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 evaluate the effect of applying function-related grouping model of Changsha medical insurance for patients convalescing from a cerebral infarction using the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS).Methods:Ninety cerebral infarction patients in convalescence were treated according to their functional status, including clinical treatment, rehabilitation, traditional Chinese medicine treatment, and rehabilitation nursing. Within 3 days after admission and at the time of discharge, they were evaluated using a comprehensive assessment system for cerebral infarction based on the ICF-RS. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA), the mini-mental state examination (MMSE) and the Boston diagnostic aphasia examination (BDAE) were also employed.Results:With the exception of ICF-RS item b280 (pain perception) and item x005 of the MAS, all of the remaining assessments indicated significant enhancements compared to the pre-treatment levels. Functional severity grading also improved significantly after the treatment. Thirteen of the ICF-RS categories indicated more favorable therapeutic outcomes after the treatment. That was accompanied by improvements in the FMA upper limb, lower limb and total scores, and in the MMSE scores. However, no significant disparity was detected in the MAS scores or the BDAE grades before and after treatment.Conclusions:The comprehensive evaluation system based on the ICF-RS effectively evaluates the effectiveness of rehabilitation after cerebral infarction in a way suitable for medical insurance purposes.

Objective:To analyze the imaging features of primary leiomyosarcoma of the inferior vena cava (PLV).Methods:This study was a case series analysis. The clinical and imaging data of 17 patients with PLV confirmed by pathology who underwent CT, MRI and/or PET-CT examinations in the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2012 to September 2022 were retrospectively collected. The CT or MRI findings, including the number, location, size, shape, margin, density (signal), enhancement characteristics, surrounding invasion, and metastasis of the lesion were analyzed.Results:Among the 17 cases there were 7 males and 10 females, aged 32 to 78 years. All patients had single tumors, the maximum diameter of the mass was 3.8 to 19.0 cm, and in 12 cases it was consistent with the inferior venacava.There were 11 cases of "petal-like" necrosis cystic lesion, and 6 cases of "fissure" necrosis cystic lesion. Collateral circulation was found around the mass in 15 cases. There were 3 cases of intraluminal type, 2 cases of extraluminal type, and 12 cases of junctional type. The tumors of intraluminal type presented as "worm-like" appearance, while the extraluminal and junctional type tumors presented as lobulated shape, with local "umbilical depression sign". The margins were clear in 3 cases and unclear in 14 cases. Vascular invasion by the mass was observed in 7 cases. On CT plain scan, the solid component of PLV presented as isodense or slightly hypodense. On MRI T1-weighted images, the solid component presented as isodense or slightly hypodense, and on fat-suppressed T2-weighted images, it presented as isodense or slightly hyperdense. On MRI diffusion-weighted imaging, 12 cases showed high signal intensity, and the corresponding apparent diffusion coefficient map showed low signal intensity. On CT enhanced scan, 8 cases showed mild to moderate enhancement of the solid part of PLV in the arterial phase and 9 cases showed obvious enhancement. In the venous phase and delayed phase, 10 cases showed continuous enhancement and 7 cases showed progressive enhancement. On MRI enhanced scan, 8 cases showed moderate enhancement and 6 cases showed obvious enhancement of the solid part of PLV in the arterial phase. In the venous phase and delayed phase, continuous progressive enhancement was observed; no enhancement was seen in the necrotic and cystic areas.Conclusion:The imaging characteristics of PLV show that the maximum diameter of the masses are consistent with the direction of inferior vena cava, most masses exhibit a "petal-like" necrotic cyst morphology with collateral circulation, and a localized "umbilical concave sign", and some cases possess hemophilic tube features.

