Objective: To investigate if high glucose (HG) exacerbates Porphyromonas gingivalis (P.g) lipopolysaccharide (LPS)-induced inflammatory response in human gingival fibroblasts (HGFs) and to explore the underlying mechanisms. To provide a basis for the mechanism of diabetes aggravating periodontitis. Methods: HGFs were divided into four groups: the control group (basal medium), the LPS group (treated with 5 μg/mL P.g-LPS for 24 h), the HG group (treated with 25 mmol/L glucose for 24 h), and the HG+LPS group (treated with 25 mmol/L glucose + 5 μg/mL P.g-LPS for 24 h). After culturing for 24 h in the respective media, the cells were harvested for experiments. Intracellular reactive oxygen species (ROS) and mitochondrial reactive oxygen species (mtROS) were detected using 2 ', 7' - dichlorodihydrofluorescein diacetate (DCFH-DA) and MitoSOX Red staining, respectively. Fluorescence intensity was analyzed by confocal fluorescence microscopy and directly measured in cell suspension. Immunofluorescence was used to detect changes in mitochondrial DNA (mtDNA) content of HGFs. Real-time fluorescence quantitative PCR was used to detect the content of mtDNA in cytoplasm and cell supernatant. Protein expression of the cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway was assessed by western blot, while mRNA expression levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) were detected by PCR. Results: Compared to the control group, both the LPS group and the HG group exhibited a significant increase in ROS and mtROS, with a more pronounced elevation in the HG+LPS group, demonstrating a synergistic effect (ROS: F = 396.5, P < 0.001; mtROS: F = 29.38, P < 0.001, CI < 1). The cytoplasmic mtDNA content was significantly elevated in the LPS group, with a more marked increase in the HG+LPS group (F = 27.85, P < 0.001). The supernatant mtDNA levels were significantly higher in both the LPS and HG groups, with a more pronounced elevation in the HG+LPS group (F = 15.26, P < 0.001). The phosphorylated proteins p-STING, p-TBK1, and p-P65 in the cGAS-STING pathway showed varying degrees of activation in the LPS and HG groups, reaching the highest levels in the HG+LPS group (p-STING: F = 52.67, P < 0.001; p-TBK1: F = 15.67, P = 0.001; p-P65: F = 9.83, P = 0.005), while p-IRF3 showed no significant differences among the groups (P = 0.072). Pro-inflammatory cytokine TNF-α was significantly higher in the HG+LPS group compared to the control group (F = 15.05, P < 0.001), and IL-1β increased in both the LPS and HG groups, with a more pronounced rise in the HG+LPS group (F = 30.98, P < 0.001). IL-6 showed no significant differences among the groups (P = 0.847). Conclusion High glucose and LPS act synergistically to enhance oxidative stress, accompanied by increased mtDNA release, which activates the cGAS-STING pathway, thereby amplifying the inflammatory response in HGFs.

