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*

Ardisia Crenata Radix is a traditional Chinese medicinal plant that belongs to the Myrsinaceae family,and its main active components are coumarins,saponins,flavonoids,and volatile oil.Bergenin,ardisicrenoside A,ardisicrenoside B,ardisiacripin A,ardisiacripin B,and embelin were identified as active anticancer compounds in in-depth studies into the anti-tumor effects of Ardisia Crenata Radix.They show high therapeutic potential in oral cancer,nasopharyngeal carcinoma,liver cancer,colon cancer,bladder cancer,cervical cancer,and leukemia,mainly by inducing tumor cell apoptosis,increasing tumor cytotoxicity,inhibiting cell proliferation,inhibiting tumor cell metastasis and migration,and inducing cell regulatory enzyme cascade reactions.However,most preclinical experimental data on cinnabar root's anti-tumor mechanism have not been verified in high-quality,multi-sample,and repeated randomized controlled trials,and there are a lack of clinical research data on tumor prognosis,pharmacodynamics,and pharmacokinetics.Accurate research experiments and clinical trials should be designed to further explore the pharmacological effects of Ardisia Crenata Radix.

Odontogenic maxillary sinusitis(OMS)is a subtype of maxillary sinusitis(MS).It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion.Due to the lack of unique clinical features,OMS is difficult to distinguish from other types of rhinosinusitis.Besides,the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis.Its current diagnosis and treatment are thus facing great difficulties.The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS.However,this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality.Based on systematically reviewed literature and practical experiences of expert members,our consensus focuses on characteristics,symptoms,classification and diagnosis of OMS,and further put forward multi-disciplinary treatment decisions for OMS,as well as the common treatment complications and relative managements.This consensus aims to increase attention to OMS,and optimize the clinical diagnosis and decision-making of OMS,which finally provides evidence-based options for OMS clinical management.

Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Objective:To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio of polycystic ovary syndrome (PCOS) and in vitro fertilisation-embryo transfer outcomes.Methods:This was a retrospective cohort study. A total of 2 868 PCOS patients were enrolled, all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021. Propensity score matching (1∶2.5) was conducted to regulate the non-random allocation of patients. Data were extracted from the hospital′s medical records. Patients with baseline LH/FSH ratio>2 were deemed as study group, patients with baseline LH/FSH ratio≤2 were deemed as control group. Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups.Results:After propensity score matching (1∶2.5), there were no statistically significant differences in baseline data between the two groups (all P>0.05), indicating that the data were comparable. In the study group, the total dose of gonadotropin (Gn) and duration of Gn were lower than those of the control group ( t=4.989, P<0.001; t=3.267, P=0.001), the rate of in vitro maturation was higher than that of the control group ( χ2=4.938, P=0.026), the number of retrieved oocytes and cleavage were higher than those of the control group ( t=-2.305, P=0.021; t=-2.816, P=0.005), but there were no differences in the number and rate of high-quality embryos between the two groups ( t=-1.636, P=0.102; t=-0.123, P=0.902). The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group ( χ2=17.277, P<0.001). Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles, the incidences of gestational diabetes mellitus in the study group were higher than those in the control group ( χ2=9.174, P=0.002; χ2=4.204, P=0.040) of singleton pregnancy. In the fresh embryo transfer cycle, the clinical pregnancy rate [30.30% (20/66) vs 47.75% (53/111)] and delivery rate [30.30% (20/66) vs 46.85% (52/111)] in the study group were lower than those in the control group ( χ2=5.198, P=0.023; χ2=4.695, P=0.030). In the frozen-thawed embryo transfer cycle, the delivery rate in the study group was higer than that in the control group [59.41% (423/712) vs 55.04% (1 053/1 913); χ2=7.526, P=0.023]. The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle ( χ2=21.308, P<0.001; χ2=20.871, P<0.001), but there were no significant differences in the control group (all P>0.05). Conclusions:PCOS patients with a higher basal LH/FSH ratio are more likely to develop moderate to severe ovarian hyperstimulation syndrome after controlled ovarian stimulation and have a higher incidence of gestational diabetes mellitus. Better pregnancy outcome could be obtained by frozen-thawed embryo transfer.

