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*

The quality of clinical trials is critical to ensuring the safety and rights of participants, and ensuring the reliability of trial data. It directly affects the scientific validity of research conclusions and the effectiveness of regulatory decisions. This study aimed to establish an efficient quality management system to enhance the overall quality of clinical trials. Our hospital had established a dedicated quality control team, and developed a quality management module which was integrated to the clinical trial management system. Since February 2021, the hospital had fully digitized the electronic management of quality control processes, and achieved closed-loop management throughout the entire clinical trial by using this system. Key measures of the system included formulating tailored quality control plans, optimizing the design of quality control checklists, and refining quality control feedback mechanisms to improve management efficiency. In 2024, the annual quality control workload had reached 807 activities, with a completion rate of 93% and a timeliness rate of 91%. These outcomes demonstrate that the system could effectively improve the management quality and efficiency of pharmaceutical and medical devices clinical trials. The system could provide insights and practical references for the standardized implementation and quality assurance of clinical trials.

The quality of clinical trials is critical to ensuring the safety and rights of participants, and ensuring the reliability of trial data. It directly affects the scientific validity of research conclusions and the effectiveness of regulatory decisions. This study aimed to establish an efficient quality management system to enhance the overall quality of clinical trials. Our hospital had established a dedicated quality control team, and developed a quality management module which was integrated to the clinical trial management system. Since February 2021, the hospital had fully digitized the electronic management of quality control processes, and achieved closed-loop management throughout the entire clinical trial by using this system. Key measures of the system included formulating tailored quality control plans, optimizing the design of quality control checklists, and refining quality control feedback mechanisms to improve management efficiency. In 2024, the annual quality control workload had reached 807 activities, with a completion rate of 93% and a timeliness rate of 91%. These outcomes demonstrate that the system could effectively improve the management quality and efficiency of pharmaceutical and medical devices clinical trials. The system could provide insights and practical references for the standardized implementation and quality assurance of clinical trials.

Objective To explore the perioperative therapeutic effects and follow-up manage-ment in 16 patients with left ventricular assist device(LVAD)implantation.Methods A retrospec-tive analysis was conducted in data of 16 patients who underwent LVAD implantation in the depart-ment of cardiovascular surgery.Data of 6-minute walk test(6MWT),European Quality of Life-5 Di-mension-5 Levels(EQ-5D-5L),New York Heart Association(NYHA)classification,echocardio-graphy,chest radiography,cardiothoracic ratio,and occurrence of complications(infection,bleed-ing,thrombosis,right heart failure,neurological issues)were collected via the electronic medical re-cord system before surgery and at 30,60,and 90 days postoperatively.Results All patients sur-vived with the pump at 90 days postoperatively.One patient with preoperative renal insufficiency un-derwent dialysis and received a heart transplant after 8 months.One patient developed a sterile granu-loma at the percutaneous lead site on the abdominal wall,which improved after treatment,no complica-tions occurred in other patients.At 90 days postoperatively,there was no statistically significant differ-ence in the right ventricular area change fraction and tricuspid annular plane systolic excursion com-pared with preoperative values(P＞0.05).The left ventricular ejection fraction,left ventricular end-diastolic diameter,and cardiothoracic ratio showed significant improvement compared with preoperative levels(P＜0.05).At 30 days postoperatively,30％of patients recovered to NYHA class Ⅰ and 70％to class Ⅱ;at 60 days,80％of patients to class Ⅰ and 20％to class Ⅱ;at 90 days,90％to classⅠ and 10％to class Ⅱ.The 6MWT and EQ-5D-5L scores of patients significantly increased within 90 days postoperatively(P＜0.01).Conclusion Through rigorous preoperative assessment by a multidisciplinary LVAD team,refinement of surgical techniques,and comprehensive management during hospitalization,self-management before discharge,daily follow-up after discharge,and fol-low-up management upon returning to the hospital for patients with LVAD implantation,the cardiac function and quality of life of patients are significantly improved at 90 days postoperatively.

