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 effect of inositol-requiring enzyme 1(IRE1)on cisplatin-induced ap-optosis of cochlear hair cells in mouse.Methods The cochlear basilar membranes of 500 healthy Kunming mice(3～5 days old)were isolated and cultured in vitro.After 24 hours,they were randomly divided into control group and cisplatin groups(4 μg/ml,8 μg/ml,16 μg/ml and 32 μg/ml),and cultured for another 24 hours.The loss of co-chlear hair cells was observed by fluorescein isothiocyanate(FITC)staining.The apoptosis of cochlear hair cells was observed by TRITC and Hoechst 33258 fluorescence staining.Western blot was used to detect the protein levels of p-IRE1α,p-JNK,Bax and caspase-3 in each group.Results Compared with control group,the hair cell loss and apoptosis rate of hair cells and the protein levels of p-IRE1α,p-JNK,Bax and caspase-3 were significantly increased in cisplatin groups(P＜0.01).Furthermore,the expression of p-IRE1α was positively correlated with the expres-sion of Bax and caspase-3 and with the apoptosis rate of hair cells(P＜0.05).Conclusion IREI may be involved in the regulation of cisplatin-induced apoptosis in cochlear hair cells.

In recent years, post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) have gradually attracted the attention of scholars as common stroke-related non-motor symptoms. As an emerging non-invasive neuroimaging tool, functional near-infrared spectroscopy (fNIRS) has been widely used in the study of neurological diseases, which can evaluate the functional status and recovery of these patients by monitoring changes in cerebral blood circulation and oxygenation signals; fNIRS is now being increasingly used in PSD and PSCI studies. This review mainly focuses on the research progress of fNIRS in identifying PSD and PSCI, exploring their neural mechanisms, and evaluating treatment effects, as well as advantages, disadvantages and future development prospects of fNIRS in clinical application, so as to provide some references for research on rehabilitation of affective disorders and cognitive disorders in stroke patients.

Objective To study the value of ultrasonography combined with serum Gastrin-17 in differenti-al diagnosis of abdominal IgA vasculitis in children.Methods A total of 80 children with IgA vasculitis admit-ted to the hospital from June 2020 to December 2022 were selected,including 45 cases of abdominal IgA vascu-litis(observation group)and 35 cases of other types of IgA vasculitis(without gastrointestinal symptoms,control group).The ultrasonographic characteristics and Gastrin-17 level of abdominal IgA vasculitis were an-alyzed,and the relationship between Gastrin-17 level and purpura symptom score was analyzed.Receiver oper-ating characteristic(ROC)curve was used to analyze the diagnostic value of ultrasonography and Gastrin-17 for abdominal IgA vasculitis in children.Results The symptom score of purpura in the observation group was significantly higher than that in the control group(P<0.001),while the serum Gastrin-17 level in the obser-vation group was significantly lower than that in the control group.Pearson correlation analysis showed that serum Gastrin-17 level was negatively correlated with purpura symptom score(r=-0.758,P<0.001).Ul-trasound images showed"doughnut"-like changes in the intestinal wall,with different degrees of central-thick-ness thickening and reduced echo,mainly submucosal thickening.ROC curve analysis showed that the cut-off value of serum Gastrin-17 in the diagnosis of abdominal IgA vasculitis in children was 2.91 pmol/L,the area under the curve was 0.787(95%CI:0.685-0.888),the sensitivity and the specificity were 75.56%(34/45)and 74.29%(26/35),respectively.The sensitivity of ultrasound combined with Gastrin-17 in the diagnosis of abdominal IgA vasculitis in children was 97.78%(44/45),the negative prediction rate was 95.65%(22/23),and the accuracy rate was 82.50%(66/80),which was significantly higher than those of single diagnosis(P<0.05).Conclusion Serum Gastrin-17 level is low in children with abdominal IgA vasculitis,and ultrasound imaging shows"doughnut"-like changes in the intestinal wall and thickening of the submucosa.Combined de-tection of the two could effectively differentially diagnose abdominal IgA vasculitis in children.

