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*

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

OBJECTIVES: Farnesoid X receptor (FXR) is a member of the nuclear receptor superfamily of ligand activated transcription factors and belongs to bile acid receptor. Studies have shown that the expression of FXR in renal tissue can reduce renal injury via regulation of glucose and lipid metabolism, inhibition of inflammatory response, reduction of oxidative stress and renal fibrosis. However, it is unclear whether FXR is involved in autophagy in renal diseases. This study aims to investigate the role of FXR in cisplatin-induced acute renal injury and whether its mechanism is related to autophagy regulation. METHODS: Twelve male WT or FXR-KO mice at 12 weeks were randomly divided into a WT group, a WT+cisplatin group, a FXR-KO group, and a FXR-KO+cisplatin group, with 6 mice in each group. The WT+cisplatin group and the FXR-KO+cisplatin group were intraperitoneally injected with cisplatin (20 mg/kg), and the WT group and the FXR-KO group were intraperitoneally injected with equal volume of cisplatin solvent. Seventy-two hours later, the mice were killed and blood and renal tissue samples were collected. The levels of SCr and BUN were detected by immunoturbidimetry. After the staining, the pathological changes of renal tissue were observed under optical microscope. The protein levels of LC3 and p62 were detected by Western blotting and immunohistochemistry. The clearance of damaged mitochondria and the accumulation of lysosomal substrate were observed under electron microscope. The apoptosis of renal tubular epithelial cells was detected by TUNEL. RESULTS: Compared with the WT group or the FXR-KO group, both SCr and BUN levels in the WT+cisplatin group or the FXR-KO+cisplatin group were significantly increased (P<0.01 or P<0.001), and SCr and BUN levels in the FXR-KO+cisplatin group were significantly higher than those in the WT+cisplatin group (both P<0.05). Under the light microscope, there were no obvious pathological changes in the renal tissue of mice in the WT group and the FXR-KO group. Both the WT+cisplatin group and the FXR-KO+cisplatin group had vacuolar or granular degeneration of renal tubular epithelial cells, flat cells, lumen expansion, brush edge falling off, and even exposed basement membrane and tubular formation. The scores of renal tubular injury in the WT+cisplatin group and the FXR-KO+cisplatin group were significantly higher than those in the WT group and the FXR-KO group, respectively (both P<0.001), and the score in the FXR-KO+cisplatin group was significantly higher than that in the WT+cisplatin group (P<0.05). Under the transmission electron microscope, the mitochondria of mouse tubular epithelial cell in the WT+cisplatin group and the FXR-KO+cisplatin group was swollen, round, vacuolated, cristae broken or disappeared; the lysosome was uneven and high-density clumps, and the change was more obvious in the FXR-KO+cisplatin group. Western blotting showed that the ratio of LC3-II to LC3-I was decreased and the expression of p62 was increased in the WT+cisplatin group compared with the WT group and the FXR-KO+cisplatin group compared with FXR-KO group (P<0.05 or P<0.01); compared with the FXR-KO group, the ratio of LC3-II to LC3-I was decreased and the expression of p62 was increased significantly in the FXR-KO+cisplatin group (both P<0.05). Immunohistochemistry results showed that the expression of total LC3 and p62 in renal cortex of the WT+cisplatin group and the FXR-KO+cisplatin group was increased significantly, especially in the FXR-KO+cisplatin group. TUNEL results showed that the mice in the WT group and the FXR-KO group had negative staining or only a few apoptotic tubular epithelial cells, and the number of apoptotic cells in the WT+cisplatin group and the FXR-KO+cisplatin group were increased. The apoptosis rates of renal tubular epithelial cells in the WT+cisplatin group and the FXR-KO+cisplatin group were significantly higher than those in the WT group and the FXR-KO group, respectively (both P<0.001), and the apoptosis rate in the FXR-KO+cisplatin group was significantly higher than that in the WT+cisplatin group (P<0.05). CONCLUSIONS Knockout of FXR gene aggravates cisplatin induced acute renal injury, and its mechanism may be related to inhibiting autophagy and promoting apoptosis.
Acute Kidney Injury/pathology* ; Animals ; Apoptosis/physiology* ; Cisplatin/adverse effects* ; Female ; Humans ; Kidney/pathology* ; Male ; Mice ; Mice, Inbred C57BL ; Mice, Knockout

