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 investigate the decoction use compliance of the children with the pediatric community acquired pneumonia(CAP) by providing the pharmaceutical care from the clinical pharmacist.Methods 252 patients with CAP were divided into the observation group and control group.The patients of the observation group were provided with pharmaceutical care,including drug use education,drug use guiding,etc,while the patients in the control group were not given any pharmaceutical care from the clinical pharmacist.Results The rate decoction use compliance in the observation group was 78.1％,which was 39.1％ in the control group,the difference between the two groups was significant (x2 =12.56,P ＜ 0.05).Conclusion Pharmaceutical care can improve the rate decoction use compliance decrease the drug waste.

Objective; To investigate the expression and distribution of IL-6 in periodontal tissues and the change of the alveolar bone of rats during orthodontic tooth movement, and to study the effects of orthodontic force on the periodontal tissue remodeling. Methods: SO gram orthodontic force was loaded on the left first maxillary molars of 25 rats in experimental group. Immunohistochem-istry and histomorphometric analysis were performed to measure the expression of IL-6 and the loss of alveolar bone at 0, 1, 3, 5, 7 " and 10 days after the application of orthodontic force. Results; The expression of IL-6 was observed to reach maximum level on day 3 and to decline thereafter in experimental group. No obvious alveolar bone loss was detected in the mesial side of the first molars. Conclusion; Although orthodontic force can evoke the local inflammatory response of periodontal tissue and the expression of pro-inflammation cytokines such as IL-6, it can not cause severe periodontal destruction and alveolar bone loss.

OBJECTIVETo summarise and analyse the experience and methods of managing the perioperative respiratory problems in patients with tumor of trachea or carina surgically treated during the last decade, and the ways of preventing severe postoperative respiratory complications in the future.

METHODSThirty-eight patients with tumor of trachea or carina surgically treated from 1991 to 2000 by different modes of tracheobronchial plastic surgery were retrospectively studied to summarise and analyse the changes in preoperative pulmonary function, postoperative complications and the management of perioperative respiratory problems.

RESULTSOut of 38 patients, 29 (76.3%) gave abnormal results to preoperative pulmonary function tests. 55.3% (21/38) of the whole series developed 45 postoperative complications with respiratory complications as the major one (80.0%). Seventeen patients who had undergone carinal pneumonectomy or carinal resection plus reconstruction gave far more complications (28 complications) than the remaining 21 patients treated by other modes of surgery (17 complications). Four patients died of postoperative complications with a mortality rate of 10.5%.

CONCLUSIONPatients treated with carinal pneumonectomy or carinal resection plus reconstruction give much more complications than patients treated by any other modes of large airway surgery. Fiberoptic bronchoscopic (FOB) guided intubation, precise surgical treatment, postoperative mechanical ventilation support, use of effective antibiotics and sufficient nutritional support are important for a successful management of these patients.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Perioperative Care ; Postoperative Complications ; Respiratory Function Tests ; Surgery, Plastic ; Tracheal Neoplasms ; surgery

OBJECTIVETo summarize surgical treatment of lung cancer patients with poor pulmonary function.

METHODSFrom 1991 to 1999, 181 lung cancer patients with poor pulmonary function underwent operation. The correlation between the results of preoperative pulmonary functional tests and the postoperative cardiopulmonary complications was analyzed by Chi-square test (chi(2)).

RESULTSIn 181 patients, pneumonectomy was done in 43, lobectomy in 118, partial lung resection in 16 and exploration in 4. The postoperative complication and mortality rates of the resection group were 42.3% (75/177) and 7.9% (14/177). The cardiopulmonary complication rates were 25.6%, 48.3%, 31.3% in pneumonectomy, lobectomy and partial lung resection. The morbidity and mortality rates of 8 patients who received preoperative chemotherapy and/or radiotherapy were 75.0% and 37.5%. The morbidity and mortality rates of 12 patients who had had a previous history of thoracotomy were 66.7% and 33.3%. In the present series, the 1-, 3- and 5-year survival rates were 71.1%, 42.2% and 31.1%. The 5-year survival rates of patients with stage I, II and III lesions were 55.0%, 25.0% and 0.

CONCLUSIONPreoperative spirometry is an important evaluation test for lung cancer patients with poor pulmonary function. It should be evaluated in combination with other pulmonary function tests such as CO(2) diffusion and cardiopulmonary excise tests, etc whenever possible. Patients with a history of thoracotomy, chemotherapy and radiotherapy should be carefully evaluated before operation to avoid high morbidity and mortality. Stage I and II lung cancer patients with poor pulmonary function can undergo operation if they have been well managed preoperatively and well taken care of with nursing care perioperatively.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms ; mortality ; physiopathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Respiratory Function Tests ; Spirometry