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 mechanisms of the flavonoids from new "Zhe Eight Flavors" Quzhou Fructus Aurantii(PTFC) against hepatocellular carcinoma based on the prediction of network pharmacology and experimental verification. METHODS From TCMSP, TCMID, ETCM, BATMAN-TCM and SwissTargetPrediction databases, the potential target proteins of PTFC, including naringin, narirutin and neohesperidin were collected. Based on the GeneCards, CTD, Disgenet, and OMIM databases, a set of target proteins for hepatocellular carcinoma was constructed. Taking the intersection of potential target proteins of PTFC and target proteins of hepatocellular carcinoma, key target proteins were obtained and a protein-protein interaction network was established. Besides, GO function and KEGG pathway enrichment analysis on the core target proteins was performed and a Compounds-Targets-Pathways-Disease network was constructed. Through proliferation, cloning, wound healing, and migration experiments, the effects of PTFC on the viability of HepG2 liver cancer cells were analyzed. Using fluorescence probe staining the impacts of PTFC on the mitochondrial membrane potential and apoptosis of HepG2 were observed. Finally, the validation of the regulatory effect of PTFC on the key predicted target PRKCA were carried out through RT-qPCR. RESULTS Based on network pharmacology, a total of 217 potential target proteins for PTFC were screened, with 59 intersecting target proteins related to diseases, including ALB, ESR1, PRKCA, and others. GO functional and KEGG pathway enrichment analysis revealed that the PTFC target proteins were involved in 193 biological processes and 13 cancer-related signaling pathways. Experimental results demonstrated that PTFC could impact the proliferation, cloning, wound healing, and migration abilities of liver cancer cells, leading to a decrease in mitochondrial membrane potential and promoting cell apoptosis. The results of RT-qPCR confirmed a significant downregulation of PRKCA expression by PTFC, validating the predictions made by network pharmacology analysis. CONCLUSION This study has revealed the potential molecular mechanism of PTFC treating hepatocellular carcinoma via the PRKCA target, laying the foundation for clinical application of PTFC.

OBJECTIVE To investigate the effects of different drying aids on the hygroscopic property of extract powder of modified Liujunzi decoction （MLJZD）， and screen the best drying aid. METHODS MLJZD extract was mixed with β-cyclodextrin， microcrystalline cellulose， lactose， arabic gum， maltodextrin， corn starch， mannitol， dextrin， soluble starch and pre-gelatinized starch at the mass ratio of 1∶0.3 and 1∶0.5， respectively. The extract powder was prepared after vacuum drying. Physical fingerprints were established with 8 physical indexes， including moisture content， bulk density， vibrating-solid density， gap rate， Carr index， Hausner ratio， angle of rest and hygroscopicity， and then similarity evaluation was performed. The matrix hotspot map was drawn to analyze the influence of physical indexes on hygroscopicity. The moisture absorption rate of MLJZD extract powder was measured at room temperature for 2， 4， 8， 10 h and 1， 2， 3， 7 d. The moisture absorption rate-time curve was drawn， and the best auxiliary materials were selected by comparison. RESULTS The similarity evaluation results of physical fingerprint showed that the prepared MLJZD extract powder were stable and the similarities were above 0.90. The matrix hotspot analysis showed that there was significant correlation between bulk density and vibratory density and the moisture absorption rate of the MLJZD extract powder （P＜0.05）. The moisture absorption rate-time curve analysis showed that the moisture absorption rate of MLJZD extract powder prepared with the mass ratio of 1∶0.5 was lower than prepared with the mass ratio of 1∶0.3. Under both ratios， lactose showed the best drying aid effect， followed by soluble starch and mannitol. CONCLUSIONS Lactose， as the drying aid （under the mass ratio of 1∶0.5）， can obviously improve the hygroabsorbance effect of the extract powder of MLJZD， which provides a reference for the selection of auxiliary materials for MLJZD solid preparations.