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 impact of metabolic labeling on Porphyromonas gingivalis(Pg)and com-pare the imaging effects of two fluorescent probes.Methods This study was reviewed by the unit Ethics Committee and was approved by the Experimental Animal Welfare Ethics Branch of the Unit Experimental Biomedical Ethics Com-mittee.Pg integrated N-azidoacetylgalactosamine(Ac4GalNAz)via a bioorthogonal reaction and was labeled with Cy5-DBCO or Cy7-DBCO via a click chemistry reaction.The bacteria were divided into Pg group(control,not fluorescently labeled),Cy5-Pg group(tagged by Cy5-DBCO),and Cy7-Pg group(tagged by Cy7-DBCO).A live/dead staining kit was applied to test the viability of Pg,Cy5-Pg,and Cy7-Pg.The mRNA levels of interleukin-6(IL-6)and IL-8 and cell pro-liferation were examined in human gingival fibroblasts(HGFs)after the challenge of Cy5-Pg,Cy7-Pg,or Pg.To investi-gate the stability of metabolic labeling,Cy5-Pg or Cy7-Pg was cocultured with Escherichia coli(E.coli).Cy5-Pg and Cy7-Pg signal intensity with serial dilutions were examined using an in vivo imaging system(IVIS).Finally,C57BL/6J mice were orally administered Cy5-Pg or Cy7-Pg for IVIS detection,and the signal-to-background ratios were calculated.Results Metabolic labeling could be applied to label live Pg in vitro.The optimal labeling concentrations for Cy5 and Cy7 were 20 μmol/L and 30 μmol/L,respectively.The area ratios of live to dead bacteria were approximately 2.0 in the three groups(F=0.318,P＞0.05).After a 6-h challenge with Cy5-Pg,Cy7-Pg,or Pg,the mRNA levels of HGFs in-creased by 7.86-,7.46-,and 6.56-fold for IL-6,respectively(F=40.886,P＜0.001)and 12.43-,13.03-,and 13.71-fold for IL-8(F=18.781,P＜0.01),were spectively,compared to that of the Ctrl group,which was not challenged by bacte-ria,where no significant differences were observed among the three groups(P＞0.05).HGFs were further challenged by Cy5-Pg,Cy7-Pg,or Pg at different MOIs,and cell proliferation was significantly inhibited(MOI=104∶1,F=153.52,P＜0.001;MOI=105∶1,F=331.21,P＜0.001;MOI=106∶1,F=533.65,P＜0.001),with no significant differences among the three groups(P＞0.05).Within 24 h of co-culturing Cy5-Pg or Cy7-Pg with E.coli,minimal E.coli was de-tected.The intensities of Cy5 and Cy7 remained stable for 3 h.Additionally,the fluorescence signal intensities of Cy5 and Cy7 were linearly correlated with the concentration(R2=0.97).After oral gavage of Cy5-Pg or Cy7-Pg in mice for the abdominal region at 1 h and 3 h,the signal-to-background ratios of Cy7-Pg were approximately 4.24-fold(t=6.893,P＜0.01)and 3.77-fold(t=4.407,P＜0.05)higher,respectively,than those of Cy5-Pg.For the isolated gastrointestinal tracts at 3 h,the signal-to-background ratio of Cy7-Pg was 5.19-fold higher than that of Cy5-Pg(t=4.418,P＜0.05).Conclusions Metabolic labeling did not significantly affect viability,immunomodulatory ability,and toxicity.The im-aging effect of Cy7 on IVIS was better than that of Cy5.Our study provided experimental evidence for the correlation be-tween periodontitis and overall health.

Dystrophinopathies caused by variants of DMD gene are a group of muscular diseases including Duchenne muscular dystrophy, Becker muscular dystrophy, and DMD-associated dilated cardiomyopathy. With the advancement of genetic testing techniques and wider implementation of genetic screening, especially the expanded carrier screening, more and more individuals carrying DMD gene variants have been identified, whereas the genetic counseling capacity is relatively insufficient. Currently there is still a lack of professional norms for genetic counseling on dystrophinopathies. In this consensus, the main points to be covered in the pre- and post-test consultation have been discussed, with an aim to provide genetic counseling guidance for the disease diagnosis, treatment, and family reproduction.

ObjectiveTo investigate the value of peroxisome proliferator-activated receptor γ（PPARγ）level in predicting hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction. MethodsA total of 92 patients with non thrombolytic acute cerebral infarction who were treated in our hospital from May 2017 to May 2020 were selected as the research objects，and they were divided into hemorrhagic transformation group（n=14）and non hemorrhagic transformation group（n=78）according to the occurrence of hemorrhagic transformation. The plasma levels of PPARγ and fibronectin（FN）were detected by enzyme-linked immunosorbent assay（ELISA）；the correlation between plasma PPAR-γand blood lipid levels in patients with hemorrhagic transformation of non thrombolytic acute cerebral infarction was analyzed；the predictive value of plasma PPARγ and FN levels on hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction was analyzed；the influencing factors of hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction were analyzed. ResultsThe levels of PPARγ and FN were higher than those in non hemorrhagic transformation group，The area under the curve（AUC）of plasma PPARγ and FN levels in predicting hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction was 0.933 and 0.860，respectively，the specificity was 89.7% and 78.2%，and sensitivity was 85.7% and 78.6%，respectively；the AUC of the combined prediction was 0.952，the specificity was 89.7%，and the sensitivity was 92.9%. PPARγ was an independent risk factor for hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction（P<0.05）. ConclusionPlasma PPARγ is a factor influencing hemorrhagic transformation in patients with non thrombolytic acute cerebral infarction，which may have important predictive value for secondary hemorrhagic transformation.

