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*

Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.

The standardized training of resident doctors has entered a new stage of quality construction.The multi-station assessment in clinical context takes clinical problems as the core and residents as the main body,and uses the way of integrating practice and clinical thinking training to help residents build the comprehensive ability to solve clinical practical problems.This paper reviews and summarizes the practice of multi-station assessment mode in a tertiary hospital in Tianjin in recent three years from the aspects of assessment scheme,examination station setting,examination content,requirements and characteristics of ex-amination questions.Problem-oriented,find out the problems existing in the operation process and put forward solutions,so as to provide a reference for further improving the assessment and training system,promoting the training management of residential training bases and improving the training quality.

Objective To study the incidence and duration of residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo(BPPV) and the clinical factors associated with the residual dizziness.Methods A total of 202 cases of confirmed BPPV patients,61 males and 141 females with the average age of 54.78± 13.71 years old,were followed up for 2 months after successful particle repositioning.The incidence and duration of residual dizziness were analyzed.The risk factors for residual dizziness were analyzed by logistic regression.Results A total of 202 cases of confirmed BPPV were included in this study,and 113 cases complained of residual dizziness.Over the time,residual dizziness disappeared gradually.The differences of the age,the duration of vertigo before treatment,recurrent,and underlying diseases between the two group were significant (P ＜0.05),while the side,the gender,the incubation period of BPPV,the duration time of BPPV,and the types of canals were not associated with the residual dizziness(P＞0.05).The logistic regression analysis showed that the duration of vertigo before treatment and the age were the risk factors for residual dizziness.Conclusion More than half of the patients included in this study complained of residual dizziness after particle repositioning,and the symptoms disappeared naturally.The duration of vertigo before treatment and the age were the risk factors for residual dizziness.

BACKGROUND:Previous studies have performed three-dimensional finite element analysis on lumbar fracture fixation. However, a few studies concerned three-dimensional finite element analysis of lumbar spinal pedicle screw fixation.
OBJECTIVE:To analyze the biomechanical characteristics of one-way screw and universal screw fixation for lumbar fractures using finite element method.
METHODS:Models of lumbar fractures treated with one-way screw and universal screw fixation were established. Three-dimensional finite element method was used to analyze and compare the maximum axial displacement, maximum bending degree, maximum stress on thepedicle screw fixation system and maximum stress of intervertebral disc in normal vertebral fracture model, one-way and universal pedicle screw fixation models.
RESULTS AND CONCLUSION:(1) The maximum axial displacement at anteflexion, posterior extension, left lateral curvature and right lateral curvature was significantly lower in the one-way fixation group and universal fixation group than in the normal group (P< 0.05-0.01). The maximum axial displacement at above directions was lower in the universalfixation group than in the one-way fixation group. (2) The maximum bending degree was significantly lower in the one-way and universal fixation groups than in the normal group (P< 0.05-0.01). The maximum bending degree at various directions was lower in the universal fixation group than in the one-way fixation group. (3) The maximum stress on the pedicle screw fixation system at various directions was lower in the universal fixation group than in the one-way fixation group (P< 0.05-0.01). (4) The maximumstress of intervertebral disc was significantly lower in the one-way and universal fixation groups than in the normal group (P< 0.05-0.01). The maximum stress of intervertebral disc at various directions was lower in the universal fixation group than in the one-way fixation group. (5) Results suggested that one-way and universal screw fixation for lumbar fracture can bear most of the stress, obviously decrease the maximum axial displacement, maximum bending degree, maximum stress on the pedicle screw fixation system and maximum stress of intervertebral disc. The stability of universal screw fixation was better than that of one-way screw fixation.

We cloned and analyzed the two genes of the 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate reductase (HDR) gene family from Huperzia serrate. The two transcripts coding HDR, named HsHDR1 and HsHDR2, were discovered in the transcriptome dataset of H. serrate and were cloned by reverse transcription-polymerase chain reaction (RT-PCR). The physicochemical properties, protein domains, protein secondary structure, and 3D structure of the putative HsHDR1 and HsHDR2 proteins were analyzed. The full-length cDNA of the HsHDR1 gene contained 1431 bp encoding a putative protein with 476 amino acids, whereas the HsHDR2 gene contained 1428 bp encoding a putative protein of 475 amino acids. These two proteins contained the conserved domain of 1-hydroxy-2-methyl-2-(E)-butenyl-4-diphosphate reductase (PF02401), but without the transmembrane region and signal peptide. The most abundant expression of HsHDR1 and HsHDR2 was detected in H. serrate roots, followed by the stems and leaves. Our results provide a foundation for exploring the function of HsHDR1 and HsHDR2 in terpenoid and sterol biosynthesis in Huperziaceae plants.

Objective To investigate the rehabilitative effect of electroacupuncture on hand function in postoperative patients with hand trauma.Methods Sixty-eight postoperative patients with hand trauma were randomly allocated to treatment and control groups, 34 cases each. The control group received routine rehabilitation therapy and the treatment group, electroacupuncture in addition. Pre-/post-treatment changes in thumb motor function, the distance from index, middle, ring and little fingers to the palm and the distance from the finger nails to the table were observed in the two groups after three months of treatment.Results There was a statistically significant post-treatment difference in the thumb motor function (abduction and opposition) grade between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the distance from index, middle, ring and little fingers to the palm and the distance from the finger nails to the table in the two groups (P<0.01). There were statistically significant post-treatment differences in the distance from index, middle, ring and little fingers to the palm and the distance from the finger nails to the table between the treatment and control groups (P<0.01).Conclusion Electroacupuncture can effectively improve hand function in postoperative patients with hand trauma.

BACKGROUND:Stem cells have been shown to not only replace damaged cells, but also secrete trophic factors, bringing a bright future for the treatment of clinical spinal cord injury.
OBJECTIVE:To review the latest advances of bone marrow mesenchymal stem cells in animal and clinical research.
METHODS:A computer-based search of Kjmed and Wanfang databases was done for relevant articles published from April 2004 to April 2014 using the keywords of“stem cells, spinal cord injuries, embryonic stem cells, neural stem cells, mesenchymal stem cells”in English and Chinese, respectively.
RESULTS AND CONCLUSION:Total y 2 745 articles were initial y retrieved, and only 50 articles were included in result analysis. Bone marrow mesenchymal stem cells have become one of the most promising sources of stem cells in the treatment of spinal cord injury. Although the bone marrow mesenchymal stem cellin the treatment of spinal cord injury is stil in its infancy, it has certain effects on the repair of spinal cord injury. The mechanism of action of bone
marrow mesenchymal stem cells in the treatment of spinal cord injury is possibly related to the substitution effect, neurotrophic effects, suppression of the immune response and promoting axonal regeneration.

Objective To evaluate the effectiveness of Chronic Care Model in hypertension management in community health services.Methods Three hundred patients diagnosed with hypertension participated in this study and were divided into intervention and control groups.In the following 9 months,intervention measures based on the Chronic Care Model were delivered to intervention group,while the conventional measures to control group.Data collected before and after the intervention were analyzed uuing descriptive statistics,t-test,x2-test and analysis of covariance by SPSS16.0 for Windows.Results The intervention group had statistically significant positive effectiveness in drinking habit,daily salt intake(decreased 0.78g),diastolic blood pressure (decreased 2mmHg),BMI(decreased 0.4) and SF-36 physical component summary score(decreased 1.7)(P＜0.05).The intervention group had better improvement in BMI and SF-36 physical component summry score than the control group.Conclusion The health outcomes of patients with hypertension could be improved by applying the Chronic Care Model featured diet,exercise habits and other health related factors management.

Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.