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*

BACKGROUND: Ferroptosis-related genes play a crucial role in regulating intracellular iron homeostasis and lipid peroxidation, and they are involved in the regulation of tumor growth and drug resistance. The expression of ferroptosis-related genes in tumor tissues can be used to predict patients' future survival times, aiding doctors and patients in anticipating disease progression. Based on the sequencing data of lung adenocarcinoma (LUAD) patients from The Cancer Genome Atlas (TCGA) database, this study identified genes involved in the regulation of ferroptosis, constructed a prognostic model, and evaluated the predictive performance of the model. METHODS: A total of 1467 ferroptosis-related genes were obtained from the GeneCards database. Gene expression profiles and clinical data from 541 LUAD patients were collected from the TCGA database. The expression data of all ferroptosis-related genes were extracted, and differentially expressed genes were identified using R software. Survival analysis was performed on these genes to screen for those with prognostic value. Subsequently, a prognostic risk scoring model for ferroptosis-related genes was constructed using LASSO regression model. Each LUAD patient sample was scored, and the patients were divided into high-risk and low-risk groups based on the median score. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated. Kaplan-Meier survival curves were generated to assess model performance, followed by validation in an external dataset. Finally, univariate and multivariate Cox regression analyses were conducted to evaluate the independent prognostic value and clinical relevance of the model. RESULTS: Through survival analysis, 121 ferroptosis-related genes associated with prognosis were initially identified. Based on this, a LUAD prognostic risk scoring model was constructed using 12 ferroptosis-related genes (ALG3, C1QTNF6, CCT6A, GLS2, KRT6A, LDHA, NUPR1, OGFRP1, PCSK9, TRIM6, IGF2BP1 and MIR31HG). The results indicated that patients in the high-risk group had significantly shorter survival time than those in the low-risk group (P<0.001), and the model demonstrated good predictive performance in both the training set (1-yr AUC=0.721) and the external validation set (1-yr AUC=0.768). Risk scores were significantly associated with the prognosis of LUAD patients in both univariate and multivariate Cox regression analyses (P<0.001), suggesting that this score is an important prognostic factor for LUAD patients. CONCLUSIONS This study successfully established a LUAD risk scoring model composed of 12 ferroptosis-related genes. In the future, this model is expected to be used in conjunction with the tumor-node-metastasis (TNM) staging system for prognostic predictions in LUAD patients.
Humans ; Ferroptosis/genetics* ; Prognosis ; Adenocarcinoma of Lung/pathology* ; Lung Neoplasms/pathology* ; Male ; Female ; Gene Expression Regulation, Neoplastic ; Middle Aged ; ROC Curve

With the rapid development of information technology,digitization of education has become an important driving force to promote education reform.In the education system of medical colleges,the construction and imple-mentation of professional curriculum courses play an important role in the cultivation of qualified medical talents.Emergence of education digitization has brought unprecedented opportunities but also some challenges to the curric-ulum construction by teachers in medical school.This paper aims to explore how to effectively promote construction of professional curriculums with information technology(IT)guided by education digitization strategy and to recom-mend a series of methods in terms of strategy implementation in medical schools.

Objective To enhance the cyclic peptide compound's membrane permeability,structural stability,and neuroprotective activity,based on the amino acid sequence of peptides of Tat-GluA2-3Y,by designing and synthesizing a serial of cyclic peptides through strategies including polypeptide cyclization,replacement of the cell-penetrating peptide,substitution with D-amino acids,and incorporation of mini polyethylene glycol fragments.Methods The target peptides were synthesized based on standard Fmoc solid-phase method,followed by analysis and purification via reverse phase high-performance liguid chromatography(RP-HPLC).The cytoprotective activity of the peptides was evaluated by using the HT-22 cell model.The transmembrane transport efficiency of the peptides was determined based on the Caco-2 monolayer intestinal epithelial cell model.Plasmatic plasma and metabolic stability of the peptides were measured by in vitro co-incubation experiments with rat plasma and human liver microsomes.Finally,the in vivo neuroprotective activity of the peptides was validated by using a mouse middle cerebral artery occlusion model.Results Seven cyclic peptides were successfully designed and synthesized by using the standard Fmoc solid-phase method,with purities exceeding 90%as confirmed by RP-HPLC.Cytoprotective activity assay demonstrated that both Tat-GluA2-3Y and CMT-C3Y exhibited activity at concentrations above 125 nmol/L,with CMT-C3Y showing superior activity as compared to Tat-GluA2-3Y.The results of the transmembrane assay demonstrated that,compared to Tat-GluA2-3Y,CMT-C3Y exhibited significant transmembrane capabilities at all tested concentrations(P<0.001).CMT-C3Y was classified as a highly permeable compound,whereas Tat-GluA2-3Y was categorized as a moderately permeable compound.Plasma stability studies indicated that over 50%of Tat-GluA2-3Y was metabolized after 4 h of co-incubation with rat plasma.After 8 h of coincubation with CMT-C3Y,the remaining amount was 88.1%,and no obvious degradation phenomenon occurred.In human liver microsomal stability tests,the half-life of Tat-GluA2-3Y was 26.1 min,as compared to 103.8 min for CMT-C3Y,highlighting the enhanced stability of CMT-C3Y.Tat-GluA2-3Y and CMT-C3Y were classified as a fast-metabolizing drug and a moderate-metabolizing drug,respectively.Animal experiments further demonstrated that at a dose of 8 mg/kg the neuroprotective activity of CMT-C3Y was significantly superior to that of Tat-GluA2-3Y(P<0.001).Conclusion The designed bicyclic peptide CMT-C3Y demonstrates significantly higher cell-penetrating efficiency and superior plasma stability as compared to Tat-GluA2-3Y,along with enhanced neuroprotective activity at both cellular and animal levels.

