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 efficacy and safety of endoscopic ultrasound-guided selective varices devascularization (EUS-SVD) for the treatment of esophagogastric varices.Methods:A total of 43 cases of liver cirrhosis with esophageal and gastric varices at the First Affiliated Hospital of Anhui Medical University from February to December 2021 were included in a retrospective cohort study. The cases were divided into two treatment groups based on endoscopic treatment: EUS-SVD group ( n=22) and conventional endoscopic sclerosant injection group (conventional gastroscopy group, n=21). The doses of sclerosants and tissue glue, effective rate of esophageal varice treatment within 2 months after surgery, rebleeding rate within 3 months after surgery, and adverse reactions were compared. Results:The differences in terms of mean patient age, gender composition, etiology of liver cirrhosis, Child-Pugh classification of liver function, classification of esophageal varices, composition of endoscopic treatment indications, and mean maximum diameter of gastric varices were not statistically significant between the two groups ( P>0.05), indicating the comparability of baseline data. Perforating veins outside the gastric wall of gastric varices could be detected during the procedure in the EUS-SVD group, and disappearance of gastric varices after injection treatment could be determined, while these two indicators could not be detected in the conventional gastroscopy group. The amounts of sclerosing agents and tissue adhesives used in the EUS-SVD group were 7.54±3.10 mL and 1.30±0.57 mL, respectively, while the corresponding amounts in the conventional gastroscopy group were 7.57±3.50 mL ( t=0.026, P=0.980) and 1.38±0.67 mL ( t=-0.452, P=0.654), respectively. The effective treatment rate for esophageal varice within 2 months after surgery was 63.6% (14/22) in the EUS-SVD group and 52.4% (11/21) in the conventional gastroscopy group, but the difference was not statistically significant ( χ2=0.559, P=0.455). The rebleeding rate within 3 months after surgery was 4.5% (1/22) in the EUS-SVD group, significantly lower than the rate of 33.3% (7/21) in the conventional gastroscopy group ( P=0.021). Neither group experienced events of ectopic embolism or death. There was no statistically significant difference between the two groups in terms of postoperative pain, fever, nausea and vomiting, or rebleeding rate within 72 hours after surgery ( P>0.05). The incidence of gastric fundus ulcers was 9.1% (2/22) in the EUS-SVD group, significantly lower than the rate of 42.9% (9/21) in the conventional gastroscopy group ( χ2=6.435, P=0.011). Conclusion:EUS-SVD treatment for esophagogastric varices is safe and effective. It can clearly display the deep-seated intramural vessels of the gastric wall, measure the diameter of the blood vessels, accurately inject tissue glue, occlude the varicose veins and perforating vessels, and reduce the occurrence of postoperative ulcers and rebleeding.

Objective:To compare the accuracy of endoscopy and endoscopic ultrasonography (EUS) combined with Indian ink marking in locating injection sites for gastric varices, and to explore the influence of the features of gastric varices under endoscopy on the injection sites.Methods:Consecutive patients with gastric varices scheduled for EUS-guided glue injection therapy at the First Affiliated Hospital of Anhui Medical University from August 2021 to October 2022 were perspectively included. Firstly, gastric varices were assessed under endoscopy, where the size of the veins were estimated while the injection site was preliminarily judged during the procedure. Then EUS was used to identify perforating feeding veins and mark injection sites with Indian ink. After tissue adhesive was injected into identified varices, the change of varices after injection was observed and the marking was identified under endoscopy again. The clarity of the markinges was confirmed and the consistency between EUS-guided Indian ink mark and that under endoscopy was compared. Patients were divided into anastomosis group and non-anastomosis group based on marking consistency to investigate the effect of gastric varices features on the location of injection sites under endoscopy. Treatment efficacy and postoperative adverse events were counted.Results:Finally, 34 patients were included and all of them underwent successful marking under EUS guidance without complications. A total of 40 marker sites were clearly visible with Indian ink staining under endoscopy. The difference in distribution between the anastomotic group and non-anastomotic group marker points between EUS and endoscopy was statistically significant ( χ2=9.103, P=0.003). Vascular occlusion rate was 100.00% (40/40). There were 13 adverse events after operation, mainly fever, abdominal pain and nausea, and no serious adverse events such as allergy and ectopic embolization occurred. There was significant difference between the blood vessel diameter of the anastomotic group (10.84±4.02 mm) and that of the non-anastomotic group (8.80±1.61 mm, t=1.870, P=0.031). The percentage of raised vessels in the anastomotic group was 88.00% (22/25), higher than that in the non-anastomotic group [53.33% (8/15)], and the difference was statistically significant ( χ2=6.009, P=0.024). Conclusion:Accuracy in positioning under endoscopy is influenced by variceal diameter and bulge shape, being less precise in varices with smaller diameters and less pronounced bulges.

