIVE:To investigate the effects,prognosis and safery of recombinant human brain natriuretic peptide on the treatment of patients with acute decompensated heart failure. METHODS:90 inpatients with acute decompensated heart failure were divided into observation group and control group according to the use of recombinant human brain natriuretic peptide or not,with 45 cases in each group. Control group received rountine anti-heart failure therapy and intravenous dripping of Nitroglycerin injection at 20 μg/min continuously for 72 h. Observation group was additionally given Lyohilized recombinant human brain natriuretic peptide with initial loading amount of 1.5 μg/kg,iv,then intravenous dropping at 0.007 5 μg/(kg·min)continuously for 72 h,on the basis of control group. Hemodynamic parameters,brain natriuretic peptide level,the difference of liquid intake and output,dyspnea,lung rales,systemic edema,the improvement of cardiac function were observed and compared between 2 groups before and after treat-ment as well as re-hospitalization rate and surriral rate 30 d after medication,the occarrence of ADR. RESULTS:After treatment, left ventricular ejection fraction of observation group was significantly higher than that of control group,and central venous pressure and brain natriuretic peptide level were lower than those of control group,with statistically significance (P<0.05). The difference of liquid intake and output after treatment was (1 171.60 ± 444.80)ml in observation group and (822.30 ± 268.40)ml in control group,with statistical significance between 2 groups(P<0.05). After treatment,the scores of dyspnea,lung rales and systemic ede-ma were decreased in 2 groups;the improvement of observation group was significantly better than that of control group,with statis-tical significance(P<0.05). Total effective rates of observation group and control group were 95.56% and 82.22%;re-hospitaliza-tion rates 30 d after medication were 17.78%and 26.67%;survival rates 30 d after medication were 88.89%and 75.56%,with sta-tistical significance between 2 groups (P<0.05). There was no statistical significanse in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and heart function of patients with acute decompensated heart failure,and effectively relieve dyspnea,lung rales and systemic edema. It is better than routine treatment in prognosis with good safety.

BACKGROUND:Condylar fracture can occur under direct and indirect forces, and however, its risk and correlation with the impact site are rarely reported. OBJECTIVE:To quickly establish normal mandible three-dimensional finite element model and to analyze the strain conditions of the condyle under force at different parts of the mandible. METHODS: An adolescent volunteer was examined by multilayer spiral CT scans, whose mandible was normal and oral cavity was healthy. We used the reverse engineering software Mimics and large finite element software MSC.Patran to establish the three-dimensional finite element model of the mandible and to verify the feasibility of the model in the impact test at the body of the mandible, chin, mandibular angle and condyle. RESULTS AND CONCLUSION:A rapid establishment of mandible dimensional finite element biomechanical model could reproduce the morphology of the mandible, which was able to obtain the overal visual impression of the mandibular condyle. Geometric model included 80 044 nodes and 18 441 units. The mandibular chin, one side of the body, mandibular angle and condyle were given 100 N force respectively. The maximum equivalent stress of the bone cortex appeared in condylar region. So the mandibular condylar fractures were at the greatest risk. Experimental results contribute to mechanicaly analyze the condylar fracture type and to judge the severity of fractures.

OBJECTIVETo understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas.

METHODSEndoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded. 15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer. 95% CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions.

RESULTSThe compliance rate of screening endoscopy of this study was 49.36% (15 709/31 826) of all, and female's compliance (54.05%, 8 447/15 628) was much higher than that of male (44.83%, 7 262/16 198) (χ(2) = 88.14, P < 0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17% (302/7 246), 17.22% (1 248/7 246), 1.67% (121/7 246), 0.83% (60/7 246), and were higher than that of females (3.45% (290/8 417), 14.82% (1 247/8 417), 1.41% (119/8 417), 0.48% (40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018, < 0.001, 0.960, 0.006). The detection rates of all grades of precursor lesions increased with age rising (all P values < 0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69% (94/3 500), 8.11% (284/3 500), 0.40% (14/3 500), 0.14% (5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were < 0.001, < 0.001, < 0.001, 0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90% (504/10 287), 17.37% (1 787/10 287), 1.79% (184/1 0287), 0.60% (62/10 287) and 1.64% (88/5 376), 13.17% (708/5 376), 1.04% (56/5 376), 0.71% (38/5 376). The 95% CI of detection rates of various lesions were, 3.78% (3.48%-4.08%) for basal cell hyperplasia, 15.93% (15.37%-16.50%) for low-grade intraepithelial neoplasia, 12.31% (11.79%-12.82%) for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53% (1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64% (0.51%-0.76%) for esophageal squamous cell cancer, respectively.

CONCLUSIONUp to 21.88% residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.