Objective: To obtain the dietary exposure of lead in primary, middle and high school students, and to provide basic foundation for food safety risk assessment and management for children and adolecsents. Methods: Weighing method, 3-days hour dietary survey, combining with the food frequency questionnaire, was applied to obtain basic dietary data in 616 primary, middle and high school students selected through multi-stage randdom sampling method from Pudong new area of shanghai. Data on lead concentrations were derived from the food safety risk monitoring system, which included 1 145 samples. Results: Lead was detected in 568 of 1 145 samples (49.61%) from 10 categories of foods. The exceeding standard rate was 3.58% (41 samples exceeded). The average content of lead was (0.12±0.25) mg/kg, fungi and algae, beans and the aquatic products were found to be the primary food sources of lead exposure. The average dietary lead exposure in primary, middle and high school students was 9.94 μg/kg per week, accounted for 39.76% of PTWI. The lead exposure level at the 97.5th percentile which accounted for 118.24% of PTWI was 29.56 μg/kg. Vegetables, beans and cereal foods were the mainly source of dietary lead exposure, with average dietary lead exposure 2.57, 2.44 and 1.43 μg/kg peer week, accounted for 10.26%, 9.76% and 5.74% of PTWI, respectively. Conclusion Lead is present in some foods available in local markets in Pudong New Area, Shanghai. Low level of dietary exposure to lead is found in primary, middle and high school students, however, it depends on dietary pattern. Continued efforts are needed to reduce the dietary exposure of lead in school students.

Objective: To investigate the clinical efficacy and adverse effects of stereotactic body radiotherapy (SBRT) in the treatment of T₂N₀M₀ non-small cell lung cancer (NSCLC) patients. Methods: By retrospectively analyzing the clinical data of 30 inoperable patients with stage T₂N₀M₀ NSCLC treated by SBRT, the overall survival, progression-free survival, cancer-specific survival and adverse effects were determined. Results: The median follow-up was 18.4 months. The 1-, 2-, and 3-year overall survival rates were 92.2%, 92.2% and 80.6%, respectively. The corresponding cause-specific survivals were 95.7%, 95.7% and 83.7%. The progression-free survivals were 70.2%, 54.1% and 40.6%. The local control rates were 100%, 94.4%, and 94.4%. The regional controls were 84.2%, 72.1%, and 54.1%; and distant controls were 84.6%, 72.4% and 64.3%, respectively. Twenty patients (66.7%) developed symptoms of grade 1 radiation-related toxicities: dyspnea, chest pain, fatigue, cough, esophagitis, or pneumonia. Among these, 5 patients suffered grade ≥2 radiation pneumonitis, and one patient experienced grade 4 radiation pneumonitis. Conclusions SBRT was efficient and safe for patients with inoperable T₂N₀M₀ NSCLC, imposing tolerable toxicities.

Objective To analyze the relationship of cerebral microbleeds (CMBs)of different regions,especially mixed-CMBs,with cerebral amyloid angiopathy (CAA)detected using 18F-AV45 positron emission tomography(PET).Methods A total of 52 consecutive patients (68.17 ± 9.89 years old)with memory decline and CMBs found in susceptibility-weighted images(SWI)according to the inclusive and exclusive criteria were recruited.Patients were divided into three groups based on different regions of CMBs,the strictly lobar CMBs (SL-CMBs) group,the deep-CMBs (D-CMBs) group and the mixed-CMBs (M-CMBs)group.Patients in the three groups underwent 18F-AV45 PET detection and then were analyzed based on the results of 18F-AV45 PET.Results The positive rates of cerebral amyloid angiopathy in the SL-CMBs,M-CMBs and D-CMBs groups were 68.4 ％ (13/19),82.4 ％ (14/17) and 25.0 ％ (4/16),respectively,with statistical significance (P =0.002).There were significant differences in positive rates of cerebral amyloid angiopathy between the D-CMBs group and the M-CMBs group and between the D-CMBs group and the SL-CMBs group(P =0.001 and 0.010,respectively),while there was no difference between the M-CMBs and SL-CMBs groups in positive rates of cerebral amyloid angiopathy(P =0.335).Using the D-CMBs group as the reference group,multivariate logistic regression analysis showed that the odds ratios of positive CCA detected by PET in SL-CMBs and M-CMBs were 30.585(95％CI:2.492-375.360)and 8.107(95％CI:1.072-61.295),respectively.Conclusions Compared with D-CMBs,M-CMBs and SL-CMBs are more likely to be related to cerebral amyloid angiopathy.The presence of M-CMBs also indicates that patients have a high probability of CAA.

