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 systematically evaluate the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.Methods Databases such as PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang Data,CBM,and VIP were searched for randomized controlled trials(RCTs)related to the efficacy and safety of ciprofol for sedation and anesthesia outside the operating room.The search covered all publications up to June 2023.Statistical analysis was performed using RevMan 5.4 software and Stata 15.0.Results Twelve RCTs were included,involving 2 192 patients,of which 1 154 were in the ciprofol group and 1 038 in the propofol group.Compared with the propofol group,the anesthesia induction time(MD=0.28 min,95％CI 0.08-0.47 min,P=0.006)and recovery time(MD=1.16 min,95％CI 0.44-1.87 min,P=0.001)were significantly longer in the ciprofol group,and the inci-dences of injection pain(OR=0.04,95％CI 0.02-0.06,P＜0.001),hypotension(OR=0.64,95％CI 0.49-0.83,P=0.0008),hypoxemia(OR=0.44,95％CI 0.21-0.91,P=0.03),and respirato-ry depression(OR=0.19,95％CI 0.11-0.32,P＜0.001)were significantly lower.There were no sta-tistically significant differences between the two groups in terms of sedation success rate,physician satisfac-tion,the difference in heart rate before and after anesthesia induction,incidence of body movement,brady-cardia,nausea and vomiting,and dizziness.Conclusion The anesthetic effect of cyclopofol and propofol is similar when used for anesthesia outside the operating room.Compared to propofol,ciprofol offers comparable anesthetic effects for sedation and anesthesia outside the operating room,with a lesser impact on respiratory function and more stable hemodynamics.Ciprofol also significantly lowers the incidence of adverse reactions such as injection pain,hypotension,hypoxemia,and respiratory depression.

Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive genetic disease caused by mutation of CYP27A1 gene. This article reported three cases with clinical phenotypes of CTX and CYP27A1 gene mutation and analyzed the pedigree with a literature review. All the three CTX cases had c.379C>T (p.Arg127Trp) missense mutation on exon 2 of CYP27A1 gene. They all had compound heterozygous mutation and two cases had new type of exon and intron compound mutation. This article enriched the types of CYP27A1 gene mutations in CTX patients. The primers of CYP27A1 gene should also cover more gene sequences including intron regions.

Objective:To report a case with frontotemporal dementia (FTD) characterized by involuntary laughter.Methods:The clinical manifestations and imaging characteristics of a patient diagnosed as FTD was analyzed. Then the results of cerebrospinal fluid, positron emission tomography-computed tomography (PET-CT) and single-photon emission computed tomography examinations were collected. Blood samples were tested for related genes of FTD.Results:The patient is a 66 years old woman with insidious onset and progressing symptoms and she was mainly manifested as laughing out loud involuntarily when looking at others, childishness, stubbornness, loss of interest, irritability and other personal changes. Mild motor and language disorders were also manifested as moving slowly and speaking unclearly. The magnetic resonance imaging showed the atrophy of bilateral frontal, temporal lobe and bilateral hippocampal while the image of PET-CT showed the metabolism was reduced in different degrees. Eventually, behavioural variant of FTD was diagnosed. The result of ANXA11 gene sequencing revealed the mutation of c.107C>G(p.P36R).Conclusions:This is the first case in which a heterozygous mutation of ANXA11 gene, which is related to amyotrophic lateral sclerosis (ALS), is found in simple FTD patient, suggesting that ANXA11 gene may play an important role in the pathogenesis of FTD. This further supports the theory that ALS and FTD are spectrum disorders.

Objective To investigate the influence of gravity levels on lower limb motions during human walking. Methods A suspended microgravity simulation system was designed for the experiment. Kinetic parameters from lower limb joints of twelve volunteers during walking were measured by the motion capture system and 3D force plate under simulated Mars gravity (1/3 G), lunar gravity (1/6 G) and earth gravity (1 G). Results Under simulated Mars and lunar gravity, the ranges of motion (ROMs) of hip and knee joints in sagittal plane significantly decreased (P＜0.01) while the ROMs of ankle joints obviously increased (P＜0.05). The ROMs of hip, knee and ankle joints in sagittal plane under earth gravity were 45.2°, 67.7°, 32.5°, respectively, while the ROMs of hip, knee and ankle joints under lunar gravity were 25.1°, 50.8°, 42.4°, respectively. In addition, the force and torque of lower limb joints in sagittal plane under lower gravity also decreased significantly (P＜0.01). Conclusions The results obtained by this study were almost the same as the research findings obtained by using treadmill. Astronauts can use the treadmill and microgravity simulation system for walking exercises under lunar gravity on the earth.

