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 explore the relationship between rumination and depression and suicide attempts, and the mediating effect of rumination between depression and suicide attempts in adolescents with depressive disorder.Methods:Clinical interviews and questionnaires were conducted on 331 adolescents aged 11-18 with depressive disorders.Depressive symptoms were assessed with patient health questionnaire-9 (PHQ-9). Rumination was assessed with ruminative responses scale-10 (RRS-10), and Chinese version of the sociality module of MINI5.0 was used to assess suicide.SPSS 23.0 software was applied to descriptive statistics, Chi-square test, t-test, Spearman correlation analysis and hierarchical regression analysis, and the SPSS macro program PROCESS V 3.4 was used for Bootstrap mediating effect. Results:The incidence of suicide attempts in adolescents with depressive disorder was 53.78%, which was significantly higher in girls (59.48%) than that in boys (40.40%), and the difference was significant ( χ2=10.16, P<0.01). In contrast to the non-suicide attempt group, suicide attempt group had higher scores on PHQ-9((11.08±9.26) vs (14.43±7.49), t=-3.634, P<0.01), brooding ((10.76±3.89) vs (12.44±3.87), t=-3.926, P<0.01), reflection ((10.05±3.54) vs (11.20±3.33), t=-3.044, P<0.01) and rumination total score ((20.81±6.78) vs (23.64±6.42), t=-3.898, P<0.01). Regression analysis revealed that girl ( β=0.175, t=3.228, P=0.001), depressive symptoms ( β=0.168, t=3.082, P=0.002), rumination ( β=0.138, t=2.364, P=0.019) were risk factors for suicide attempts.Rumination played a complete mediating effect between depressive symptoms and suicide attempts (effect value=0.013, 95% CI=0.003-0.027). Depression symptoms significantly and positively predicted rumination ( P<0.01), and rumination significantly and positively predicted suicide attempts ( P<0.05). Conclusion:The incidence of suicide attempts was high in adolescents with depressive disorders.Depressive symptoms affect suicide attempts mainly through rumination.Clinicians should assess the rumination of adolescents with depressive disorders.In addition, clinicians should implement concurrent psychotherapy to adjust the cognitive response and reduce rumination, in order to improve the mental health and reduce suicide attempts.

Objective:To evaluate the feasibility and clinical efficacy of deformed complex vertebral osteotomy (DCVO) technique on the treatment of angular kyphosis of cured spinal tuberculosis.Methods:A retrospective study was performed on patients with angular kyphosis of cured spinal tuberculosis who underwent the DCVO technique or posterior vertebral column resection (PVCR) technique from Jan, 2007 to Jan, 2019. 33 patients were included, 18 males and 15 females, the average age was 39.5±15.0 years old (ranged 9-78 years old). The vertebral deformity in thoracic vertebrae 14 cases, thoracolumbar vertebrae 16 cases, and lumbar vertebrae 3 cases. 20 cases underwent the DCVO technique, while 13 cases underwent PVCR technique. For DCVO group, the multiple malformed vertebrae were considered a malformed complex, and a larger range and angle wedge osteotomy was performed within the complex using the DCVO technique. PVCR technique would resect the whole deformed vertebrae, and subsequently brought the two separated spinal columns together with instruments and titanium mesh. The intro-operative blood loss, operating time and complications were recorded. The radiological measurements included preoperative and postoperative spinopelvic parameters, which including thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and segmental kyphosis. The recovery of neurological function was evaluated by Frankle classification.Results:All patients were followed up for 7-72 months. Comparing with the cases underwent PVCR technique, the DCVO group has a significantly lower blood loss (1315.00±462.57 ml), operating time (293.00±83.86 min) and complications rate (1.5%). At the time of preoperation, postoperation and last follow-up, the deformity angle of DCVO group was 96.80°±6.32°, 29.10°±6.96°and 29.05°±6.49°, which gained an average 69.9% correction rate. The statistical analysis suggested that deformity angle was enormously corrected. And there was an insignificant difference between DCVO group and PVCR group. Meanwhile, the preoperative, postoperative and follow-up TK of DCVO group was 96.96°±29.13°, 37.15°±4.88° and 37.00°±3.89°respectively, whosecorrection rate was 67.1%; LL was 66.70°±21.21°, 42.25°±5.53° and 41.90°±4.98°, which have a significant difference between pre-operation and post-operation/follow-up ( F=23.997, P<0.001) ; SVA was 75.95±18.63 mm, 16.30±6.88 mm and 16.55±7.30 mm. PI was 47.50°±6.12°, 47.35°±5.54°and 47.90°±5.93°, PT was 37.25°±9.63°, 18.50°±1.99° and 19.00°±1.65°; SS was 10.25°±8.27°, 29.15°±5.91° and 28.85°±5.77°. The sagittal and spinopelvic parameters of two groups improved significantly at postoperation and follow-up. No obviously difference of spinal parameters was found between two groups at preoperation and postoperation. Both groups have cases with dysneuria. And all of these cases achieved different degrees of recovery at follow-up. Conclusion:The use of DCVO technique for the treatment of post-tubercular angular kyphosis is safe and efficiency. DCVO leads a better clinical outcomes and lower complication rate than VCR technique.