Objective To investigate the application value of combined detection of antikeratin (AKA) antibody,anti-cyclic citrullinated peptide(anti-CCP) antibody,anti-RA33 antibody,RF and ESR in the diagnosis of rheumatoid arthritis(RA).Methods One hundred cases of RA and 60 cases of suspected RA in our hospital from June 2014 to May 2015 were collected.One hundred and twenty cases of non-RA other autoimmune diseases served as the control group.The indirect immunofluorescence assay (IFA) was used to detect anti-KA antibody,anti-CCP antibody and anti-RA33 antibody were detected by using ELISA.The rate scatter turbid assay was used to detect RF.The Westergren method was used to detect ESR.The diagnostic performance of each diagnostic indicator was evaluated.Results The detection rates of anti-KA antibody,anti-CCP antibody,anti-RA33 antibody,RF and ESR in the RA group were in turn 64%,75%,44%,84% and 51% respectively,the detection rate(sensitivity) of 5-indicator parallel detection were 97%, the specificity of 5-indicator series detection was 89.2%;in the suspected RA group,the detection rates of 5-indicator were in turn 16.7%, 31.7%,13.3%,20%,15% respectively,which in the control group were in turn 0.8%,2.5%,1.7%,0.8% and 5.8% respectively.The detection rates of 5-indicator in the RA group was significantly higher than that in the suspected RA group,showing extremely significant difference (P<0.001),the detection rate of 5-indicator had extremely significant difference between the suspected RA group and control group (P<0.001),the sensitivity of five-indicator parallel detection was 97%,which was significantly higher than that of single indicator detection (P<0.05),the detection specificity of 5-indicator series detection was up to 100%,which was also significantly higher than that of single indicator detection (P<0.05),the missed diagnosis rate of parallel detection was minimal,while the negative predictive value was highest,the misdiagnosis rate of series detection was lowest,the positive predictive value was highest,the Youden index of parallel detection was largest.Conclusion The single detection of anti-CCP antibody and RF have good sensitivity and specificity, but 5-indicator combined detection has higher sensitivity and specificity,which can better reduce the missed diagnosis rate and misdiagnosis rate,can greatly improve the efficiency of diagnosis,and has an important clinical significance for the early diagnosis of RA.

Objective To evaluate the safety and clinical efficacy of stereotactic body radiation therapy (SBRT) for lung cancer.Methods A retrospective analysis was performed on 200 patients with primary non-small cell lung cancer (NSCLC)(118 patients) or solitary pulmonary metastasis (82 patients) who underwent SBRT in Zhejiang Cancer Hospital from January 2012 to September 2015.The 80% isodose line covered 95% of the planning target volume,and the 100% isodose line covered 100% of the internal gross tumor volume.The fractional dose was 4.0-18.0 Gy daily or every other day,and the biologically equivalent dose ranged from 40.0 to 151.2 Gy (median 100 Gy).Results All patients completed treatment.The follow-up rate was 96.0%.The complete response and partial response rates were 14.8%(17/115) and 65.2%(75/115) for the primary tumor group,versus 25%(19/77) and 38%(29/77) for the metastasis group.The incidence rates of grade Ⅱ and Ⅲ acute radiation pneumonitis were 4.7% and 3.1%,respectively.The median follow-up was 14.9 months.The 1-and 2-year local control rates were 95.7% and 84.3% for the primary tumor group,versus 92% and 73% for the metastasis group.The 1-and 2-year overall survival rates were 94.5% and 92.0% for the primary tumor group,versus 85% and 62% for the metastasis group.Conclusions SBRT is a safe and effective treatment for early primary NSCLC and solitary pulmonary metastasis,resulting in high 1-and 2-year local control and overall survival rates and low rate of complications.

