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*

Gene regulation relies on the precise binding of transcription factors (TFs) at regulatory elements, but simultaneously detecting hundreds of TFs on chromatin is challenging. We developed cFOOT-seq, a cytosine deaminase-based TF footprinting assay, for high-resolution, quantitative genome-wide assessment of TF binding in both open and closed chromatin regions, even with small cell numbers. By utilizing the dsDNA deaminase SsdAtox, cFOOT-seq converts accessible cytosines to uracil while preserving genomic integrity, making it compatible with techniques like ATAC-seq for sensitive and cost-effective detection of TF occupancy at the single-molecule and single-cell level. Our approach enables the delineation of TF footprints, quantification of occupancy, and examination of chromatin influences on TF binding. Notably, cFOOT-seq, combined with FootTrack analysis, enables de novo prediction of TF binding sites and tracking of TF occupancy dynamics. We demonstrate its application in capturing cell type-specific TFs, analyzing TF dynamics during reprogramming, and revealing TF dependencies on chromatin remodelers. Overall, cFOOT-seq represents a robust approach for investigating the genome-wide dynamics of TF occupancy and elucidating the cis-regulatory architecture underlying gene regulation.
Transcription Factors/genetics* ; Humans ; Chromatin/genetics* ; Animals ; Binding Sites ; Mice ; DNA Footprinting/methods*

Objective To observe the value of intratumoral and peritumoral radiomics features of apparent diffusion coefficient(ADC)for predicting prognosis of children with medulloblastoma(MB).Methods Data of 74 children with MB were retrospectively analyzed.The children were divided into progression group(n=29)or non-progression group(n=45)according to results of 2-year follow-up,also into training set(n=44)or validation set(n=30)at the ratio of 6∶4.The intratumoral and peritumoral radiomics features were extracted and screened based on ADC images.The intratumoral,peritumoralas well as intratumoral+peritumoral radiomics models were established,and 3 combination models were constructed combining with clinical and conventional imaging features.The predictive efficiency were compared between each 2 combination models.Results In training set,the area under the curve(AUC)of clinical-conventional imaging-peritumoral radiomics model and clinical-conventional imaging-intratumoral+peritumoral radiomics model were both larger than that of peritumoral radiomics models(both P＜0.05).In validation set,AUC of clinical-conventional imaging-intratumoral+peritumoral radiomics model was the largest,but no significant difference of AUC was found among 3 combination models(all P＞0.05).Conclusion The intratumoral and peritumoral ADC radiomics features could be used to predict prognosis of MB children.Combining with clinical and conventional imaging features might improve the efficiency of prediction.

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

ObjectiveTo observe the clinical course and explore the risk factors for SARS-CoV-2 RNA negative conversion duration （NCD） in asymptomatic and mild-symptomatic patients infected with the SARS-CoV-2 Omicron variant. MethodsClinical data were collected from 244 confirmed cases of corona virus disease （COVID-19） with Omicron variant infection admitted to a temporal makeshift hospital in Shanghai from April 9， 2022 to May 20， 2022. Demographic and clinical data were analyzed， with a primary focus on the time of COVID-19 nucleic acid conversion. Univariate and multivariate Cox regression analysis were used to determine identify risk factors associated with NCD. ResultsThe median duration of negative RNA conversion was 9 days （ranged 7‒12 days）. The percentage of patients with positive nucleic acid results on the 5th， 7th， 10th， and 14th days after confirmed infection was 68.4%， 47.1%， 20.1%， and 5.7%， respectively. Kaplan-Meier curves indicated a median nucleic acid conversion time of 12 days （ranged 10‒14 days） for patients with hypertension， 9 days （ranged 7‒11 days） in patients without hypertension， and 11 days （ranged 9‒13 days） for patients aged ≥60 years， and 9 days （ranged 7‒11 days） for patients aged <60 years. Multivariate Cox regression analysis showed that only hypertension was an independent risk factor of NCD （RR=1.60； 95% CI： 1.03‒2.49， P=0.036）. ConclusionIn asymptomatic or mildly symptomatic patients infected with the Omicron variant， 20.1% patients continue to exhibit positive viral nucleic acid on the 10^th days of infection. The independent risk factor associated with the conversion of SARS-CoV-2 nucleic acid to negative is hypertension.