Objective:To explore the differences of immune reconstitution between peripheral blood stem cell transplantation and umbilical cord blood transplantation.Methods:A total of 300 patients (aged 18 (8, 33), 163 males and 137 females) with malignant hematological diseases who received allogeneic hematopoietic stem cell transplantation in the First Affiliated Hospital of University of Science and Technology of China from January 2018 to March 2020 were enrolled in this study, including 255 cases of umbilical cord blood transplantation and 45 cases of peripheral blood stem cell transplantation. Multicolor flow cytometry was applied to analyze lymphocyte subsets of the percentages and absolute counts in the two donor types and peripheral blood of patients after receiving hematopoietic stem cell transplantation. The differences between the two grafts were compared, and the lymphocyte subsets results were evaluated at 1, 2, 3, 4, 6, 9, 12, and 18 months after transplantation. 18-month disease-free survival (DFS) within the 300 patients under the two transplantation types were retrospectively analyzed.Results:1. The proportion of NKT cells in peripheral blood group was significantly higher than that in cord blood group (2.79% vs 0.24%, P<0.001). 2. The proportion of helper T cells in the UCBT group was higher than that in the PBSCT group, as well as the counts 6 months after transplantation ( P<0.05). 3. The proportion of NK1 cells (3 rd to 9 th month) and count (4 th to 12 th month) in UCBT group were significantly higher than those in PBSCT group ( P<0.05). 4. NKT cells in the UCBT group were lower than those in the PBSCT group (proportion and count) throughout the monitoring process ( P≤0.001). 5. The proportion of DNT cells (within 1 year) and count (within 6 months) in the UCBT group were significantly lower than those in the PBSCT group ( P<0.05). Conclusions:Compared with the peripheral blood stem cell transplantation group, the umbilical cord blood transplantation patients had a faster rate of lymphocyte reconstitution, and patients received umbilical cord blood transplantation had a stronger ability of immune reconstitution and could achieve long-term hematopoiesis.

Depression is a common emotional disorder, which has high incidence rate and mortality worldwide. Ascorbic acid (AA) is also known as vitamin C. As a kind of reducing vitamin, AA participates in anti-oxidation, enzyme assistance and neuro-modulation in the central nervous system. Clinical evidence and animal studies show that AA has anti-depressant effect. This article reviews the function of AA in the nervous system, the current researches on relation between AA and depression, and possible mechanism, and analyzes its therapeutic significance in this disease, hoping to provide new ideas for the clinical treatment of depression.

Objective:To investigate the correlation between neutrophil to lymphocyte ratio (NLR) and 30-day clinical outcomes in patients with spontaneous cerebral hemorrhage and whether adding NLR to ICH score improve the accuracy of predicting poor outcomes.Methods:Patients with spontaneous intracerebral hemorrhage admitted to the Department of Neurology, the Second People's Hospital of Hefei from March 2018 to April 2019 were enrolled retrospectively. The demographic and baseline clinical and imaging data were documented. The absolute neutrophil counts and absolute lymphocyte counts within 24 h of onset were obtained and NLR was calculated. At 30 d after the onset of cerebral hemorrhage, the modified Rankin Scale was used to evaluate the outcomes. Good outcome was defined as ≤2, and poor outcome was defined as >2. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcomes. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of baseline NLR, ICH score and NLR+ ICH score for poor outcomes in patients with spontaneous cerebral hemorrhage. Results:A total of 159 patients with spontaneous cerebral hemorrhage were enrolled, including 106 males (66.67%), age 62.29±15.10 years. Neutrophil count was (7.30±3.95)×10 9/L, lymphocyte count was (1.41±0.67)×10 9/L, and NLR was 6.94±7.66. Baseline hematoma volume was 17.93±25.87 ml, median ICH score 0 (interquartile range 0-1). The outcomes of 60 patients (37.7%) were poor at 30 d. Univariate analysis showed that coronary heart disease, systolic blood pressure, diastolic blood pressure, high-sensitivity C-reactive protein, fasting blood glucose, white blood cell count, neutrophil count, NLR, hematoma broken into the ventricle, hematoma volume, NIHSS and ICH scores in the poor outcome group were significantly higher than those of the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that NLR was an independent predictor of poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage (odds ratio 1.135, 95% confidence interval 1.092-2.321; P=0.038). The ROC curve analysis showed that the best cut-off value of NLR was 6.679, and the sensitivity and specificity of predicting poor outcomes were 51.67% and 76.77% respectively; the best cut-off value of ICH score was 1.0, and the sensitivity and specificity of predicting poor outcomes were 69.71% and 89.80% respectively; the sensitivity and specificity of the combined application of NLR + ICH score to predict poor outcomes were 74.58% and 82.65% respectively. Conclusions:NLR was independently associated with poor outcomes at 30 d after the onset of spontaneous cerebral hemorrhage. Adding it to the ICH score could improve the accuracy of predicting poor outcome.