Burkitt lymphoma is a highly aggressive B-cell lymphoma and the fastest proliferating human malignant tumor.If the disease is found in the early stage,the patient could have a high possibility to be cured successfully,whereas the prognosis is poor in the late stage.Burkitt lymphoma can occur in children and adults,and it is categorized as local(Africa),sporadic,and immunodeficiency associated type.Sporadic Burkitt lymphoma mainly affects children and ado-lescents,and the most common initial sites are abdominal organs and lymph nodes.Sporadic Burkitt lymphoma manifested by initial oral and maxillofacial lesions is rela-tively rare.Here,a case of pediatric sporadic Burkitt lym-phoma,with oral and maxillofacial lesions as the first symptoms,was reported.The patient was treated in the Department of Periodontology,Shandong University School and Hospital of Stomatology.After timely checkup was pro-vided,the patient was transferred to another hospital and had good results.In this article,an incidence of Burkitt lympho-ma,with oral and maxillofacial lesions as the first symptom,was reviewed to provide reference for oral clinicians to achieve early diagnosis and treatment of patients with Burkitt lymphoma with oral diseases and improve the success rate of treatment.

White matter hyperintensities (WMHs) were once thought to be a normal aging phenomenon. However, the available evidences suggest that WMHs are an indicator of poor brain and cardiovascular health, indicating an increased risk of ischemic stroke, cognitive impairment, depression, and death. This article reviews the effects and mechanisms of physical activity and exercise on WMHs, so as to provide a basis for better prevention of WMHs.

Objective:To learn about the operation of fluoride reduction and water improvement projects, the current situation of water fluoride level and the changing trend of fluorosis in drinking water-borne endemic fluorosis areas in Shaanxi Province, and to evaluate the effect of prevention and control measures.Methods:From March 2014 to December 2021, 15 endemic villages in drinking water-borne endemic fluorosis areas of Dali, Dingbian, Jingbian, Jingyang and Liquan counties in Shaanxi Province were selected as monitoring villages to investigate the operation of water improvement projects. Water samples were collected, and the water fluoride level was detected according to the "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006). "Diagnosis of Dental Fluorosis" (WS/T 208-2011) was done to detect dental fluorosis in all children aged 8 - 12 who were born and lived in the monitoring village. Using "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2008) and "Determination of Fluoride in Urine - Ion Selective Electrode Method" (WS/T 89-2015), X-ray examination and urine fluoride level test were performed on adults over 25 years old who had lived in the monitoring village for more than 5 years, respectively.Results:From 2014 to 2021, a total of 122 water improvement projects were investigated, all of which were in normal operation. The qualified rate of water fluoride increased from 81.25% (13/16) in 2014 to 100.00% (11/11) in 2021. A total of 5 595 children aged 8 - 12 were examined, 1 790 children with dental fluorosis were detected, with a detection rate of 31.99%. The detection rate of dental fluorosis in children decreased from 52.05% (304/584) in 2014 to 9.68% (93/961) in 2021, showing an overall downward trend (χ 2trend = 533.76, P < 0.001). In 2014, 791 adults were examined, and 256 patients with skeletal fluorosis were detected, the detection rate was 32.36%. In 2019, 770 adults were examined, and 88 patients with skeletal fluorosis were detected, with a detection rate of 11.43%. The detection rate of skeletal fluorosis in adults in 2019 was lower than that in 2014, and the difference was statistically significant (χ 2 = 99.54, P < 0.001). In 2014, 754 adult urine samples were collected, and the geometric mean of urine fluoride was 2.571 mg/L. In 2019, 770 adult urine samples were collected, and the geometric mean of urine fluoride was 1.292 mg/L. The geometric mean of urine fluoride in adults in 2019 was lower than that in 2014, and the difference was statistically significant ( Z = - 12.74, P < 0.001). Conclusions:From 2014 to 2021, the water improvement projects in drinking water-borne endemic fluorosis areas in Shaanxi Province are running normally, and the qualified rate of water fluoride has increased. The incidence of dental fluorosis in children and skeletal fluorosis in adults has decreased. In the later stage, it is necessary to continuously strengthen the monitoring and management of water improvement projects to prevent the rebound of water fluoride from causing residents' illness.