Objective:To explore the dynamic temporal variability of brain functional networks in individuals with internet gaming disorder(IGD)using dynamic functional connectivity density(dFCD).Methods:From January 2019 to December 2021, resting-state functional magnetic resonance imaging data were recruited from 55 patients with IGD and demographically matched 50 healthy controls.Data analysis was performed by IBM SPSS 21.0 software. The functional connectivity density(FCD) combined with sliding window analysis was employed to calculate the temporal variability of global functional connectivity.FCD in whole brain was further devided into ipsilateral and cotralateral parts.The temporal variability of dFCD was further quantified utilizing the standard deviations of whole brain, intra-, and inter-hemispheric FCD. Finally, Pearson correlation analysis was performed between dFCD variance in differential brain regions and clinical behaviors.Results:The inter-hemispheric dFCD in the left posterior cingulate cortex(-0.16±0.24) and the left precuneus(-0.08±0.23) in patients with IGD were lower that those in healthy controls(0.002±0.260, 0.12±0.36)( t=-3.502, -4.160, both P<0.05).And the intra-hemispheric dFCD in the left calcarine, the left precuneus, and the left posterior cingulate cortex in patients with IGD were lower that those in healthy controls( t=-3.809, -4.360, -3.561, all P<0.05).Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC negatively correlated with the severity of IGD( r=-0.380, -0.413, both P<0.05). Conclusion:Patients with IGD show intra-and inter-hemispheric dFCD differences in the visual attention network and default mode network, which may respond to the underlying neurobiological basis for the presence of cognitive dysfunction and impaired concentration.

Fibroblast activation protein (FAP) is not only specifically expressed in cancer-associated fibroblasts (CAFs) of most neoplastic diseases, but also highly expressed in some diseases characterized by tissue remodeling. FAP inhibitors (FAPIs) PET can target the distribution of FAP in tissues and organs. Currently, 68Ga-FAPIs have played essential roles in the exploration, diagnosis, precise staging, targeted therapy, and clinical management of various malignant tumors. And 68Ga-FAPIs PET has shown the unique value and great potential in diagnosing and treating non-neoplastic diseases. This article aims to review the application and research progress of 68Ga-FAPIs in various non-neoplastic diseases such as cardiac imaging, immunoglobulin (Ig)G4-related disease, fibrosis, osteoarthropathy, and so on.

Objective:Fatigue is one of the common disabling non-motor symptoms of multiple system atrophy(MSA).This study aimed to investigate the prevalence of fatigue in MSA patients and its relationship with anxiety and depression.Methods:In this cross-sectional study, 44 MSA inpatients from Xuanwu Hospital of Capital Medical University were enrolled.Fatigue was defined as a Fatigue Severity Scale(FSS)score ≥4.The motor symptoms of the patients were evaluated using the Unified Parkinson's Disease Rating Scale(MDS-UPDRS)and Unified Multi-System Atrophy Rating Scale(UMSARS).The Hamilton Rating Scale for Depression(HAMD), Geriatric Depression Scale(GDS)and Hamilton Anxiety Scale(HAMA)were used to assess anxiety and depression.Results:The mean age of the MSA patients was 60.1±6.4 years, and the score of FSS was 4.3±2.4, with 28 patients(63.6%)having fatigue.Compared with the non-fatigue group, the fatigue group showed clear anxiety(HAMA: 16.5±8.9 vs.9.4±5.0, t=-2.292, P=0.010)and depression(HAMD: 14.4±7.0 vs.8.4±3.4, t=6.192, P=0.017; GDS: 18.2±7.4 vs.10.7±5.2, t=-3.560, P=0.044).The severity of fatigue in MSA patients was positively correlated with anxiety( r=0.516, P<0.001), depression(HAMD: r=0.551, P<0.001; GDS: r=0.636, P=0.000)and the score of activities of daily living( r=0.320, P=0.034), but not correlated with motor symptoms or disease severity. Conclusions:Nearly two-thirds of MSA patients have symptoms of fatigue, and fatigue is significantly associated with levels of anxiety and depression, affecting patients' mood and activities of daily living.