Objective:To investigate the correlation between clinical periodontal indexes of periodontitis and glomerular filtration rate (GFR) in a non-diabetic elderly population in four communities of Shijingshan, Beijing.Methods:This was a cross-sectional study. Questionnaires, blood biochemical examinations, and periodontal indexes were conducted in elderly people (35 to 84 years old) in four communities of Shijingshan, Beijing between May and July 2005. Non-diabetic patients with fasting blood glucose<6.1 mmol/L, postprandial blood glucose<7.8 mmol/L, and ≥ 10 remaining teeth were included. Patients with diabetes, fasting blood glucose ≥6.1 mmol/L or postprandial blood glucose ≥7.8 mmol/L, and total residual teeth less than 10 were excluded. A total of 362 study subjects met the inclusion criteria. The survey subjects were selected by convenient sampling method. The mean full-mouth probing depth (PD), bleeding index (BI), attachment loss (AL), and plaque index (PLI), as well as PD≥4 mm% (the number of sites with PD≥4 mm as a percentage of the total number of sites in full mouth), PD≥5 mm%, PD≥6 mm%, AL≥3 mm%, AL≥4 mm%, AL≥5 mm% and AL≥6 mm% were used for the analysis. Serum creatinine values was used to calculate GFR. GFR≥90 ml/(min·1.73 m 2) was defined as normal group and GFR<90 ml/(min·1.73 m 2) was defined as reduced group. Univariate analysis was conducted between two groups. Multivariate regression analysis was performed with GFR as dependent variable and adjusted for risk factors such as age, sex, smoking, waist-hip ratio and physical activity. Results:There were 164 subjects in the normal GFR group (45.3%) and 198 in the reduced GFR group (54.7%). Percentage of males in the reduced GFR group, 118 in total, accounting for 59.6%, were significantly higher than in the normal GFR group (73, 44.5%)( P=0.004). The median of age, uric acid, triglyceride, and waist-to-hip ratio (65 years, 323 mmol/L, 1.73 mmol/L, 0.90) were significantly higher in the reduced GFR group than in the normal GFR group (54 years, 277 mmol/L, 1.45 mmol/L, 0.88) ( P<0.05). The median of PD mean, AL mean, BI mean, PD≥4 mm%, AL≥3 mm%, and AL≥4 mm% in the reduced GFR group were 2.80 mm, 2.52 mm, 2.06, 20.4%, 46.5%, and 30.4%, respectively, which were significantly higher than those in the GFR normal group (2.60 mm, 2.37 mm, 1.93, 16.6%, 42.9%, 28.9%) ( P<0.05). After adjusting for confounding factors such as age, gender, smoking, waist-to-hip ratio and physical activity, the results of logistic regression analysis showed that PD mean, AL mean, PD≥4 mm%, PD≥5 mm%, PD≥6 mm%, AL≥3 mm% and AL≥4 mm% of clinical periodontal indexes were significantly correlated with reduced GFR in this population ( OR values were 1.765, 1.879, 1.430, 1.713, 1.771, 1.428, 1.445, respectively, P<0.05). Conclusions:In the non-diabetic elderly population in communities of Shijingshan, Beijing, clinical periodontal indexes reflecting the degree of periodontal tissue destruction were associated with a decreased level of GFR.

