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*

Nutritional support therapy is one of the extremely important treatment methods for patients in the intensive care unit. Timely and effective nutritional support regimens can improve patients' immune function, reduce complications, and optimize clinical outcomes. Energy expenditure is influenced by multiple factors, including patients' baseline characteristics (such as physical condition, gender, age) and dynamic changes in indicators (such as body temperature, nutritional support regimens, and therapeutic interventions). The currently recognized "gold standard" for accurately assessing energy metabolism in clinical practice is the indirect calorimetry system, also known as the metabolic cart. This device monitors carbon dioxide production and oxygen consumption in real time and uses specific algorithms to estimate the metabolic proportions of the three major nutrients (carbohydrates, fats, and proteins) in energy expenditure. An appropriate nutrient ratio helps maintain the balance between supply and demand in the body's nutritional metabolism. In the management of critically ill patients, the application of the metabolic cart enables personalized nutritional therapy, avoiding over- or under-supply of energy and optimizing the use of medical resources. Furthermore, with real-time, quantitative data support from the energy metabolism monitoring system, clinicians can develop more precise nutritional intervention strategies, thereby improving patient prognosis. This article provides a systematic review of the technical features of the metabolic cart and its application value in various critical care scenarios, aiming to offer a reference for indirect calorimetry in clinical practice.
Humans ; Critical Illness/therapy* ; Nutritional Support ; Energy Metabolism ; Calorimetry, Indirect

Objective:In view of the incomplete evaluation system of actual combat injury treatment ability of grassroots officers and soldiers at present, this paper aims to construct a multi-dimensional evaluation system for combat injury treatment to provide theoretical guidance and evaluation means for warfighting-oriented training on combat injury treatment.Methods:Through literature review, expert consultation, and hierarchical analysis, we determined the factors to evaluate the comprehensive ability of field first aid for combat injuries of grassroots officers and soldiers from the perspective of actual combat, and then established a system for evaluating the actual combat injury treatment ability of grassroots officers and soldiers, in which the weights of factors in each dimension were determined.Results:An evaluation system of actual combat injury treatment ability of grassroots officers and soldiers was formed, which included 4 first-level indices and 16 second-level indices in tactics, strategies, treatment, and protection dimensions.Conclusions:The established evaluation system can provide a reference for actual combat injury treatment training at the grassroots level.

Bruton's tyrosine kinase inhibitors (BTKi) are a class of novel small-molecule targeted antitumor drugs used to treat B-cell malignancies. However, safety issues associated with BTKi may lead to treatment interruption, compromising their efficacy. To promote the standardized management of safety in BTKi treatment, Evidence-Based Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society, Expert Committee on Lymphoma of Chinese Society of Clinical Oncology, Expert Committee on Leukemia of Chinese Society of Clinical Oncology, Integrated Cancer Cardiology Branch of China Anti-Cancer Association, Hematology Branch of the Chinese Medical Association, and Hospital Pharmacy Professional Committee of the Cross-Straits Medicine Exchange Association formulated the Evidence-based Expert Consensus on the Clinical Management of Safety of Bruton′s Tyrosine Kinase Inhibitors (2024), which was published in the Chinese Journal of Cancer Research in June 2024. It covered 9 clinical issues in the following 3 domains: (1) the management of common adverse reactions of BTKi such as bleeding, cardiovascular events, hematological toxicity, infections, rashes, diarrhea, and arthralgia; (2) the management of drug-drug interactions; (3) management guidance for special populations. This consensus provides evidence-based recommendations for the safety management of BTKi medication in clinical practice. This article provides an interpretation and evidence summary of the consensus in Chinese, aiming to facilitate its implementation in China, enhance the safety management of BTKi treatment, and improve patient outcomes.

Objective:In view of the incomplete evaluation system of actual combat injury treatment ability of grassroots officers and soldiers at present, this paper aims to construct a multi-dimensional evaluation system for combat injury treatment to provide theoretical guidance and evaluation means for warfighting-oriented training on combat injury treatment.Methods:Through literature review, expert consultation, and hierarchical analysis, we determined the factors to evaluate the comprehensive ability of field first aid for combat injuries of grassroots officers and soldiers from the perspective of actual combat, and then established a system for evaluating the actual combat injury treatment ability of grassroots officers and soldiers, in which the weights of factors in each dimension were determined.Results:An evaluation system of actual combat injury treatment ability of grassroots officers and soldiers was formed, which included 4 first-level indices and 16 second-level indices in tactics, strategies, treatment, and protection dimensions.Conclusions:The established evaluation system can provide a reference for actual combat injury treatment training at the grassroots level.