Objective To investigate the effects of Rapamycin and mammalian target of rapamycin - small in-terfering RNA (mTOR siRNA)on the proliferation,apoptosis and collagen Ⅰ(COLⅠ),collagen Ⅲ(COLⅢ)and fi-bronectin(FN)in premature rats lung fibroblasts exposed to hyperoxia. Methods 900 mL/ L volume fraction of oxygen was used to establish hyperoxia - damaged cell models,and the premature rats lung fibroblasts were divided into air control group,hyperoxia group,hyperoxia + rapamycin group and mammalian target of rapamycin - small interfering RNA transfection group. Cell proliferation was assessed by using 3 -(4,5 - Dimethylthiazol - 2 - yl)- 2,5 - dipheny-ltetrazolium bromide assay. Apoptosis were detected by Annexin V - FITC and propidium lodide (PI)double staining. The expressions of COLⅠ,COLⅢ and fibronectin was assessed by using enzyme linked immunosorbent assay and Bcl - 2,P53 and pro - fibrotic factors of connective tissue growth factor(CTGF)and transforming growth factor β(TGF - β)by using Western blot. Results Compared with the air control group,the proliferation of lung fibroblasts decreased and the apoptosis increased in the hyperoxia group,while the contents of COLⅠ(28. 30 ± 0. 53 vs. 17. 43 ±0. 37),COLⅢ(27. 86 ± 1. 02 vs. 17. 43 ± 0. 37)and fibronectin(32. 87 ± 0. 42 vs. 21. 57 ± 0. 47),P53(0. 810 ± 0. 119 vs. 0. 160 ± 0. 018),TGF - β(0. 580 ± 0. 108 vs. 0. 210 ± 0. 008)and CTGF(0. 590 ± 0. 017 vs. 0. 220 ± 0. 007)were also increased but the expression of Bcl - 2(0. 150 ± 0. 004 vs. 0. 600 ± 0. 130)protein was decreased, and the differences were all statistically significant (all P < 0. 01). Compared with the hyperoxia group,the proliferation of lung fibroblasts was increased in the hyperoxia + rapamycin group,but the apoptosis was decreased,the contents of COLⅠ(23. 17 ± 0. 60 vs. 28. 30 ± 0. 53),COLⅢ(17. 09 ± 0. 58 vs. 27. 86 ± 1. 02)and fibronectin(28. 11 ± 0. 68 vs. 32. 87 ± 0. 42),P53(0. 430 ± 0. 008 vs. 0. 810 ± 0. 119),TGF - β(0. 380 ± 0. 008 vs. 0. 580 ± 0. 108)and CTGF (0. 040 ± 0. 006 vs. 0. 590 ± 0. 017)were decreased while the expression of Bcl - 2(0. 290 ± 0. 009 vs. 0. 150 ± 0. 004) protein was increased,and the differences were all statistically significant (all P < 0. 01). In the mTOR siRNA transfec-tion group,compared with the hyperoxia + rapamycin group,the proliferation of lung fibroblasts was increased,but the apoptosis was decreased;the contents of COLⅠ(15. 71 ± 0. 34 vs. 23. 17 ± 0. 60),COLⅢ (13. 85 ± 1. 36 vs. 17. 09 ± 0. 58)and fibronectin(20. 18 ± 0. 28 vs. 28. 11 ± 0. 68),P53(0. 300 ± 0. 006 vs. 0. 430 ± 0. 008),TGF - β(0. 150 ± 0. 002 vs. 0. 380 ± 0. 008)and CTGF(0. 140 ± 0. 004 vs. 0. 040 ± 0. 006)were decreased while the expression of Bcl - 2 (0. 460 ± 0. 012 vs. 10. 290 ± 0. 009)protein was increased,and the differences were all statistically significant (all P < 0. 01). Conclusion Rapamycin and mTOR siRNA can protect lung injury caused by hyperoxia and have a certain inhibitory effect on pulmonary fibrosis,and mTOR siRNA effect is more obvious,so the mechanism may be through the inhibition of mTOR signaling pathway.