Objective: To observe the impacts of Xinnaoning capsules on the aortic intimal structure, serum levels of diponectin (APN) and calcium sensing receptor (CaSR) expression in rats with myocardial infarction, and explore the endothelial protection mechanisms of Xinnaoning. Methods: 15 male Sprague Dawley (SD) rats in sham operation group were randomly selected from 60 rats, the rest 45 rats were fed with high fat diet for 6 weeks and received coronary artery ligation operation. The successful modeling rats were randomly divided into model group, western medicine group and traditional Chinese medicine(TCM) group, and fed with high fat diet for 8 weeks. The sham operation group fed with normal diet. The western medicine group and TCM group received atorvastatin and Xinnaoning capsules, respectively; the sham operation group and model group received same amount of distilled water. After treatment of 4 weeks, the aortic intimal structure was observed by hematoxylin-eosin (HE); the serum levels of triacylglycerol (TG), total cholesterol (TC), low density lipoprotein (LDL) and high density lipoprotein (HDL) were measured by microplate test; serum levels of APN and CaSR expression were determined by enzyme linked immunosorbent assay (ELISA) and Western blot, respectively. Results: Compared with sham operation group, aortic intimal structure derangement and plaque formation in intima in model group, and serum levels of TG, TC, LDL and CaSR expression were increased; HDL and APN were decreased (P<0.05). Compared with model group, the endarterium was more smooth in the western medicine group and TCM group, serum levels of TG, TC, LDL and CaSR expression were decreased; HDL and APN were increased (P<0.05). And there were no significant differences between western medicine group and TCM group (P>0.05). Conclusions Xinnaoning capsules are effective for myocardial infarction.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

OBJECTIVETo observe the effects of different frequencies of electroacupuncture (EA) at "Baihui (GV 20)" and "Shenshu(BL 23)" for the learning and memory ability as well as glycogen synthase kinase-3β (GSK-3β) and growth associated protein-43 (GAP-43) in hippocampal tissue of rats with Alzheimer's disease(AD), so as to explore the mechanism of different frequencies of EA for the prevention and treatment of AD.

METHODSOne hundred and twelve healthy Wistar male rats were divided into seven groups by random number table, namely a normal group, a sham operation group, a model group, an acupuncture group, a 2 Hz EA group, a 30 Hz EA group, and a 50 Hz EA group, 16 rats in each one. The rats in the normal group were conventionally raised in the laboratory without any treatment. 0.9% NaCl solution was injected into bilateral dentate convolution of hippocampus in rats of the sham operation group. AD model was established by β-amyloid protein1-42 (Aβ1-42) injected into bilateral dentate convolution of hippocampus in the other groups. 15 days after establishment, no treatment was applied in the model and sham operation groups, and EA with corresponding frequencies at "Baihui (GV 20)" and "Shenshu (BL 23)" was used in the three EA groups for 2 sessions, once a day and 7 times as one session. There was 1 day between the two sessions. The same acupoints were adopted in the acupuncture group, without electrical connection. The escape latency, the first spanning platform time, and the number of crossing platform were tested in the Morris water maze immediately after treatment. The expressions of GSK-3β and GAP-43 were examined by immunohistochemistry and Western blot.