Adult ; Age Distribution ; Aged ; Carcinoma, Squamous Cell ; epidemiology ; China ; epidemiology ; Endoscopy ; Esophageal Neoplasms ; epidemiology ; Female ; Humans ; Iodides ; Male ; Middle Aged ; Precancerous Conditions ; epidemiology ; Sex Distribution

Objective To understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas. Methods Endoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded.15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer.95%CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions. Results The compliance rate of screening endoscopy of this study was 49.36%(15 709/31 826) of all, and female's compliance (54.05%,8 447/15 628) was much higher than that of male(44.83%,7 262/16 198)(χ2=88.14, P<0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17%(302/7 246),17.22%(1 248/7 246),1.67%(121/7 246),0.83%(60/7 246),and were higher than that of females(3.45%(290/8 417),14.82%(1 247/8 417),1.41%(119/8 417),0.48%(40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018,<0.001,0.960,0.006) . The detection rates of all grades of precursor lesions increased with age rising(all P values <0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69%(94/3 500),8.11%(284/3 500),0.40%(14/3 500), 0.14%(5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were<0.001,<0.001,<0.001,0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90%(504/10 287),17.37%(1 787/10 287),1.79%(184/1 0287),0.60%(62/10 287) and 1.64%(88/5 376),13.17%(708/5 376),1.04%(56/5 376),0.71%(38/5 376).The 95%CI of detection rates of various lesions were, 3.78%(3.48%-4.08%) for basal cell hyperplasia, 15.93%(15.37%-16.50%) for low-grade intraepithelial neoplasia,12.31% (11.79%-12.82%)for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53%(1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64%(0.51%-0.76%) for esophageal squamous cell cancer, respectively. Conclusion Up to 21.88%residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.

Objective To understand the distribution of esophageal squamous cell cancer and precursor lesions in high-risk areas of China, and to provide evidence for determining the reference ranges of detection rates in high-risk areas. Methods Endoscopy with Lugol's iodine staining was performed on 15 709 local residents aged 40 to 69 years old in Linzhou of Henan province and Feicheng of Shandong province from 2005-2009. 35 cases without accurate pathology diagnosis and 11 cases with vital disease before screening were excluded.15 663 subjects were enrolled in this study. Compliance was calculated by the percentage of the people who had endoscopic screening among the target population. Chi-square test and trend chi-square test were used to compare the distribution differences in age, gender and areas of esophageal squamous cell cancer and precancer.95%CI of the detection rates was then employed to represent the reference ranges of esophageal squamous cell cancer and precursor lesions. Results The compliance rate of screening endoscopy of this study was 49.36%(15 709/31 826) of all, and female's compliance (54.05%,8 447/15 628) was much higher than that of male(44.83%,7 262/16 198)(χ2=88.14, P<0.001). The detection rates of basal cell hyperplasia, low grade intraepithelial neoplasia, high grade intraepithelial neoplasia and esophageal squamous cell cancer of males were 4.17%(302/7 246),17.22%(1 248/7 246),1.67%(121/7 246),0.83%(60/7 246),and were higher than that of females(3.45%(290/8 417),14.82%(1 247/8 417),1.41%(119/8 417),0.48%(40/8 417), respectively). Except for high-grade intraepithelial neoplasia, the detection rates of male were higher than that of female (P values were 0.018,<0.001,0.960,0.006) . The detection rates of all grades of precursor lesions increased with age rising(all P values <0.001), among which the detection rates of the mentioned four lesions for 40-44 years old were 2.69%(94/3 500),8.11%(284/3 500),0.40%(14/3 500), 0.14%(5/3 500), and that of 65-69 years old were 5.46% (46/843), 23.25% (196/843), 3.68% (31/843), 2.14% (18/843). The proportion of esophageal precursor lesion of Linzhou were higher than that of Feicheng observably except for esophageal squamous cell cancer (P values were<0.001,<0.001,<0.001,0.437). The detection rates of the four lesions of Linzhou and Feicheng were 4.90%(504/10 287),17.37%(1 787/10 287),1.79%(184/1 0287),0.60%(62/10 287) and 1.64%(88/5 376),13.17%(708/5 376),1.04%(56/5 376),0.71%(38/5 376).The 95%CI of detection rates of various lesions were, 3.78%(3.48%-4.08%) for basal cell hyperplasia, 15.93%(15.37%-16.50%) for low-grade intraepithelial neoplasia,12.31% (11.79%-12.82%)for mild dysplasia and 3.62% (3.33%-3.91%) for moderate hyperplasia, 1.53%(1.34%-1.72%) for high-grade intraepithelial neoplasia and 0.64%(0.51%-0.76%) for esophageal squamous cell cancer, respectively. Conclusion Up to 21.88%residents that were asymptomatic were suffered from esophageal squamous cancer or precursor lesions in high-risk areas in China. The distribution of esophageal squamous cell cancer and precursor lesions was closely related to the gender and the age, which suggested that males were supposed to be paid more attention to.