Objective: To investigate the screening results of adolescent scoliosis in Chuzhou City, Anhui Province, and analyze the influencing factors for scoliosis, so as to provide insights into the prevention and control of scoliosis among adolescents. Methods: Students were selected from six primary and middle schools in Chuzhou City using the stratified random cluster sampling method from April to June 2023. Demographic information, daily behaviors and postures, and exercise status were collected through questionnaire surveys. Scoliosis was screened and diagnosed according to the Screening for Abnormal Spinal Curvature in Children and Adolescents. Influencing factors for scoliosis among primary and middle school students were identified using a multivariable logistic regression model. Results: A total of 1 823 questionnaires were allocated, and 1 768 effective questionnaires were recovered, with an effective response rate of 96.98%. There were 537 primary school students, 1 000 junior high school students and 231 senior high school students, with an average age of (13.40±1.92) years. There were 948 male students (53.62%) and 820 female students (46.38%). A total of 131 cases of scoliosis were screened positive, with a positive rate of 7.41%. The results of multivariable logistic regression analysis showed that gender (female, OR=1.759, 95%CI: 1.135-2.727), body mass index (OR=0.593, 95%CI: 0.538-0.654), sleeping position (side lying, OR=0.598, 95%CI: 0.377-0.951; prone lying, OR=2.336, 95%CI: 1.201-4.545), frequency of reading in bed (often, OR=2.099, 95%CI: 1.201-3.670), way of carrying backpack (shoulders, OR=0.580, 95%CI: 0.370-0.908), and exercise level (OR=0.428, 95%CI: 0.296-0.618) were influencing factors of scoliosis among primary and middle school students. Conclusion The positive rate of scoliosis screening among primary and middle school students in Chuzhou City was 7.41%, which was influenced by gender, age, body mass index, sleeping posture, reading in bed, way of carrying backpack and exercise level.

Objective To explore the effect of myotubularin-related protein 6(MTMR6)on the invasion of hepatocellular carcinoma cell line HepG2 and the potential molecular mechanism.Methods By analyzing the sequencing results of liver cancer tissues and adjacent tissues in Gene Expression Omnibus(GEO)database,MTMR6 gene was screened out,and Spearman analysis was used to analyze the correlation of MTMR6 and pathway in the Cancer Genome Atlas(TCGA)database.Finally,the interaction between MTMR6 and signaling pathway proteins was analyzed with Genemania database.Then the expression of MTMR6 in human normal liver cell line LO-2 and hepatoma cell lines Huh-7 and HepG2 were measured and compared among the cell lines.Then HepG2 cells was selected as the study object.After MTMR6 gene was knocked down or over-expressed in HepG2 cells,Transwell assay was employed to observe invasion ability,and Western blotting was adopted to detect the expression of MTMR6,PI3K,p-PI3K,AKT,p-AKT,mTOR,p-mTOR MMP-2 and MMP-9.Results The expression of MTMR6 was significantly higher in the hepatocellular carcinoma tissues than the paracancer tissues,and it was in a positive linear correlation with PI3K/AKT/mTOR signaling pathway(P＜0.01),showing interaction with PI3K,AKT and mTOR.The expression level of MTMR6 was significantly higher in the HepG2 cells than the LO-2 and Huh-7 cells(P＜0.01).Over-expression of MTMR6 obviously enhanced invasion ability(P＜0.01),while its knockdown decreased the ability(P＜0.01)in HepG2 cells.Knockdown of MTMR6 gene also resulted in decreased phosphorylation of PI3K,AKT and mTOR,and expression levels of MMP-2 and MMP-9(P＜0.01),while over-expression of MTMR6 promoted the phosphorylation of PI3K,AKT and mTOR,and up-regulated the expression of MMP-2 and MMP-9(P＜0.01).In addition,LY294002(a specific PI3K inhibitor)treatment could block the PI3K/AKT/mTOR pathway and down-regulate the expression of MMP-2 and MMP-9(P＜0.01),but had no effect on MTMR6 expression.Conclusion MTMR6 may promote the invasion of hepatoma cells through activation of PI3K/AKT/mTOR signaling pathway.