RESULTS①Morris water maze tests showed that the escape latency and the first spanning platform time significantly increased in the model group compared with those in the normal group (both<0.01), and the number of crossing platform decreased (<0.01). Compared with the model group, the escape latency and the first spanning platform times decreased in the acupuncture and three EA groups (all<0.01), and the numbers of crossing platform increased (<0.01). Compared with the acupuncture and 2 Hz, 30 Hz EA groups, the escape latency decreased in the 50 Hz EA group (<0.01,<0.05); the first spanning platform time reduced (all<0.01); the number of crossing platform increased (<0.01,<0.05). ②The expressions of GSK-3β and GAP-43 of the model group increased compared with those of the normal group(both<0.01). The expressions of GSK-3β in the acupuncture and three EA groups decreased compared with that in the model group (all<0.01), and the expressions of GAP-43 increased (all<0.01). The expressions of GSK-3β decreased and GAP-43 increases in the 50 Hz EA group compared with those in the acupuncture group and 2 Hz, 30 Hz groups (all<0.01).

CONCLUSIONSEA may promote synaptic damage rehabilitation by down regulating GSK-3β and up regulating GAP-43 to improve learning and memory ability of AD rats. The effect of 50 Hz EA is better than those of 30 Hz and 2 Hz EA and acupuncture.

Objective To investigate the mechanism of electro-acupuncture (EA) at different frequency in improving synaptic plasticity injury in Alzheimer's disease(AD) rats, and to provide the theoretical basis for the clinical application of electro-acupuncture for the treatment of AD. Methods Ninety Wistar rats were randomly divided into normal group, model group, sham-operation group, and 2 Hz, 30 Hz, 50 Hz acupuncture groups, 15 rats in each group. AD rat model was established by injection of amyloid β1-42 (Aβ1-42) into the lateral ventricle. The rats in EA groups were treated with EA on Baihui and Shenshu acupoints at different frequencies (2, 30, 50 Hz). Learning and memory ability and space exploration ability of rats in each group were measured by Morris water maze test. The synaptic ultrastructure of hippocampus was observed by transmission electron microscopy. Nerve fibers were stained using Golgi techniques. The protein and phosphorylation levels of glycogen synthase kinase 3 beta (GSK-3β) in the brain tissues were detected by Western blotting method. Results(1) Compared with the normal group, the average escape latency time in the model group was significantly prolonged (P < 0.05), and the number of platform crossing was significantly reduced (P < 0.05), indicating that AD model had been established successfully. The average escape latency of rats in EA groups was significantly shortened and the frequency of platform crossing was increased as compared with those of the model group (P < 0.05). (2) The synaptic morphology of the hippocampus showed that the anterior membrane, posterior membrane and the interspace of the synapses in the model group were blurred, and the membrane structures of synapses were incomplete and dissolved. But the synaptic ultrastructures of the 3 EA groups were improved.(3) In the model group, the neurofibrillary tangles were found in the brain tissue, while the neurofibrillary tangles were relieved and the nerve fibers became clear in EA groups.(4) The levels of GSK-3β and GSK-3β(pTyr216) in the model group were significantly higher than those in the normal group (P < 0.05), whearas the GSK-3β(pSer9) level was significantly down-regulated (P < 0.05). In the EA groups, the levels of GSK-3βand GSK-3β(pTyr216) were down-regulated, while GSK-3β(pSer9) level was increased with the frequency of EA, and there was significant difference compared with the model group (P<0.05). (5) Compared with 2 Hz and 30 Hz EA groups, the number of plateau crossing, the average escape latency and the protein and phosphorylation levels of GSK-3β in 50 Hz EA group were significantly improved (P < 0.05). The improvement of synaptic morphology and neurofibrillary tangles of 50 Hz EA group was superior to that of the other 2 EA groups. Conclusion EA at different frequency can improve the learning and memory ability of AD rats, and the effect of 50 Hz is stronger. The therapeutic effect might be achieved by regulating the expression level of GSK-3βprotein and phosphorylation levels, which can improve synaptic plasticity damage of AD rats.

