Objective To evaluate cardiac involvement in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) using echocardiography combined with electrocardiography. Methods A retrospective analysis was performed on the detailed medical records of AAV patients treated in Jining First People’s Hospital between January 2020 and December 2024. Eighty patients were enrolled in the AAV group, and the risk of heart disease was compared between the AAV group and a control group with 80 subjects matched for age, sex, and cardiovascular disease risk factors. Results Electrocardiographic abnormalities were observed in 78.75% of patients in the AAV group, while significant electrocardiographic abnormalities only occurred in symptomatic patients in the control group. There were no differences in left atrial enlargement or interventricular septal thickening between the AAV group and the control group. The overall left ventricular systolic function in the AAV group was lower than that in the control group (8.75% vs. 0). The incidence of reduced diastolic function in the AAV group was significantly higher than that in the control group (37.5% vs. 15%). The incidence rates of tricuspid regurgitation, mitral regurgitation, aortic regurgitation, and pericardial effusion in the AAV group were significantly higher than those in the control group. Pericardial thickening, aortic stenosis, pulmonary hypertension, and rare periaortic granulomas were found in the AAV group, but not in the control group. Conclusion Echocardiography and electrocardiography are important examination methods for evaluating cardiac involvement in AAV. These methods have key roles in disease screening, diagnosis and treatment, follow-up, and prognosis judgment.

Objective To explore the effect of sequential therapy with butylphthalide on the risk of post-stroke epilepsy(PSE)in patients with cerebral infarction.Methods The clinical data of patients with cerebral infarction hospitalized in Langfang People's Hospital from October,2016 to October,2022 were selected and analyzed.Patients receiving butylphthalide sequential treatment were included in the butylphthalide group,patients who were hospitalized at the same time with matching gender,age(±5 years),basic disease,clinical drug treatment scheme and follow-up period but did not receive butylphthalide treatment were included in the control group.The general clinical data,laboratory examination results on admission,and incidence of PSE in the two groups were compared,and multivariate Logistic regression was used to analyze the correlation between sequential therapy with butylphthalide and PSE occurrence in patients with cerebral infarction.Results A total of 1,200 patients were included,with 600 patients in each group.There was no significant difference in general clinical data such as sex,age,complications and living habits between the two groups(P＞0.05).There were no significant differences between the two groups in the patients distribution of TOAST classification,NIHSS score(P＞0.05).The incidence of PSE in butylphthalide group was significantly lower than that in control group(4.17％vs.7.83％,P＜0.05).The application of sequential treatment with butylphthalide was a protective factor for PSE occurrence in patients with cerebral infarction[OR=0.352,95％CI(0.151,0.821),P=0.016].Conclusion Sequential treatment with butylphthalide can reduce the risk of post-stroke epilepsy in patients with cerebral infarction.

Objective:To investigate the diagnostic value of umbilical cord blood lactic acid and base excess for multi-organ dysfunction following neonatal asphyxia.Methods:A retrospective analysis was conducted on the clinical data of 244 patients at high risk for perinatal asphyxia who received treatment at Dongyang People's Hospital from January 2021 to December 2023.Based on the presence of organ dysfunction, the infants were divided into three groups: a single organ dysfunction group (Group A, n = 55), a multi-organ dysfunction group (Group B, n = 16), and a no organ dysfunction group (Group C, n = 173). Lactic acid levels and base excess values were compared among the three groups. Receiver operating characteristic curves were used to validate the predictive value of lactic acid and base excess values for organ dysfunction. Results:There were no statistically significant differences in general data among the three groups ( P > 0.05). In Group B, the lactic acid level was 15.10 (13.85, 16.83) mmol/L, and the base excess value was 9.80 (6.65, 15.18) mmol/L. In Group A, the lactic acid level was 7.70 (6.25, 11.70) mmol/L, and the base excess value was 5.70 (3.85, 9.60) mmol/L. In Group C, the lactic acid level was 6.80 (4.30, 9.00) mmol/L, and the base excess value was 4.00 (3.00, 6.50) mmol/L. The lactic acid level and base excess value in Group B were significantly higher than those in both Group A and Group C. Additionally, the lactic acid level and base excess value in Group A were significantly greater than those in Group C ( t = 2.60, 20.19, 2.95, 1.92, all P < 0.05). Receiver operating characteristic curve analysis revealed that the combined assessment of base excess value and lactic acid level was more effective than evaluating each parameter individually in predicting the presence of organ damage and multiple organ dysfunction syndrome. Additionally, the detection of base excess value was found to be superior to the measurement of lactic acid level. The areas under the curve values for the combined assessment of base excess value and lactic acid level for the presence of organ damage and multiple organ dysfunction syndrome were 0.694 and 0.856, respectively. In comparison, the AUC values for base excess value detection were 0.678 and 0.846, while the AUC values for lactic acid level measurement were 0.633 and 0.797, respectively. Conclusions:Umbilical cord blood lactic acid and base excess are correlated with organ dysfunction following neonatal asphyxia, and both parameters have clinical value in assessing organ damage.

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*

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis is a special type of dermatomyositis. It has characteristic clinical manifestations, mild myositis symptoms, and is prone to be accompanied by rapidly progressive interstitial lung disease, which indicates a poor prognosis. Its pathogenesis remains unclear, and may be related to genetic and environmental factors. This review summarizes progress in the treatment of anti-MDA5 antibody-positive dermatomyositis in recent years, in order to provide new ideas for its clinical treatment.

Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis is a special type of dermatomyositis. It has characteristic clinical manifestations, mild myositis symptoms, and is prone to be accompanied by rapidly progressive interstitial lung disease, which indicates a poor prognosis. Its pathogenesis remains unclear, and may be related to genetic and environmental factors. This review summarizes progress in the treatment of anti-MDA5 antibody-positive dermatomyositis in recent years, in order to provide new ideas for its clinical treatment.

Objective To explore the effect of sequential therapy with butylphthalide on the risk of post-stroke epilepsy(PSE)in patients with cerebral infarction.Methods The clinical data of patients with cerebral infarction hospitalized in Langfang People's Hospital from October,2016 to October,2022 were selected and analyzed.Patients receiving butylphthalide sequential treatment were included in the butylphthalide group,patients who were hospitalized at the same time with matching gender,age(±5 years),basic disease,clinical drug treatment scheme and follow-up period but did not receive butylphthalide treatment were included in the control group.The general clinical data,laboratory examination results on admission,and incidence of PSE in the two groups were compared,and multivariate Logistic regression was used to analyze the correlation between sequential therapy with butylphthalide and PSE occurrence in patients with cerebral infarction.Results A total of 1,200 patients were included,with 600 patients in each group.There was no significant difference in general clinical data such as sex,age,complications and living habits between the two groups(P＞0.05).There were no significant differences between the two groups in the patients distribution of TOAST classification,NIHSS score(P＞0.05).The incidence of PSE in butylphthalide group was significantly lower than that in control group(4.17％vs.7.83％,P＜0.05).The application of sequential treatment with butylphthalide was a protective factor for PSE occurrence in patients with cerebral infarction[OR=0.352,95％CI(0.151,0.821),P=0.016].Conclusion Sequential treatment with butylphthalide can reduce the risk of post-stroke epilepsy in patients with cerebral infarction.

Objective:To investigate the diagnostic value of umbilical cord blood lactic acid and base excess for multi-organ dysfunction following neonatal asphyxia.Methods:A retrospective analysis was conducted on the clinical data of 244 patients at high risk for perinatal asphyxia who received treatment at Dongyang People's Hospital from January 2021 to December 2023.Based on the presence of organ dysfunction, the infants were divided into three groups: a single organ dysfunction group (Group A, n = 55), a multi-organ dysfunction group (Group B, n = 16), and a no organ dysfunction group (Group C, n = 173). Lactic acid levels and base excess values were compared among the three groups. Receiver operating characteristic curves were used to validate the predictive value of lactic acid and base excess values for organ dysfunction. Results:There were no statistically significant differences in general data among the three groups ( P > 0.05). In Group B, the lactic acid level was 15.10 (13.85, 16.83) mmol/L, and the base excess value was 9.80 (6.65, 15.18) mmol/L. In Group A, the lactic acid level was 7.70 (6.25, 11.70) mmol/L, and the base excess value was 5.70 (3.85, 9.60) mmol/L. In Group C, the lactic acid level was 6.80 (4.30, 9.00) mmol/L, and the base excess value was 4.00 (3.00, 6.50) mmol/L. The lactic acid level and base excess value in Group B were significantly higher than those in both Group A and Group C. Additionally, the lactic acid level and base excess value in Group A were significantly greater than those in Group C ( t = 2.60, 20.19, 2.95, 1.92, all P < 0.05). Receiver operating characteristic curve analysis revealed that the combined assessment of base excess value and lactic acid level was more effective than evaluating each parameter individually in predicting the presence of organ damage and multiple organ dysfunction syndrome. Additionally, the detection of base excess value was found to be superior to the measurement of lactic acid level. The areas under the curve values for the combined assessment of base excess value and lactic acid level for the presence of organ damage and multiple organ dysfunction syndrome were 0.694 and 0.856, respectively. In comparison, the AUC values for base excess value detection were 0.678 and 0.846, while the AUC values for lactic acid level measurement were 0.633 and 0.797, respectively. Conclusions:Umbilical cord blood lactic acid and base excess are correlated with organ dysfunction following neonatal asphyxia, and both parameters have clinical value in assessing organ damage.

Ameloblastoma is a benign tumor characterized by locally invasive phenotypes,leading to facial bone destruction and a high recurrence rate.However,the mechanisms governing tumor initiation and recurrence are poorly understood.Here,we uncovered cellular landscapes and mechanisms that underlie tumor recurrence in ameloblastoma at single-cell resolution.Our results revealed that ameloblastoma exhibits five tumor subpopulations varying with respect to immune response(IR),bone remodeling(BR),tooth development(TD),epithelial development(ED),and cell cycle(CC)signatures.Of note,we found that CC ameloblastoma cells were endowed with stemness and contributed to tumor recurrence,which was dominated by the EZH2-mediated program.Targeting EZH2 effectively eliminated CC ameloblastoma cells and inhibited tumor growth in ameloblastoma patient-derived organoids.These data described the tumor subpopulation and clarified the identity,function,and regulatory mechanism of CC ameloblastoma cells,providing a potential therapeutic target for ameloblastoma.

Ubiquitin-specific protease (USP) is a major member of the deubiquitinating enzymes (DUB) family. Dysregulation of DUB could lead to dysfunction of the ubiquitin system, which in turn regulates the tumor progression. USP regulates the development and progression of hepatocellular carcinoma (HCC) by selectively degrading or stabilizing substrate proteins related to oncogenes, tumor suppressors, DNA damage repair, and cell cycle. This article summarizes the research progress of USP in HCC and the application of USP-specific small molecule inhibitors, providing a reference for targeting USP as a diagnostic and therapeutic tool for HCC.