Objective:To investigate the status quo of human resources of dentists who deal with periodontal disease in Beijing area through an online survey, which may hopefully provide a preliminary basis for the decision-making of administrative departments and the formulation of periodontal professional development plan.Methods:The dentists who deal with periodontal disease at least half a day per week in Beijing area were investigated. A questionnaire was designed by the chairman of the Periodontology Committee of Beijing Stomatological Association. The questionnaire was sent to and finished by the dentists via "WenJuanXing" online survey software. The contents of the survey included general condition, the property of practice unit, title and position of the dentist, membership of professional society, time and content of periodontal treatment, adoption of new technology and new method of periodontal therapy during the past one year, status of periodontal treatment in the local population and reasons, understanding and influencing factors of periodontal professional development.Results:A total of 1 255 dentists completed the survey, who came from all 16 districts in Beijing, mainly Haidian, Chaoyang, Dongcheng and Xicheng Districts [The total percentage of these four main districts was 70.3% (882/1 255)]. The mean age of the dentists was (36.1±8.3) years. Among the dentists, 71.1% (892/1 255) were females, 88.1% (1 106/1 255) got a Bachelor′s degree or above. It was estimated that 35.4% (444/1 255) of the dentists had received standardized periodontal training ever. The percentage of dentists carrying out new technology in the past one year was as high as 68.1% (855/1 255). There were only 163 periodontal specialists (13.0%) out of the dentists in the survey. Only 15.9% (200/1 255) of the dentists routinely performed periodontal surgery. The majority of the dentists [82.8% (1 039/1 255)] were from the state-owned hospitals. Fifty-four point seven percemt (686/1 255) of the dentists thought that lack of knowledge was the main reason why the general public failed to receive periodontal treatment. As for the biggest bottleneck affecting periodontal professional development, fifty-one point zero percent (640/1 255) of the dentists attributed it to the public neglect.Conclusions:The periodontal practitioners in Beijing are young, highly educated, unevenly distributed in 16 districts and mostly females. State-owned oral health institutions are an important force in periodontal diagnosis and treatment services in Beijing. The number of periodontal specialists need to be improved. Promotion of standardized periodontal surgery and the popularization of healthcare knowledge on periodontal disease should also be the focus in the future.

Objective:To evaluate the effect of imatinib on growth impairment in children with chronic myeloid leukemia (CML-CP) in the chronic phase.Methods:From July 2018 to July 2019, questionnaires were distributed to CML children aged <18 years at the time of diagnosis who were receiving imatinib for at least 3 months or to their parents in China. The height-for-age standard deviation score (HtSDS) and the difference of standard deviation integral (△HtSDS) were used to explore the change in height with imatinib therapy.Results:The data of 238 respondents were included; 138 (58.0% ) respondents were men. The median age at the first diagnosis of CML was 11.0 years (range, 1.4-17.9 years) , and 93 (39.0% ) respondents were at the prepuberty stage. At the time of completing the questionnaires, the median age was 15.0 years (range, 2.0-34.0 years) . The median duration of imatinib therapy was 28 months (range, 3-213 months) . Among all the respondents, the mean HtSDS when completing the questionnaires (-0.063±1.361) was significantly lower than that at the time of starting imatinib treatment (0.391±1.244) ( P<0.001) . Total 71.0% respondents showed growth impairment that was more common in those starting imatinib therapy at prepubertal age than in those starting at pubertal age. Multivariate analysis showed that younger at the start of imatinib therapy ( P<0.001) and longer duration of imatinib therapy ( P<0.001) were significantly associated with severe growth impairment on imatinib therapy. Conclusions:Imatinib induced growth impairment in children with CML-CP. Younger the age of initiation and longer the duration of imatinib therapy, more obvious the effect of imatinib on growth impairment.