Objective To explore the clinical efficacy of knee osteoarthritis treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.Methods 120 patients with knee osteoarthritis were randomly divided into observation group and control group,60 patients in each group.The observation group was treated by abdominal acupuncture combined with sodium hyaluronate injected in intraarticular.The control group was treated with intraarticular injection of sodium hyaluronate alone.Results After a follow up of 6 months, the total effective rate of the treatment group was 95.00%,which was higher than 78.33% of the control group, the difference was statistically significant (x2=7.21,P<0.01).Conclusion Abdominal acupuncture combined with intraarticular injection of sodium hyaluronate is a good way to treat middle and old age patients with knee osteoarthritis.

Objective To study the changes of transforming growth factor-β (TGF-β),connective tissue growth factor (CTGF) and collagen 1 (COL1) in newborn rat's lung tissue and the expressions of 4EBP1 (eukaryotic promoter) and P7OS6K (mammalian target of rapamyein pathway downstream target protein) after rapamycin and hyperoxia intervention,and to study the influence of mammalian target of rapamyein (mTOR) pathway on hyperoxic lung injury and the possible intervention methods.Method A total of 48 21-day-old neonatal rats were assigned into 8 groups (n =6),including air control group,3 d group (3 days after hyperoxic exposure),7 d group (7 days after hyperoxic exposure),14 d group (14 days after hyperoxic exposure),air + RAPA group (air + rapamycin),3 d + RAPA group (3 days after hyperoxic exposure + rapamycin),7 d + RAPA group (7 days after hyperoxic exposure + rapamycin) and 14 d + RAPA group (14 days after hyperoxic exposure + rapamycin).In the hyperoxic group,newborn rats were exposed to 90％ oxygen for 3,7,14 days respectively.The rats in the hyperoxia + rapamycin intervention groups received intraperitoneal injection of rapamycin and inhaled high concentrations of oxygen for 3,7,14 days respectively.Air ± rapamycin group received intraperitoneal injection of rapamycin for 3 days.To study the pathological changes of lung tissures after hyperoxia and rapamycin intervention,we used ELISA to detect the changes of TGF-β,CTGF and COL1 and Western blot to detect the variations of mTORC1,P70S6K and 4EBP1 expression.Result TGF-β,CTGF,COL1 levels at 3 days,7 days and 14 days after hyperoxic exposure (TGF-[β:33.7±2.8 vs.58.6 ±3.1 vs.98.8 ±1.5 ng/mg,CTGF:50.1 ±1.8 vs.68.7 ± 2.2 vs.94.4 ±2.5 ng/mg,COL1:471.9 ±5.7 vs.529.7 ±7.0 vs.556.4 ±8.5 ng/mg) were significantly higher than the air control group (TGF-β:25.5 ± 1.9 ng/mg,CTGF:41.7 ± 1.4 ng/mg,COL1:414.4 ± 8.9 ng/mg) (P ＜ 0.01).While the levels in rapamycin intervention group were significantly lower than all the hyperoxia + rapamycin intervention groups (P ＜ 0.01).The lung tissue pathological grades in 3 d + RAPA group and 7 d + RAPAgroup were significantly lower than those in the 3 d group and 7 d group (3.5 ± 0.8 vs.6.3 ± 2.3 and 9.7 ± 2.0 vs.14.0 ± 2.4) (P ＜ 0.01).The mTORC1,P70S6K,4EBP1 expressions in 3 d + RAPA group were lower than 3 d group (mTORC1:0.26 ± 0.04 vs.0.29±0.08,P70S6K:0.29±0.01 vs.0.31 ±0.08,4EBP1:0.31 ±0.06 vs.0.33 ±0.06) (P＜0.05),while the expressions in 7 d + RAPA and 14 d + RAPA groups were significantly lower than 3 d + RAPAgroup (P ＜0.01).Conclusion mTOR signal pathway may be involved in the repairing process of hyperoxic-induced lung fibrosis.Rapamycin can reduce the levels of TGF-β,CTGF and COL1 and inhibit the expressions of mTOR pathway downstream target protein P70S6K and 4EBP1,thus reduce lung injury atearly stage.