Objective To explore the frequency domain characteristics of pedestrian head dynamic response in vehicle collisions and investigate the correlation between frequency domain parameters and time domain injury criteria.Methods Finite element modelling based on human body model was used to simulate the process of pedestrian head-vehicle impacts,and the wavelet packet signal analysis method was employed to obtain the frequency domain response of pedestrian head in the simulations.Results The head energy under impacts at the bonnet area was mainly dispersed in the 0-300 Hz frequency band,while the head energy under impacts at the windshield area was mainly concentrated in the 0-5 Hz frequency band.The peak energy of frequency band for pedestrian head generally increased with the increase of linear and rotational speed,and the influence of rotational speed on the peak energy of frequency band was more significant when the linear speed was higher.The linear correlation R2 between the peak energy of the head frequency band caused by the collision between the bonnet and windshield area and the time-domain criterion for skull injury were 0.85 and 0.61,respectively.But their correlation with the time-domain indicators for brain injury evaluation was relatively low(R2＜0.5).Conclusions The frequency domain response characteristics of pedestrian heads are affected by collision speed and location.The peak energy of the frequency band can potentially characterize the risk of skull injury,but the frequency band and concentration of the peak energy in the frequency band are not related to the risk of head injury.This study can provide references for the evaluation of head blunt injury combined with time-frequency response.

Objective To investigate the preventive effects of lidocaine administered through different routes on cardiovascular stress responses during anesthesia tracheal intubation. Methods Total 120 patients scheduled for elective surgery under general anesthesia were randomly divided into three groups: intravenous injection group （group IV）, throat spray group （group LJ）, and control group （group CT）, with 40 patients in each. Group IV received 50 mg of lidocaine via intravenous injection 1 minute before tracheal intubation. Group LJ received 50 mg of lidocaine sprayed into the pharyngeal cavity, glottis, and subglottic area. Group CT did not receive any treatment, and the remaining procedures were performed following the routine general anesthesia induction protocol. Heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and mean arterial pressure （MAP） were recorded at four time points: T₀ （before tracheal intubation）, T₁ （immediately after tracheal intubation）, T₂ （3 minutes after intubation）, and T₃ （5 minutes after intubation）. Statistical analysis of the data was performed using SPSS 22.0. Results There were no significant differences in HR at various time points within the group LJ. The changes in HR in the group IV and group CT were different statistically from those in the throat spray group. The blood pressure of patients in all three groups increased to varying degrees immediately after tracheal intubation, with the group CT showing particularly significant changes that differed significantly from both the group IV and the group LJ. The group LJ rapidly returned to levels close to those before intubation. Conclusion The preventive effects of lidocaine on stress responses during tracheal intubation were different depending on the route of administration. The inhibitory preventive effect of the throat spray method was superior to that of intravenous lidocaine, especially in preventing changes in heart rate.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Objective To investigate the impact of immunohistochemical detection of omentin-1(omentin-1),secreted phosphoprotein 1(SPP1),and mismatch repair(MMR)protein expression status on the clinicopathological characteristics and prognosis of endometrial cancer(EC),in order to provide references for disease assessment,prognosis evaluation,and the development of molecular targeted therapies.Methods A total of 159 patients diagnosed with EC who were admitted to our hospital between December 2019 and December 2021 were enrolled as the study group.Additionally,152 samples of normal endometrial tissue were collected from patients undergoing hysterectomy due to benign uterine diseases and served as the control group.The expression levels of omentin-1,SPP1,and MMR proteins in endometrial tissues were compared among the study group,the control group,and EC patients with different clinicopathological characteristics and prognostic outcomes.Spearman correlation analysis was performed to evaluate the correlations among these biomarkers in EC tissues.The influencing factors of EC prognosis were analyzed through multivariate logistic regression.Kaplan-Meier survival curves were constructed to assess the association between the expression of these proteins and patient prognosis.Results The positive expression rate of SPP1 and the MMR deletion rate in endometrial tissues of the study group were significantly higher than those in the control group(P<0.05),while the positive expression rate of omentin-1 in endometrial tissues was significantly lower than that in the control group(P<0.05).In patients with EC exhibiting myometrial invasion≥1/2,the proportion of omentin-1 negativity was lower compared to omentin-1 positivity(P<0.05).Among EC patients with poorly differentiated tumors,the rates of SPP1 positivity and MMR deficiency were significantly increased(P<0.05).Spearman