Objective To evaluate the effect of doxofylline on pulmonary inflammatory response induced by mechanical ventilation in rats with chronic obstructive pulmonary disease (COPD).Methods Thirty adult male Sprague-Dawley rats,aged 8 weeks,weighing 200-250 g,were divided into 3 groups (n=10 each) using a random number table method:control group (C group),COPD group and doxofylline group (Dox group).Rats were fed in normoxia for 2 months,and normal saline 0.2 ml was injected into the trachea on 1st and 30th days in C group.Rats were exposed to cigarette smoke for 30 min every day,lasting for 2 months,and lipopolysaccharide 200 μg (0.2 ml) was injected into the trachea on 1st and 30th days in COPD and Dox groups.Two months later,rats in each group were anesthetized,tracheally intubated,and then mechanically ventilated.Doxofylline 50 mg/kg was intravenously injected immediately after intubation in Dox group,and the equal volume of normal saline was given instead in C and COPD groups.Pulmonary specimens were taken after 120 min of mechanical ventilation for examination of pathological changes and for determination of wet/dry weight ratio (W/D ratio) and tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) contents (by enzyme-linked immunosorbent assay).Results No significant pathological change of lung tissues was found in C group,and COPD pathological changes were observed in COPD and Dox groups.Compared with C group,the W/D ratio and TNF-α level were significantly increased,and the IL-10 level was decreased in COPD and Dox groups (P＜0.05).Compared with COPD group,the W/D ratio and TNF-α level were significantly decreased,and the IL-10 level was increased in Dox group (P＜0.05).Conclusion Doxofylline can reduce the pulmonary inflammatory response induced by mechanical ventilation in rats with COPD.

AIM:To investigate the effect of Sonic Hedgehog ( Shh) signaling blockade on the growth of hema-tocarcinoma cells and underlying mechanisms.METHODS: The expression of Shh signaling molecules in hematocarci-noma cell lines BEL-7402, Huh7 and HepG2 was detected by RT-PCR.The cell viability was detected by MTT assay.The cell cycle and apoptosis were analyzed by flow cytometry.The expression of apoptosis-related proteins was determined by Western blot.RESULTS:Shh signaling molecules were all expressed in BEL-7402, Huh7 and HepG2 cells.The mRNA expression of Patched ( Ptch) , Gli1 and Gli2 was down-regulated by anti-Shh antibody.Blockade of Shh signaling pathway inhibited the proliferation of hepatocarcinoma cells with increasing cells in G0/G1 phase and induced the apoptosis of hepa-tocarcinoma cells.Treatment with anti-Shh antibody down-regulated the protein expression of pro-caspase-3, pro-caspase-8 and pro-caspase-9, while up-regulated the protein levels of cleaved caspase-3, cleaved caspase-8 and cleaved caspase-9 in BEL-7402 cells.CONCLUSION:Blockade of Shh signaling pathway inhibits the growth of hepatocarcinoma at different levels by cell cycle arrest and inducing apoptosis of hematocarcinoma cells.

Objective To formulate the clinical application specification of antibiotics ,make a deference index of antibac-terial drugs in chest department according to the investigation about the antibiotics′utility situation in chest department in 2014 and provide a theoretic foundation for the clinical doctor to promote the clinical rational drug use .Methods The antibiotics′ap-plication information of 300 cases inpatients in the chest department of a hospital in 2014 were researched and analyzed through retrospection ,regarding with the relevant regulations and related clinical practice guidelines ,the clinical application specifica-tion of antibiotics was formulated and the analysis ,calculation ,statistics to the actual and theoretical value of the rate and inten-sity of antibiotics′application ,the application rate of the prophylactic antibiotics of type I incision on the inpatients in the chest department had been done .The differentiation index of them were establish .Results The rates of the actual antibiotics′appli-cation and the prophylactic antibiotics of type I incision respectively were 72 .7% and 92 .6% ,while the intensity of antibiotics′application was 61.2 DDDs/(100 persons · d ) . The deference indexes of them were developed 69 .3% , 63 .0% and 49.3 DDDs/(100 persons · d) .Conclusions There′re still much irrational places in the use of antibiotics in chest department of the hospital .It′s essential to strengthen supervision in order to promote the rational use of antibiotics in clinical practice .

Acupuncture Therapy ; Herpes Zoster ; complications ; Humans ; Male ; Middle Aged ; Motor Neuron Disease ; etiology ; therapy ; Neuralgia, Postherpetic ; etiology ; therapy