Bruton's tyrosine kinase inhibitors (BTKi) are a class of novel small-molecule targeted antitumor drugs used to treat B-cell malignancies. However, safety issues associated with BTKi may lead to treatment interruption, compromising their efficacy. To promote the standardized management of safety in BTKi treatment, Evidence-Based Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Hospital Pharmacy Professional Committee of the Chinese Pharmaceutical Association, Division of Therapeutic Drug Monitoring of Chinese Pharmacological Society, Expert Committee on Lymphoma of Chinese Society of Clinical Oncology, Expert Committee on Leukemia of Chinese Society of Clinical Oncology, Integrated Cancer Cardiology Branch of China Anti-Cancer Association, Hematology Branch of the Chinese Medical Association, and Hospital Pharmacy Professional Committee of the Cross-Straits Medicine Exchange Association formulated the Evidence-based Expert Consensus on the Clinical Management of Safety of Bruton′s Tyrosine Kinase Inhibitors (2024), which was published in the Chinese Journal of Cancer Research in June 2024. It covered 9 clinical issues in the following 3 domains: (1) the management of common adverse reactions of BTKi such as bleeding, cardiovascular events, hematological toxicity, infections, rashes, diarrhea, and arthralgia; (2) the management of drug-drug interactions; (3) management guidance for special populations. This consensus provides evidence-based recommendations for the safety management of BTKi medication in clinical practice. This article provides an interpretation and evidence summary of the consensus in Chinese, aiming to facilitate its implementation in China, enhance the safety management of BTKi treatment, and improve patient outcomes.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective This study aimed to analyze the current epidemic situation of cancer in Yunnan province in 2020,and to provide theoretical basis for the prevention and treatment of cancer in Yunnan province.Methods The data on the incidence and mortality of cancer were collected from 129 cancer registration areas in Yunnan province in 2020.A total of 89 counties(cities,dis-tricts)that met the quality control standards were included in this analysis.Among them,there were 16 in urban areas,covering a pop-ulation of 7,593,622(24.16%),and 73 in rural areas,covering a population of 23,838,542(75.84%).The number of malignant tumor cases,deaths,the crude incidence and China age-standardized incidence(China Standardized Incidence),the crude mortality and China age-standardized mortality(China Standardized Mortality),the cumulative incidence and mortality from 0 to 74 years old,as well as the order of cancer incidence and death were statistical analyzed.Results In 2020,66,719 new cases of cancer were re-ported from 89 tumor registration areas in Yunnan province,with a crude rate of 212.26/100,000 and the China age-standardized in-cidence of 150.33/100,000;The reported number of deaths from cancer was 39,251,with a crude mortality of 124.88/100,000 and the China age-standardized mortality of 82.45/100,000.The incidence and mortality of cancer were higher in men than those in fe-male,and higher in rural than those in urban areas.According to the crude incidence rate and crude mortality,the top 5 cancers with the highest crude incidence were lung cancer,female breast cancer,colo-rectum cancer,liver cancer and thyroid cancer,and the top 5 cancers with the highest crude mortality were lung cancer,liver cancer,colo-rectum cancer,stomach cancer and female breast cancer.Conclusion Lung cancer,liver cancer,colo-rectum cancer and female breast cancer are still the key cancers for prevention and con-trol in Yunnan province.The incidence of thyroid cancer is relatively high,and there are significant differences in the incidence and mortality of cancer between urban and rural areas and between sexes.The corresponding cancer prevention should be carried out ac-cording to the current epidemic situation of cancer in Yunnan province.