Objective To observe the effect of cupping plus medication on the quality of life and estrogen level in perimenopausal syndrome patients. Method A total of 40 eligible perimenopausal syndrome patients were randomized into a cupping-medication group and a Chinese medication group, 20 cases in each group. The Chinese medication group was intervened by Er Xian decoction, the cupping-medication group was intervened by moving cupping on the back in addition to the treatment given to the Chinese medication group, once a week. Each item of the Menopause-specific Quality of Life (MENQOL), the levels of estradiol (E2), follicle-stimulating hormone (FSH) and luteotropic hormone (LH) in serum were observed before and after the treatment, and the results were analyzed. Result After two treatment courses, the vasomotor symptoms, mental state, physiological state, and sexual life scores in the two groups were significantly improved compared to the scores before the treatment (P<0.05,P<0.01), and there was a significant difference between the two groups in comparing the MENQOL total score (P<0.01). The between-group comparison after the treatment showed that the cupping-medication group was significantly superior to the Chinese medication group (P<0.05). After two treatment courses, the serum E2 levels in the two groups were significantly higher than those before the treatment (P<0.01), and the increase in the cupping-medication group was more significant than that in the Chinese medication group (P<0.05). After the treatment, the serum FSH and LH levels in the two groups were lower compared to those before the treatment, but without statistical significance (P>0.05). Conclusion Moving cupping on the back plus Er Xian decoction can effectively improve the quality of life of perimenopausal syndrome patients and significantly increase the serum E2 level, superior to using Er Xian decoction alone.

Objective To study the treatment effect of cinnamaldehyde on Aspergillus fumigatus biofilm(BF) in vitro .Meth‐ods The models of A .fumigatus BF were established in vitro ;the minimum inhibitory concentration(MIC) on A .fumigatus was measured .The crystal violet assay and scanning electron microscopy were employed to determined the treatment effect of A .fumiga‐tus biofilm under varying concentrations of cinnamaldehyde .Results BF models were established successfully in vitro .MIC value of A .fumigatus of cinnamaldehyde was 256 μg/mL ;The biofilm biomass in serially increasing concentrations of cinnamaldehyde(1 MIC ,1/2 MIC ,1/4 MIC)were 0 .81 ± 0 .11 ,1 .13 ± 0 .18 and 1 .59 ± 0 .11 respectively .Compared to untreated control group(2 .18 ± 0 .15) ,difference achieved statistical significance(P<0 .05) .SEM studies revealed the deformity of three‐dimensional structures of biofilms treated with sub‐MICs of cinnamaldehyde .Conclusion Cinnamaldehyde has significant antifungal activity against Aspergil‐lus fumigatus ,sub‐MICs could disrupt the mature biofilm in vitro .

Objective To observe the effect of electroacupuncture with different frequencies on learning and memory ability, synaptic morphology and synaptic density in the hippocampus of Alzheimer's disease rats. Methods Forty-eight healthy Wistar rats were randomly di-vided into normal group, sham operation group, model group, 2 Hz, 30 Hz and 50 Hz electroacupuncture groups with 8 cases in each group. The Alzheimer's disease model was established by injecting Aβ1-42 into two sides of lateral cerebral ventricle. The sham operation group was injected with normal saline instead. The electroacupuncture groups received electroacupuncture at Baihui (DU20) and Shenshu (BL23) acu-points. The learning and memory ability was evaluated with Morris water maze test, and the morphology and density of synapse were ob-served by electron microscope. Results Compared with the model group, the latency was shorter, the time of crossing the platform was short-er and the number of crossing the platform was more in the electroacupuncture groups (P<0.01), especially in the 50 Hz electroacupuncture group (P<0.01). The number of synapse and the synaptic density were more in the electroacupuncture groups than in the model group (P<0.01), especially in the 50 Hz electroacupuncture group (P<0.01). Conclusion Electroacupuncture could improve learning and memory abili-ty and increase synaptic density in rats with Alzheimer's disease, especially with high frequency.