BACKGROUND:There are few studies concerning estrogen receptorβgene, and its mechanism of regulating the bone metabolism is stil unclear now. OBJECTIVE:To analyze the effect of estrogen receptorβ(ERβ) silencing on the expressions of transforming growth factorβ1 (TGF-β1) and bone morphogenetic protein 2 (BMP-2) in human osteoblasts METHODS:There were three groups:blank control group (hFOB 1.19 uninfected with any retrovirus);negative control group (containing invalid interference fragment ERβ-shRNA-nc);optimal RNAi group (ERβ-shRNA-3). ERβ-shRNA retroviral vectors in the optimal RNAi group were used to transfect human osteoblasts fol owed by resistance screening and cel expansion. MTT assay was used to detect the proliferative activity of ERβ-silenced osteoblasts. Then under estrogen intervention, the stable inhibition rate of ERβwas determined using western blot assay, and the expressions of TGF-β1 and BMP-2 in human osteoblasts after ERβsilencing were detected by RT-PCR technology and western blot assay. RESULTS AND CONCLUSION:Human osteoblasts that were stably transfected by ERβ-shRNA-3 retroviral vector was selected successful y, and ERβsilencing had no significant influence on the cel proliferation (P>0.05). Under the interference of estrogen, the silencing efficiency of ERβprotein was (93.11±0.57)%(P<0.05), and after ERβsilencing, the expressions of TGF-β1 and BMP-2 were increased by (26.65±3.81)%and (16.62±1.71)%at mRNA level, and increased by (23.79±3.76)%and (18.08±3.20)%at protein level (both P<0.05). In conclusion, ERβmay play an important role in bone metabolism by regulating the expressions of TGF-β1 and BMP-2.

Gastric cancer is one of the most common malignancies worldwide; however, the molecular mechanism in tumorigenesis still needs exploration. BCL2L11 belongs to the BCL-2 family, and acts as a central regulator of the intrinsic apoptotic cascade and mediates cell apoptosis. Although miRNAs have been reported to be involved in each stage of cancer development, the role of miR-24 in GC has not been reported yet. In the present study, miR-24 was found to be up-regulated while the expression of BCL2L11 was inhibited in tumor tissues of GC. Studies from both in vitro and in vivo shown that miR-24 regulates BCL2L11 expression by directly binding with 3'UTR of mRNA, thus promoting cell growth, migration while inhibiting cell apoptosis. Therefore, miR-24 is a novel onco-miRNA that can be potential drug targets for future clinical use.
Animals ; Apoptosis ; genetics ; Apoptosis Regulatory Proteins ; deficiency ; genetics ; Base Sequence ; Bcl-2-Like Protein 11 ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Down-Regulation ; genetics ; Gene Silencing ; Male ; Membrane Proteins ; deficiency ; genetics ; Mice ; MicroRNAs ; genetics ; Proto-Oncogene Proteins ; deficiency ; genetics ; Rats ; Stomach Neoplasms ; genetics ; pathology

Objective:To investigate the influence of chemotherapy on the phenotype of secreted protein, acidic and rich in cysteine (SPARC) in gastric cancer (GC). Methods:Immunohistochemistry was used to analyze SPARC expression in 132 GC patients. Among these patients, 54 with preoperative chemotherapy and 78 without preoperative chemotherapy were selected to analyze the effect of chemotherapy on SPARC phenotype by comparing the postoperative specimens of the two cohorts. Results:SPARC expression was higher in GC lesions than in the desmoplastic stroma surrounding the tumor cells and noncancerous tissues. High SPARC expression was related to invasion depth, lymph node metastasis, and TNM staging. SPARC expression was lower in patients with preoperative chemotherapy than in controls ( P<0.05). Gross type, histology, depth of invasion, lymph node metastasis, TNM staging, and SPARC phenotype correlated with the overall survival of the patients with preoperative chemotherapy. Further multivariate analysis suggested that lymph node metastasis, histology, and SPARC phenotype after chemotherapy were independent prognostic indicators of GC. Conclusion:SPARC expression was associated with invasion depth, lymph node metastasis, TNM staging and GC prognosis. Preoperative chemotherapy may change the phenotype of SPARC in GC patients.