Objective The aim of this study was to analyze the incidence and mortality of prostate cancer in cancer registra-tion areas of Yunnan province in 2020,as well as its changing trends from 2012 to 2020,and provide suggestions for the prevention and treatment of prostate cancer in Yunnan province.Methods The data of prostate cancer incidence and mortality in cancer regis-tration areas of Yunnan province from 2012 to 2020 were collected and organized.Excel 2016 and SPSS 18.0 software were used to calculate the crude incidence,crude mortality,age-standardized incidence rate by World standard population(ASIRW),age-stand-ardized mortality rate by Chinese standard population(ASMRC),truncated rate,cumulative rate and other indicators.ASIRW and ASMRC were calculated by using Segi's World population composition.Joinpoint 4.8.0.1 software was used to calculate the annual percentage change(APC)and 95%CI of ASIRW and ASMRC of prostate cancer from 2012 to 2020,and analyze their annual change trends.Results In 2020,the crude incidence and ASIRW of male prostate cancer in cancer registration areas of Yunnan province were 9.71/100,000 and 6.21/100,000,respectively.ASIRW in urban areas(7.94/100,000)was higher than that in rural areas(5.48/100,000).In 2020,the crude mortality and ASMRC of male prostate cancer in cancer registration areas of Yunnan province were 4.68/100,000 and 2.87/100,000,respectively.ASMRC in urban areas(3.68/100,000)was higher than that in rural areas(2.53/100,000).In 2020,the incidence and mortality of male prostate cancer in Yunnan province increased with age,were at a low level before the age of 45,and began to rise rapidly after the age of 55.From 2012 to 2020,there was no statistically significant change trend in ASIRW and ASMRC of male prostate cancer in Yunnan province(APC were 1.79%and 3.61%,P>0.05).However,ASIRW and ASMRC of rural males were on the rise(APC were 4.45%and 3.85%,respectively,P<0.05).Conclusion ASIRW and ASMRC of male prostate cancer in cancer registration areas of Yunnan province in 2020 are higher in urban men than those in rural areas.The change trend of ASIRW and ASMRC from 2012 to 2020 is flat,and rural elderly men should be paid more attention.

Objective This study aimed to analyze the incidence and mortality of cervical cancer in tumor registration areas of Yunnan province in 2020,as well as the trend of incidence and mortality from 2012 to 2020,in order to provide a basis for the pre-vention and treatment of cervical cancer in Yunnan province.Methods The data of cervical cancer incidence and mortality were col-lected and sorted out in tumor registration areas of Yunnan province from 2012 to 2020.The crude incidence,crude mortality,age-standardized incidence rate by World standard population(ASIRW)(referred to the World standard incidence),age-standardized mortality rate by World standard population(ASMRW)(referred to the World standard mortality)and other indicators of cervical canc-er in 2020 were statistically analyzed according to the urban and rural areas.The annual percent change(APC)was used to evaluate the changing trend of cervical cancer incidence and mortality from 2012 to 2020,and the GM(1,1)model was used to predict the crude incidence and ASIRW from 2021 to 2025.Results In 2020,there were 2426 new cases of cervical cancer in tumor registration area of Yunnan province,ranking fifth in the incidence of female malignant tumors.The crude incidence and ASIRW were 15.83/100,000 and 11.16/100,000,respectively.There were 831 deaths from cervical cancer,ranking sixth deaths of female malignant tumors.The crude mortality and ASMRW were 5.42/100,000 and 3.52/100,000,respectively.ASIRW was higher in rural areas(11.86/100,000)than that in urban areas(9.11/100,000).ASMRW was slightly higher in urban areas(3.63/100,000)than that in rural areas(3.48/100,000).The age-specific incidence of cervical cancer increased rapidly after the age of 20,and reached a peak in the 55-59 age group;The age-specific mortality of cervical cancer increased rapidly after the age of 35,reaching a peak in the 75-79 age group.ASIRW of cervical cancer in Yunnan province from 2012 to 2020 showed a downward trend with annual changes(APC=-7.54%,95%CI:-13.19%--1.53%),and the trend change was statistically significant(P<0.05).The prediction of the GM(1,1)model showed that the crude incidence and ASIRW of cervical cancer in Yunnan province would continue to decline from 2021 to 2025.Conclusion The incidence and mortality of cervical cancer are relatively low in Yunnan province,but it is still a common malignant tumor in women.The incidence of cervical cancer in Yunnan province is showing a trend of becoming younger,and rural women are the key population for prevention and treatment.