Objective To analyze the effects of glucocorticoid stent implantation combined with nasal endoscopic surgery on nasal ventilation function and serum levels of eosinophil cationic protein(ECP),fibronectin(Fn)and aquaporin-1(AQP-1)in patients with chronic sinusitis with nasal polyp(CSwNP).Methods 60 patients with CSwNP from January 2022 to February 2023 were included in the study,and then they were divided into experimental group and control group,with 30 cases in each,using random number table method.The experimental group was treated with glucocorticoid stent implantation based on the original nasal endoscopic surgery,and the control group was treated with nasal endoscopic surgery,and both groups were treated until 12 weeks after surgery.The two groups of nasal symptoms,quality of life,nasal structure and ventilation function,serum levels of ECP,Fn,AQP-1,and adverse reactions were compared.Results Compared before the treatment,scores of nasal mucosal structure(Lund-Mackay scale),nasal symptom visual analogue scale(VAS)(including:nasal obstruction,runny nose,stuffy head,decreased sense of smell,nasal dryness/scab)and serum levels of ECP were decreased,distance from minimum nasal cross section to anterior nostril(DCAN)was shortened in two groups 12 weeks after treatment,and the experimental group was lower than the control group,the differences were statistically significant(P<0.05).Compared before the treatment,12 weeks after treatment,the nasal minimum cross-sectional area(NMCA),score of world health organization abbreviated quality of life(WHOQOL-100),nasal cavity volume(NCV),serum levels of Fn,AQP-1 were increased in two groups,and the experimental group was higher than the control group,the differences were statistically significant(P<0.05).During treatment,the incidence of adverse reactions was similar between the two groups(P>0.05).Conclusion Glucocorticoid stent implantation combined with nasal endoscopic surgery can control nasal symptoms in patients with CSwNP,improve nasal structure and ventilation function,regulate serum levels of ECP,Fn,AQP-1,and improve patients'quality of life.

Neurodegenerative diseases are often associated with inflammatory mechanisms, where persistent or excessive inflammatory responses can lead to neuronal damage and subsequent pathological changes. In acute neurological conditions such as stroke or traumatic brain injury, inflammation is a key factor that triggers acute neuronal injury and long-term sequelae. In chronic neurodegenerative diseases, including Alzheimer's disease, cognitive dysfunction, Parkinson's disease, and multiple sclerosis, the chronic activation of inflammation is closely related to gradual degeneration of neurons. Resolvin D1 (RvD1), an endogenous pro-resolving mediator, plays a crucial role in controlling the intensity and duration of inflammation by inhibiting excessive activation of immune cells, modulating the release of pro-inflammatory cytokines, and maintaining the integrity of the blood-brain barrier. This review focuses on the mechanisms of RvD1 in mediating inflammatory damage in major neurological diseases, aiming to provide theoretical support for a deeper understanding of disease mechanism, optimized therapeutic strategies, and enhanced outcome.

Objective To investigate the correlation between the level of oxidative stress indicators in placental tissues and placental perfusion level in twin-to-twin transfusion syndrome (TTTS). Methods A total of 105 cases of dichorionic monoamniotic monozygotic twin pregnant women were included in the study. They were divided into control group of 90 cases and observation group of 15 cases based on whether TTTS occurred during pregnancy. The levels of oxidative stress indicators[malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-PX)]in placental tissues below the attachment points of the two umbilical cords in the two groups were detected. The maximum diameters of arterio-arterial (AA) anastomosis, veno-venous (VV) anastomosis, and arterio-venous (AV) anastomosis, as well as the difference ratio of placental tissue areas (PTD), were compared between the two groups. The correlation between the levels of oxidative stress indicators in placental tissues and placental perfusion level was analyzed. Results Compared with placental A and placental B in the control group, the MDA level in the placental tissues of the blood supply end and the blood recipient end in the observation group was increased, while the SOD and GSH-PX levels were decreased, and the maximum diameter of AA anastomosis was reduced, there were statistically significant differences (P < 0.05). In the observation group, the MDA level in the placental tissues of the blood supply end was higher than that of the blood recipient end, the SOD and GSH-PX levels were lower than those of the blood recipient end, and the maximum diameter of AA anastomosis was smaller than that of the blood recipient end, with statistically significant differences (P < 0.05). The maximum diameters of AV anastomosis and PTD in the observation group were larger than those in the control group (P < 0.05). There was no significant difference in the maximum diameter of VV anastomosis between the two groups (P>0.05). Pearson correlation analysis showed that there were no significant correlations of MDA, SOD and GSH-PX levels with the maximum diameter of AA anastomosis and PTD in the placental tissues of the control group (P>0.05).In the placental tissues of the blood supply end and the blood recipient end in the observation group, MDA levels showed a strong negative correlation with the maximum diameter of AA anastomosis and a strong positive correlation with the maximum diameter of AV anastomosis and PTD (P < 0.05). SOD and GSH-PX levels showed strong positive correlations with the maximum diameter of AA anastomosis and strong negative correlations with the maximum diamete of AV anastomosis and PTD (P < 0.05). Conclusion There is a significant imbalance of oxidative stress in placental tissues of TTTS pregnant women, and the decrease in antioxidant activity of placental tissues may be an important cause of placental perfusion injury.