Objective To explore the rationality of correcting urinary iodine (UI) concentration by using urine specific gravity (U-SG).Methods Weighing method and refractometer method were used respectively to measure specific gravity of 10-30 g/L mass concentration of different inorganic salts (sodium chloride,sodium sulfate,ammonium biphosphate) and organic matters(urea,glucose,glycine) aqueous solution,and urine plus 10-30 g/L sodium chloride or urea.UI concentrations in urine samples of 27 pregnant women respectively were expressed by direct method,weighing method U-SG correction and refractometer method U-SG correction.One random urine sample was collected for six batches in different seasons from children aged 8-10 and pregnant women for determination of U-SG and UI concentration.UI concentration was determined by arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results ①Measured by weighing method,specific gravity of inorganic salt (sodium chloride,sodium sulfate,ammonium biphosphate) aqueous solution was significantly greater than that of organic matters (urea,glucose,glycine) aqueous solution which had the same mass concentration.The specific gravity of 10 g/L sodium chloride aqueous solution was 1.008,and that of 30 g/L urea solution was 1.006.②Measured by weighing method,10 g/L sodium chloride was added to 3 urine samples separately.Accordingly the increases of USG were 0.006,0.008 and 0.007,respectively.Otherwise,the increases of U-SG were 0.003,0.002 and 0.004,respectively,when adding 10 g/L urea.~he median results of UI concentrations in urine samples from 27 pregnant women were 106.4,165.2 and 211.8 μg/L,respectively,expressing obtained by direct method,weighing method USG correction and refractometer method U-SG correction.④The determination results of six batches urine collected from children aged 8-10 in different seasons,the median results of U-SG measured by refractometer method were 1.019 0-1.021 2,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 134.5-181.7 μg/L and 157.7-190.4 μg/L.The determination results of six batches urine samples of pregnant women in different seasons,the median results of U-SG measured by refractometer method were 1.013 4 -1.017 1,the median UI concentration results obtained by direct method and refractometer method U-SG correction were 96.2-138.9 μg/L and 135.2-181.6 μg/L.Conclusions The change of sodium chloride concentration in urine is the most important reason for the change of U-SG.In China,the main source of UI is the intake of edible iodized salt.Iodized salt intakes directly affect the U-SG and UI concentration.If the U-SG is used to correct the UI concentration,there will be a phenomena that the lower intake of iodized salt the lower U-SG.So the UI concentration was falsely increased significantly after correction.Conversely higher intakes of iodized salt caused higher U-SG.The UI concentration was falsely reduced significantly after correction.Therefore,U-SG cannot be used to correct the UI concentration.

Objective_To investigate the effect of ginsenoside Rg1 on the spleen structure and function of aging rats and its relative mechanism.Methods_Forty SD rats were randomly divided into normal control group, aging model group (D-galactose 120 mg/kg,qd ×42 d), Rg1 intervention group(D-galactose 120 mg/kg,qd ×42 d and Rg1 20 mg/kg, from day 15th,qd ×28 d) and Rg1 control group.After finishing injections the spleen index was meas-ured, paraffin sections were then made to observe spleen microscopic structure.Senescence-associatedβ-Galactosi-dase( SA-β-Gal) stain was used to detect aging splenocytes.The proliferative capacity of splenocytes stimulated with Concanavalin A (ConA) was measured by CCK-8.The content of IL-2,IL-6 and advanced glycosylation end products(AGEs) was detected by ELISA.The level of ROS was analyzed by flow cytometry(FCM).Malondialde-hyde(MDA), superoxide dismutase (SOD) were detected by enzymatic assay.The expression of senescence-associ-ated protein P53,P21 and RB were detected by Western blot analysis.Results_Comparing the Rg1 intervention group with the aging model group, spleen index, splenic white pulp area proportion, the proliferative capacity of splenocytes were significantly increased (P<0.05);The secretory capability of IL-2 and IL-6, the active content of SOD were obviously increased(P<0.01);The percentage of SA-β-Gal positive splenocytes, the productions of ROS and MDA were significantly decreased (P<0.01);The production of AGEs was decreased (P<0.05);The expressions of P53,P21 and Rb were also significantly down-regulated ( P<0.01) .Conclusions_Ginsenoside Rg1 relieves injure of the spleen in aging rats induced by D-galactose.It is suggested that the mechanism may be Rg1 in-hibiting oxidative stress and down-regulating P53-P21-RB signaling pathway.