Objective Simvastatin, as a widely used lipid-lowering drug, exhibits a potential effect of promoting bone forma-tion. The present study aimed to investigate the effect of oral simvastatin on lumbar vertebral bone mass and intervertebral disc ( IVD) degeneration in ovariectomized ( OVX ) rats. Methods Thirty female Sprague-Dawley rats were subjected to dual OVX ( n=20) or sham surgery ( n=10) and the OVX rats were treated orally with either saline vehicle (OVX+V, n=10) or simvastatin (OVX+SIM, n=10 ) at 5 mg per kg of the body weight per day. After 6 months of intervention, the microstructure of the L3 vertebra was ob-served by micro-CT, the bone mineral density ( BMD) in the L5-6 ver-tebrae determined by dual-energy X-ray absorptiometry, and histo-logical changes of the L5-6 vertebrae analyzed by van Gieson stainingand semi-quantitative evaluation. Results Compared with the sham-operation group, both the OVX+V and OVX+SIM groups showed significantly decreased BMD in L5([0.2933±0.0110] vs [0.2423±0.0081] and [0.2598±0.0249] g/cm2, P<0.05), L6 ([0.2907±0.0150] vs [0.2395±0.0061] and [0.2572±0.0121] g/cm2, P<0.05), and L5-6([0.2860±0.0115] vs [0.2380± 0.0059] and [0.2528±0.0126] g/cm2, P<0.05), but all the 3 parameters were remarkably higher in the OVX+SIM than in the OVX+V group (P<0.05). Micro-CT analysis manifested significantly lower BV/TV and Tb.N but higher Tb.Sp in the OVX+V than in the sham operation group ( P<0.05) . Abundant notochordal cells and extracellular matrix in the nucleus pulposus with well-arranged outer annulus fibrosus were observed in the rats of the sham operation group. The animals of the OVX+V and OVX+SIM groups displayed de-generation of the nucleus pulposus, annulus fibrosus, reduced notochordal cells and their replacement by chondrocyte-like cells in the nucleus pulposus, mucoid degeneration in the matrix, and disruption of the nuclear-annular border in the annulus fibrosus. The disc de-generation scores were significantly higher in the OVX+V and OVX+SIM than in the sham operation group (4.35±0.9 and 3.53±0.42 vs 2.48±0.92, P<0.05). Conclusion OVX induces not only bone loss in vertebrae but also IVD degeneration in rats, while simvasta-tin can partly prevent bone loss in lumbar vertebrae without aggravating IVD degeneration in OVX rats.

Objective To study the effect of calcitonin on the expression of vascular endothelial growth factor in femoral fracture healing in ovariectomized rats .Methods 80 female rats of 3 months old were randomly divided into four groups :Sham operation group(Sham ,10 cases);Ovariectomized operation group(OVX ,10 cases);Ovariectomy+ fracture+ salinegroup(Control ,30 cases) and Ovariectomy+ fracture +calcitonin group(Experimental ,30 cases) .Rats in Sham group and OVX group were performed ovari-otomy and killed after 4 weeks ,femoral bone mineral density was measured .For rats in Control group and Experimental group ,right middle femoral facture was performed 4 weeks later after ovariectomy .Calcitonin(16 IU/kg)were injected subcutaneously once per 2 days in Experimental group ,while those in Control group were given equal volume of normal saline .Rods in these two groups were killed after 3 ,6 ,9 weeks(10 at a time) ,femoral bone mineral density(BMD)was measured;hematoxylin-eosin staining and im-munohisto-chemical staining were performed at the 3th ,6th and 9th week after fracture ,respectively .Results Compared with Sham group ,rats weight in OVX group gained more(P< 0 .05) ,and BMD in OVX group significantly decreased more(P< 0 .05) .HE staining ,at the 3th week after fracture ,endochondral ossification domained in fracture healing ,and no significant difference existed (P>0 .05)in BMD .At the 6th week after fracture ,bone trabecula in both groups arranged in order ,compared with the control group ,BMD in experimental group increased significantly(P<0 .05) .At the 9th week after fracture ,bone trabecula in both groups arranged closely ,BMD in both groups showed significant difference(P<0 .05) .There was no significant difference of vascular endo-thelial growth factor(VEGF)between experimental group and control group at the 3th ,6th ,9th week after fracture(P>0 .05) .Con-clusion The results suggest that calcitonin treatment could enhance the bone mineral density significantly after fracture ,but it has no impact on the expression of VEGF in osteoporotic fracture healing .

The arteries and/or the veins of 30 human stomaches (11 adults,19 infants)were perfused with coloured gelatin or methylmethacrylate.The specimens were madeinto section and spreading preparation,and cast,and studied under LM and SEM.The main results were as follows:1.Mucosal arterioles divided into 2kinds of branches,i.e.luminal arteriole and glandular arteriole,and hadanastomosis.Luminal capillaries which lay in lamina propria around gastric pitoriginated from the luminal arterioles and from the glandular capillaries.2.Mucosalcapillaries drained into mucosal venule at 3 levels,viz.the luminal surface,theglandular neck and the glandular base.There were 2 kinds of venular anastomosis:the anastomosis between the straight mucosal venulae at the level of the glandularneck or the base of the gastric pit,and the basal venular plexus which lay betweenthe muscularis mucosae and the base of gastric gland.3.Mucosal blood vesselsobserved on transverse section might be divided into 3 parts:base-body,neck-body,and gastric pit.In neck-body part the density of capillaries is the highest.4.Flat,round or elliptic impressions of endothelial nuclei can be seen on the cast ofmucosal venule under SEM.It was interesting that a pit was noted at the center ofeach impre-ssion.The importance of mucosal blood vessels in the mucosa is forprotection from invasion and damage effected by luminal contents.