To explore the potential associations between perceived stress and health-promoting behaviors based on the theoretical schema of the middle-range theory of adaptation to chronic illness. From January to May 2021, a convenience sampling method was used to recruit 230 young and middle-aged patients with metabolic syndrome who underwent physical examination in the inpatient center of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The Health-Promoting Health Profile-Ⅱ, Chinese Perceived Stress Scale, Coping and Adaptation Processing Scale-Short Form, and Multi-dimensional Scale of Perceived Social Support were used in the cross-sectional study. The chain mediation effect procedure and bootstrap sampling test were used to examine the mediating role of adaptability and social support between perceived stress and health-promoting behaviors. The mean score of health-promoting behaviors was 100.0±14.6, the mean score of perceived stress was 22.0± 6.9, the mean score of adaptability was 47.0±6.1, and the mean score of social support was 63.8±10.8. Perceived stress had a negative impact on patients' health-promoting behaviors (=-0.309, <0.05). The adaptability (effect size= -0.112, 95%:-0.199~-0.038) and social support (effect size= -0.032, 95%:-0.083~played a mediating role and a chain mediating role in the process of perceived stress influencing patients' health-promoting behaviors (effect size= -0.045, 95%:-0.093~-0.020). Adaptability and social support play an intermediary role between perceived stress and health-promoting behaviors in young and middle-aged patients with metabolic syndrome. Healthcare professionals can motivate patients to develop healthy behaviors by developing intervention strategies on adaptability and social support.
Adaptation, Psychological ; Cross-Sectional Studies ; Humans ; Metabolic Syndrome ; Middle Aged ; Social Support ; Stress, Psychological

To design and develop a Wechat applet for intelligent health management of metabolic syndrome. Based on the needs and requirements of individuals undergoing health check-up, patients with metabolic syndrome and medical workers, a Wechat applet for metabolic syndrome management was designed and developed, which involving health data collection, health risk prediction, health management knowledge base fusion and intelligent recommendation, data privacy and security. The platform consists of three user ports: individuals undergoing health check and patients with metabolic syndrome, the medical workers and the system administrators. The main functions of the platform included metabolic syndrome risk prediction, intelligent recommendation of health management strategies, health behavior record and supervision, experts' consultation and health knowledge guide. The Wechat applet developed in this study can be used for metabolic syndrome risk prediction for general population, and health management for patients with metabolic syndrome, which helps them to enhance health management awareness and health behavior adherence.
Humans ; Metabolic Syndrome/therapy* ; Software

To evaluate and summarize the evidence of diet and physical activity management in patients with metabolic syndrome (MS). BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, Agency for Healthcare Research and Quality (AHRQ) network, National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Medlive, Registered Nurses' Association of Ontario (RNAO) network, American Diabetes Association (ADA) network, New Zealand Guideline Group (NZGG) network, Canadian medical association clinical practice guidelines network, PubMed, EmBase, Web of Science, CINAHL, Cochrane Library, CNKI, China Science and Technology Journal Database, Wanfang Knowledge Data Service Platform and Chinese biomedical database were searched systematically to obtain guidelines, evidence summary, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on diet and physical activity management in patients with MS. The retrieval period is from the establishment of database to November 2021. Two researchers with evidence-based medicine background evaluated the quality and evidence level of the included literature. A total of 36 articles met the criteria, including 3 guidelines, 5 expert consensus, 1 clinical decision and 27 systematic reviews. We summarized 49 pieces of evidence related to diet and physical activity in patients with MS, involving 15 aspects, namely diet goals, diet patterns, diet time, carbohydrate intake, fat intake, fiber intake, salt intake, fruits, vegetables and grains intake, coffee intake, effects of diet, principle of physical activity, intensity, form, time of physical activity, effects of physical activity, physical activity prescription of patients with MS and cardiovascular disease, and the joint effects of diet and physical activity. Diet and physical activity management can effectively improve the health outcomes of patients with MS. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.
Canada ; Consensus ; Diet ; Exercise ; Humans ; Metabolic Syndrome/therapy*