Objective:To develop a short-term prognostic model of spontaneous cerebral hemorrhage based on eXtreme Gradient Boosting (XGBoost) machine learning, and to compare its predictive performance with a Logistic regression model.Methods:Patients with sICH admitted to Department of Neurology, Second People's Hospital of Hefei from January 2018 to March 2022 were chosen; their general demographic characteristics, medical history, laboratory indices and cranial imaging data were retrospectively collected. The prognoses of patients 90 d after discharge were evaluated according to modified Rankin Scale (mRS) scores (good prognosis: mRS scores<3; poor prognosis: mRS scores≥3). XGboost and multiple Logistic regression models were used to screen out the factors for prognoses of patients 90 d after discharge, and area under receiver operating characteristic (ROC) curves, sensitivity, specificity and prediction accuracy of the 2 models were analyzed and compared.Results:A total of 413 patients with sICH were included; 180 patients(43.6 %) had poor prognosis and 233 (56.4%) had good prognosis 90 d after discharge. Multivariate Logistic regression results showed that age≥65 years, hemorrhage into the ventricle, hematoma volume of 20-40 mL, hematoma volume>40 mL and National Institutes of Health Stroke Scale (NIHSS) scores were independent influencing factors for short-term prognoses of sICH ( P<0.05). The variables in the XGBoost model were ranked in order of importance: NIHSS scores, systolic blood pressure at admission, Glasgow coma scale (GCS) scores, age≥65 years, hemorrhage into the ventricle, hematoma volume of 20-40 mL, and hematoma volume>40 mL. AUC of XGBoost model in predicting the prognosis was 0.895 (95% CI: 0.820-0.947), enjoying sensitivity of 68.89%, specificity of 94.83%, and prediction accuracy of 83.5%. AUC of Logistic regression model in predicting the prognosis was 0.894 (95% CI: 0.818-0.946), enjoying sensitivity of 93.33%, specificity of 70.69%, and prediction accuracy of 80.58%. Conclusion:The short-term prognostic model based on XGboost for sICH patients has high predictive efficacy, whose predictive accuracy is better than traditional Logistic regression.

Objective:To investigate the experience and perception of general practice residents on standardized training based on stratified progressive teaching model.Methods:From January to April 2022, focus group interviews were conducted among general practice residents who received standardized training at Peking University First Hospital.Results:Seventeen residents were selected by the purpose sampling method in the study, including 7 males and 10 females aged 24-39 years. Four themes were extracted from the interviews: lower levels of basic knowledge and feeling pressure at clinical work felt by junior residents; lack of clinical research ability and systematic training felt by senior residents; the rotation form and teaching contents were mono in grassroots practice bases; desire of raising salary levels for residents.Conclusions:In order to upgrade the quality of general practice residency training, it is necessary to strengthen the knowledge, skill training and research ability training of general practice residents, improve their treatment, and perfect the standardized training program accordingly.

Stroke is a cerebrovascular disease that damages brain tissue due to blockage or rupture of blood vessels, and is one of the leading causes of death and disability worldwide. Diagnosing, monitoring stroke and the treatment effects all rely on neuroimaging that detects changes in the brain. Near-infrared spectroscopy (NIRS) is a novel neuroimaging technique which is based on the non-invasively measuring of concentration changes of oxyhemoglobin and reduced hemoglobin. This review summarizes the underlying mechanisms of NIRS and its current clinical application in stroke, as well as the limitations of NIRS in broader clinical applications.