The glymphatic system, as "waste" clearance pathway in the brain, plays a critical role in maintaining the homeostasis of the brain cell microenvironment. It has been found that changes in the glymphatic system are common in many neurological diseases. MRI is currently the only technology that can achieve human glymphatic imaging, and has the advantages of high soft tissue resolution and sensitivity to tracers. Quantitative MRI can objectively evaluate the changes of inflow and outflow of glymphatic system. Therefore, in this review, we introduce the application of quantitative MRI technology in the glymphatic system in detail, aiming to provide help for the diagnosis and treatment of diseases related to glymphatic system.

Background Hand-arm vibration disease is harmful to human body, but there are no effective diagnosis and treatment so far, and current occupational exposure limits underestimate the health damage caused by high-frequency vibration exposure. Objective To evaluate and compare the damage to workers' peripheral circulation and peripheral nerve caused by different frequencies of vibration operation. Methods Drilling workers (n=187) from a mining company in Shandong Province and golf club head grinding workers (n=228) from a sports equipment factory in Guangdong Province were selected as study subjects. Hand symptoms were investigated. SV106 vibration meter was used to measure the target operation-associated vibration frequency spectrum. The 8 h energy-equivalent frequency weighted acceleration, cumulative vibration exposure level (CVEL), and the working age related to causing white finger in 10% of an exposed group were calculated. Result The study subjects were all male. More grinding workers reported hand symptoms than the drilling workers, e.g. peripheral circulation injury (52.6% vs 19.3%), peripheral nerve injury (71.5% vs 23.0%), hand stiffness (64.0% vs 7.0%), and deformed fingers (69.7% vs 4.3%) (all P<0.001). The main vibration frequencies of grinding operation (500-800 Hz) were much higher than those of drilling operation (125~160 Hz). CVEL and working age of vibration exposure showed a linear rising relationship with the cumulative prevalence rate of peripheral circulation and peripheral never injury, the fitting lines all showed good fitting effects (R²=0.812-0.988), and the slope of the fitting line of the grinding workers was larger than that of the drilling workers. The working age of vibration exposure associated with 10% cumulative prevalence of white finger was shorter in the grinding workers than in the drilling workers (6.81 years vs 10.27 years). According to the ISO prediction formula, the working age of vibration exposure was associated with 10% white finger prevalence shorter in the drilling workers than in the grinding workers (3.12 years vs 8.23 years). Conclusion Both the vibration exposure level and the prevalence of hand symptoms are high in two groups of workers with different vibration frequencies, and vibration exposure at a higher frequency tends to have severer damage to workers' hands.