Objective To analysis the common abnormalities in fetus with ventriculomegaly and clinical significance. Methods Collected from March 2010 to December 2016,298 cases of pregnant women whose fetus with ventriculomegaly and accepted the prenatal diagnosis of pregnancy,including 109 cases of isolated cerebral ventriculomegaly(IVM),and 189 cases of non-isolated cerebral ventriculomegaly(NIVM).They were divided into mild groups(10.0-11.9 mm),moderate group(12.0-14.9 mm)and severe group(≥15.0 mm)according to the width of the lateral ventricle. Results(1)The most common abnormality of the NIVM were neurodevelopmental system(37.30%,94/252);The second was ultrasonic soft index(27.78%,70/252).(2)The most frequent combi-nation in mild group was ultrasonographic soft mark anomalies(44.76%,47/105),followed by other ultrasonic indi-cators(18.10%,19/105).The abnormal incidence of central nervous system was higher in middle group(45.16%, 42/93),followed by ultrasonic soft index abnormality(21.51%,20/93).The abnormality of the central nervous sys-tem was 62.96%(34/54)in severe group,followed by an abnormal(14.81%,8/54).(3)There was a difference in the nervous system and the ultrasonic-soft indicator between the non-isolated lateral ventricle dilation with different lateral ventricle widths(P<0.001).There was no difference in cardiovascular abnormalities. Conclusion Prena-tal ultrasound revealed that fetus with cerebral ventriculomegaly should carefully examine whether other abnormali-ties existed to determine the prognosis of the fetus and whether intervention should be taken.There was a difference between the different types of lateral ventricle and the prognosis.

Objective To explore the clinical efficacy and indications of kyphoplasty with movement and secondary en?largement of balloon for the compression fracture of vertebral body with ruptured posterior wall. Methods A retrospective analy?sis was carried out on the data of 29 patients (10 males, 19 females;age range:55-86 years old;mean age:71 years old;29 verte?bral bodies in total) who suffered from compression fracture of the thoracolumbar spine and below, and underwent kyphoplasty through the movement and secondary enlargement of balloon within the vertebral body and were followed up from January 2011 to November 2014. These patients had backache, accompanied by lowered support, limitation of movement, no symptom of nervous lesion on both lower extremities and no past history of balloon kyphoplasty. All fractured vertebral bodies were at T 11 or below, in?cluding 1 case at T11, 4 cases T12, 11 cases L1, 9 cases L2 and 4 cases L3. The causes of injury included fall (19 cases), car accident (8 cases) and unknown reasons (2 cases). All patients underwent kyphoplasty with the movement and secondary enlargement of bal?loon within the vertebral body. Photos were taken immediately after the surgery, at 1 month, 3 months, 6 months and 12 months, and these patients were assessed and analyzed in terms of vertebral height, Cobb angle, visual analogue score (VAS) and Oswestry disability index (ODI). Results The operation time (including the formation and solidification of bone cement) of 29 patients was 40 to 65 min and the mean time was 55 ± 7 min;the blood loss during operation was 2 to 15 ml and the mean blood loss was 5 ± 2 ml;the injected volume of bone cement was 2.5-7.5 ml and the mean volume was 5.5±0.5 ml. Post?operative pain was relieved and ambulation was performed under the protection of lumbar orthosis brace. Statstical analysis was conducted on VAS, ODI, vertebral height and Cobb angle before operation and at 1 month, 3 months, 6 months and 12 months after operation, showing statistically significant differences. X ray examination found that there was no alternation or displacement of bone cement location, and no change in vertebral morphology, the vertebral height and cobb angle remained the post?operative status, and posterior wall rupture of the vertebral body was recovered well. CT revealed that the morphology of bone cement was irregular and closely integrated with bone substance, and no cavity or fissure was seen. Conclusion Kyphoplasty with movement and secondary enlargement of bal?loon within the vertebral body has a good, definite clinical efficacy in treating compression vertebral fracture with incomplete pos?terior wall of the vertebral body without obvious displacement of fractured bone and symptom of nervous lesion on both lower ex?tremities. This surgery is easy to operate, and has an immediate analgesic effect, which could recover vertebral height as well as re?duce kyphosis deformity and improve patient’s prognosis.