Clinical medicine is a practical, highly skilled natural science. Solid clinical skills are the cornerstone of medical students' growth and development. According to the change of medical education environment, the tension of doctor-patient relationship and the lack of practical ability, we build a set allround , systematic clinical practice teaching system based on practice curriculum teaching , centralized practice teaching, social practice teaching, practice skills assessment and practice skills competition. The research and practice of the system not only promotes teachers' and student's emphasis on the training of clinical practical skills but also improves student's clinical practice skills, strengthen teachers' clinical skills teaching ability, and boost the construction of clinical skills experimental center.

OBJECTIVE:To study the protective effects of Polygonum hydropiper extract on acute gastric mucosal lesion (AGML)in rats. METHODS:48 rats were randomly divided into normal group(normal saline),model group(normal saline), positive group(ranitidine hydrochloride,0.05 g/kg),P. hydropiper extract low-dose,medium-dose and high-dose groups(2.7, 8.1,24.3 g/kg by crude drug),i.g. for consecutive 7 d,once a day. Except for normal group,other groups were given absolute ethyl alcohol to induce AGMI model after 1 h of last administration. 1.5 h after modeling,gastric mucosal lesion index of rats was calculated;the pathological changes of gastric tissue in rats were observed;nuclear factor E2 related factor 2(Nrf2)content and SOD activity in gastric tissue of rats were determined by ELISA. RESULTS:Compared with normal group,the gastric mucosa of model group was damaged obviously,there was blood capillary rupture in submucosa,gastric mucosal lesion index was increased significantly(P<0.01);Nrf2 content and SOD activity were significantly decreased in gastric tissue of rats(P<0.05 or P<0.01). Compared with model group,gastric mucosal lesion of rats was relieved to different extent;in positive group,P. hydropiper extract medium-dose and high-dose groups,gastric mucosal lesion index was decreased significantly(P<0.05),and Nrf2 content and SOD activity were increased significantly(P<0.05 or P<0.01). CONCLUSIONS:P. hydropiper extract has good protective effect on absolute ethyl alcohol-induce AGMI,the mechanism of which may be associated with raising Nrf2 content and enhancing SOD activity in gastric mucosal tissue.

Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang.There were 3 542 samples collected,based on the International Diabetes Federation(IDF)standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed,and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic(ROC)curve.Results According to IDF standard,the waist circumference(85 cm for men,82 cm for women)corresponded to the shortest distance in ROC curve,at these cut-offs of abdominal obesity for component of metabolic syndrome,the prevalences of metabolic syndrome were 21.3%,19.5%in men, while 23.0%in women,the prevalence of women was higher than that of men(P<0.05).The prevalences of≥1,≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly.Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level.The cut-off points of waist circumference(85 cm for men,82 cm for women)combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs.

Objective To investigate the expression and significance of miR?135a?5p in endometrial carcinoma and to correlate expression levels with clinicopathological features. Methods Fifty five endometrial carcinoma samples and thirty normal endometrial tissue samples were surgically obtained,and the expression of miR?135a?5p was quantitated by real?time polymerase chain reaction. The relationship between the expression level of miR?135a?5p and clinicopathological data of individual patients was analyzed. Results The expression of miR?135a?5p was lower in the endo?metrial carcinoma group than in the normal endometrial group(P=0.021),and correlated significantly with the histologic grade of the endometrial neoplasm(P=0.008). Conclusion The expression of miR?135a?5p is lower in endometrial carcinoma than in normal endometrial tissue. In en?dometrial carcinoma,the miR?135a?5p expression status has a statistically significant relationship with the histological characteristics of the tumor.