Background Long-term exposure to hand-transmitted vibration can lead to hand-arm vibration syndrome, one manifestation of which is impaired peripheral blood circulation in the arms. Altered expressions of prostacyclin I₂ (PGI₂) and thromboxane A₂ (TXA₂) in blood may be one of the important mechanisms of vibration-induced hand-arm vibration syndrome. Objective To reveal the effects of rat tail vibration on the expressions of PGI₂ and TXA₂ in plasma, and to establish the correlation between the change of rat plasma PGI₂ to TXA₂ ratio and rat tail vibration. Methods Fifty SPF-grade male SD rats were randomly divided into five groups: control group, 1 d exposure group, 3 d exposure group, 7 d exposure group, and 14 d exposure group, with 10 rats in each group. The rats were placed in rat immobilizes on a immobilization table, and the rats' tails were connected to a shaker and fixed with medical tape. There was no overlap between the immobilizes and between the rats' tails by no contact between the immobilization table and the shaker. The exposure dose was 125 Hz, 5.9 m·s⁻², 4 h·d⁻¹, and the vibration direction was linear vertical vibration. Abdominal aortic blood was taken at the end of vibration exposure, and the expressions of PGI₂, TXA₂, and their hydrolysates 6-keto-prostaglandin F_1α (6-keto-PGF_1α) and thromboxane B₂ (TXB₂) were measured by enzyme-linked immunosorbent assay, and the 6-keto-PGF_1α/TXB₂ values were calculated. Spearman rank correlation was used to analyze whether the expression of vascular factors correlated with the accumulated time of vibration. Results The expression levels of plasma 6-keto-PGF_1α were (896.12±124.37), (1068.13±119.41), (1215.26±122.64), and (1317.94±106.54) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, which were higher than that in the control group, (830.60±109.47) ng·L⁻¹ (P<0.001). The PGI₂ expression levels were (86.49±2.40), (107.90±2.65), (114.02±2.16), and (126.95±1.94) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, all higher than (60.09±2.11) ng·L⁻¹ in the control group (P＜0.001). The expression levels of TXB₂ were (132.14±4.10), (145.52±4.09), (179.91±4.98), and (204.10±3.22) ng·L⁻¹ in the 1 d, 3 d, 7 d, and 14 d groups of rats, respectively, which were higher than that in the control group, (106.08±3.26) ng·L⁻¹ (P<0.001). The expression levels of plasma TXA₂ were (211.99±3.24), (236.33±3.88), and (245.45±4.23) ng·L⁻¹ in rats in the 3 d, 7 d, and 14 d groups, respectively, which were all elevated compared with (174.79±4.19) ng·L⁻¹ in the control group (P<0.001). Compared with the control group, the 6-keto-PGF_1α/TXB₂ values were decreased in the 7 d and 14 d groups (P<0.05). The 6-keto-PGF_1α, PGI₂, TXB₂, and TXA₂ expressions were positively correlated with vibration accumulation time (r=0.84, 0.84, 0.80, 0.84, P<0.001) and the 6-keto-PGF_1α/TXB₂ values were negatively correlated with vibration accumulation time (r=-0.24, P=0.003). Conclusion Local exposure of rat tail to vibration could increase the expressions of PGI₂ and TXA₂ in blood, and the elevated expressions show a dose-effect relationship with the duration of vibration exposure, but the PGI₂/TXA₂ tends to decrease with the accumulation of vibration exposure.

Background The metabolites and metabolic pathways of hand-arm vibration syndrome have not yet been elucidated. Objective To investigate the effect of local vibration on endogenous metabolites in rat serum by metabolomic analysis, to preliminarily explore the potential metabolic pathway of endogenous metabolites, so as to provide evidence for further research on the mechanism of hand-arm vibration syndrome. Methods Thirty-two SPF male SD rats, (211.3±11.1) g, 7−8 weeks of age, were selected and randomly divided into three groups: control group (14 rats, without vibration), 7 d vibration group (9 rats, continuously vibration for 7 d), and 14 d vibration group (9 rats, continuous vibration for 14 d). The vibration rats were vibrated every day for 4 h, the frequency weighted acceleration was 4.9 m·s⁻², the vibration frequency was 125 Hz, and the vibration direction was one-way vertical vibration. The control group had the same conditions except not contacting vibration. After the vibration exposure, the blood samples taken from the abnormal aorta of rats were collected, and the changes of rat serum metabolome were analyzed by ultra-performance liquid chromatography-tandem time-of-flight mass spectrometry. Principal components analysis (PCA) was used to explore changes in rat serum metabolic profile, and orthogonal partial least squares-discriminant analysis (OPLS-DA) was used to screen out differential metabolites. Combined with online databases, a metabolic pathway enrichment analysis of differential metabolites was performed. Results The PCA analysis showed that compared with the control group, the rat serum metabolic profiles in the 7 d group and the 14 d group were clearly differentiated, and the rat serum metabolic profiles in the 7 d group and the 14 d group partially overlapped. The OPLS-DA analysis showed significant differences between groups. The main parameters were: model interpretation rate R²Y=0.914, model predictive ability Q²=0.58. The OPLS-DA analysis screened out 26 and 119 differential metabolites from the 7 d group and the 14 d group respectively, and there were 24 common differential metabolites between the 7 d group and the 14 d group. The metabolomic pathway analysis showed that local vibration-induced changes in rat serum metabolism were mainly related to arachidonic acid metabolism in the 14 d group, among which the metabolites with significant effects were arachidonic acid, prostaglandin E₂, and prostaglandin D₂. Conclusion Local vibration could affect the normal metabolism in rats, and the metabolic pathway with significant influence is arachidonic acid metabolism after a 14 d exposure and the involved metabolites are arachidonic acid, prostaglandin E₂, and prostaglandin D₂.