Objective:To study the correlation between zinc finger protein A20 (A20) and basic fibroblast growth factor (BFGF) and liver fibrosis in chronic hepatitis B.Methods:A retrospective study was conducted to select 120 patients with chronic hepatitis B diagnosed and treated in the Fifth Hospital of Shijiazhuang City from January 2019 to December 2020, all of whom underwent liver tissue biopsy, and 25 cases of liver pathological specimens who underwent liver hemangioma resection were selected. The correlation between the expression of A20 and BFGF in liver tissue and the stage of hepatic fibrosis and inflammation were analyzed.Results:The expression of A20 in the S1 - S4 phase was higher than that in the S0 phase: (6.12 ± 1.22)%, (10.18 ± 2.43)%, (16.94 ± 5.06)%, (25.99 ± 7.57)% vs. (0.81 ± 0.29)%; the expression of BFGF in the S1 - S4 phase was higher than that in the S0 phase: (6.12 ± 1.22)%, (10.18 ± 2.43)%, (16.94 ± 5.06)%, (25.99 ± 7.57)% vs. (0.81 ± 0.29)%, there were statistical differences ( P<0.05). The expression of A20 in the G1 - G4 phase was higher than that in the G0 phase: (6.56 ± 1.87)%, (10.01 ± 3.29)%, (15.54 ± 5.01)%, (25.86 ± 8.02)% vs. (0.85 ± 0.71)%; the expression of BFGF in the G1 - G4 phase was higher than that in the G0 phase: (5.91 ± 1.52)%, (9.65 ± 2.48)%, (15.03 ± 4.86)%, (24.62 ± 7.22)% vs. (0.79 ± 0.41)%, there were statistical differences ( P<0.05). The results of Pearson test showed that there was a positive correlation between liver A20 and BFGF ( r = 0.824, P<0.05). Conclusions:The expressions of A20 and BFGF in liver tissue increase with the aggravation of liver pathological fibrosis and inflammation, which can be used as important indicators to evaluate the severity of liver fibrosis.

Objective To investigate the impact of esketamine hydrochloride in combination with ultrasound-guided transverse thoracic muscle plane block on stress response and inflammatory levels in patients undergoing cardiac valve replacement under general anesthesia.Methods A total of 120 patients who underwent elective extra-corporeal circulation-supported median open heart valve replacement were selected and randomly assigned into four groups using the random number table method:general anesthesia alone(Group G),general anesthesia with intrave-nous administration of esketamine(Group E),general anesthesia with transverse thoracic plane block(Group T),and esketamine combined with transverse thoracic muscle plane block(Group ET);each group consisted of 30 cases.Patients in group E and group ET received a continuous infusion of esketamine hydrochloride injection at a rate of 0.2 mg/kg-1?h-1 until the completion of the surgical procedure,while patients in group G and group T received an equivalent volume of saline solution until the completion of the surgical procedure.After the induction of general anesthesia,patients in group T and group ET underwent ultrasound-guided bilateral transverse thoracic muscle plane block,while patients in group G and group E did not receive any specific intervention.All four groups received identical protocols for anesthesia induction and maintenance,with self-controlled intravenous analgesic pumps administered to all patients postoperatively.The following time points were recorded:1 day prior to surgery(T0),pre-induction of anesthesia(T1),1 minute post-tracheal intubation(T2),1 minute post-median sternotomy(T3),1 minute prior to initiation of cardiopulmonary circulation(T4),1 minute after cessation of cardiopulmonary circula-tion(T5),1 minute after completion of surgery(T6),1 day post-surgery(T7),2 days post-surgery(T8),and 3 days post-surgery(T9).Mean Arterial Pressure(MAP)and Heart Rate(HR)were continuously monitored from T1 to T6.The levels of blood glucose and lactate were measured and recorded at T1,T4 to T6.The levels of White Blood Cells(WBC)and C-Reactive Protein(CRP)were assessed at T0,as well as at T7 to T9.The occurrence of postoperative adverse reactions was documented in all four groups.Results(1)Comparison of hemodynamics among the four groups:Compared with group G,there was a significant decrease in MAP and HR at T3 in group T(P<0.05).At the T5 time point,MAP was lower in group ET compared to group E,while HR was higher in group ET compared to group T(P<0.05).(2)The lactate and blood glucose levels of the four patient groups after extracorporeal circulation transfer were higher than those at the T1 time point(P<0.05).Patients in group E had lower lactate values at the T5 time point and lower blood glucose values at the T6 time point compared to group G(P<0.05).Additionally,patients in group E exhibited lower lactate and blood glucose values at both the T5 and T6 time points compared to those in group T(P<0.05).(3)Compared to T0,the levels of white blood cells(WBC)and C-reactive protein(CRP)were increased in all four groups after surgery(P<0.05).At the T7 time point,the WBC levels in group E and group T were significantly lower than those in group G(P<0.05).Furthermore,compared to group E and group T,the level of WBC in group ET was significantly lower at T7,while the level of CRP was significantly lower at T8(P<0.05).(4)There were no significant differences observed in postoperative adverse reactions among the four groups(P>0.05).Conclusion Combining low-dose esketamine hydrochloride with transverse thoracic muscle plane block under general anesthesia during open heart valve replacement surgery can effectively stabilize the patient's hemodynamics,mitigate perioperative stress response and postoperative inflammation levels,thereby demonstrating significant clini-cal utility.