correlation analysis revealed that omentin-1 expression was negatively correlated with both MMR protein deletion and SPP1 overexpres-sion(P<0.05),whereas MMR deficiency was positively correlated with SPP1 overexpression(P<0.05).In the poor prognosis group,the positive expression rate of SPP1 and the deletion rate of MMR were elevated,while omentin-1 expression was reduced in endometrial tissues(P<0.05).The results of multivariate logistic analysis showed that omentin-1 negative,SPP1 positive,and MMR deletion were risk factors for the prognosis of EC patients(P<0.05).Kaplan-Meier survival curves were constructed based on follow-up data(Figures 1-3),indicating that patients with omentin-1 negativity,SPP1 positivity,and MMR deficiency had significantly worse prognoses(P<0.05).Conclusions With the development and progression of the clinicopathological features of EC,abnormalities were observed in the immunohistochemical expression of omentin-1,SPP1,and MMR proteins.Specifically,omentin-1 negativity,SPP1 positivity,and MMR protein deletion were associated with a poorer prognosis in EC patients.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Objective:To summarize the best available evidence for exercise interventions in patients with systemic lupus erythematosus (SLE) .Methods:The PIPOST model from the Joanna Briggs Institute (JBI) Centre for Evidence-Based Healthcare in Australia was used to construct the evidence-based nursing question. A top-down approach based on the "6S" evidence pyramid model was employed to search for relevant evidence, including clinical guidelines, consensus statements, systematic reviews, best practices, and evidence summaries. The search was conducted across BMJ Best Practice, UpToDate, guideline repositories, professional association websites, and Chinese and international databases. Eligible literature was screened for quality assessment, and high-quality evidence was extracted. The search timeframe covered publications from database inception to June 15, 2024.Results:A total of 15 studies were included, comprising 1 clinical decision-making article, 3 guidelines, 6 systematic reviews, and 5 randomized controlled trials. A total of 25 evidence statements were synthesized across 6 key aspects: exercise principles, exercise assessment, exercise modalities, exercise intensity, exercise frequency and duration, and exercise monitoring.Conclusions:The best evidence summarized in this study provides a valuable reference for clinical healthcare professionals implementing exercise interventions for patients with systemic lupus erythematosus.

Objective To investigate the impact of immunohistochemical detection of omentin-1(omentin-1),secreted phosphoprotein 1(SPP1),and mismatch repair(MMR)protein expression status on the clinicopathological characteristics and prognosis of endometrial cancer(EC),in order to provide references for disease assessment,prognosis evaluation,and the development of molecular targeted therapies.Methods A total of 159 patients diagnosed with EC who were admitted to our hospital between December 2019 and December 2021 were enrolled as the study group.Additionally,152 samples of normal endometrial tissue were collected from patients undergoing hysterectomy due to benign uterine diseases and served as the control group.The expression levels of omentin-1,SPP1,and MMR proteins in endometrial tissues were compared among the study group,the control group,and EC patients with different clinicopathological characteristics and prognostic outcomes.Spearman correlation analysis was performed to evaluate the correlations among these biomarkers in EC tissues.The influencing factors of EC prognosis were analyzed through multivariate logistic regression.Kaplan-Meier survival curves were constructed to assess the association between the expression of these proteins and patient prognosis.Results The positive expression rate of SPP1 and the MMR deletion rate in endometrial tissues of the study group were significantly higher than those in the control group(P<0.05),while the positive expression rate of omentin-1 in endometrial tissues was significantly lower than that in the control group(P<0.05).In patients with EC exhibiting myometrial invasion≥1/2,the proportion of omentin-1 negativity was lower compared to omentin-1 positivity(P<0.05).Among EC patients with poorly differentiated tumors,the rates of SPP1 positivity and MMR deficiency were significantly increased(P<0.05).Spearman correlation analysis revealed that omentin-1 expression was negatively correlated with both MMR protein deletion and SPP1 overexpres-sion(P<0.05),whereas MMR deficiency was positively correlated with SPP1 overexpression(P<0.05).In the poor prognosis group,the positive expression rate of SPP1 and the deletion rate of MMR were elevated,while omentin-1 expression was reduced in endometrial tissues(P<0.05).The results of multivariate logistic analysis showed that omentin-1 negative,SPP1 positive,and MMR deletion were risk factors for the prognosis of EC patients(P<0.05).Kaplan-Meier survival curves were constructed based on follow-up data(Figures 1-3),indicating that patients with omentin-1 negativity,SPP1 positivity,and MMR deficiency had significantly worse prognoses(P<0.05).Conclusions With the development and progression of the clinicopathological features of EC,abnormalities were observed in the immunohistochemical expression of omentin-1,SPP1,and MMR proteins.Specifically,omentin-1 negativity,SPP1 positivity,and MMR protein deletion were associated with a poorer prognosis in EC patients.