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*

OBJECTIVE: To analyze the efficacy and safety of decitabine-based myeloablative preconditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia (AML). METHODS: The clinical characteristics and efficacy of 115 AML patients who underwent allo-HSCT at the First Medical Center of Chinese PLA General Hospital from August 2018 to August 2022 were retrospectively analyzed, including 37 patients treated with decitabine conditioning regimen (decitabine group) and 78 patients without decitabine conditioning regimen (non-decitabine group). The cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), non-relapse mortality (NRM) and graft versus host disease (GVHD) were analyzed. RESULTS: For the patients in first complete remission (CR1) state before allo-HSCT, the 1-year relapse rates of decitabine group(22 cases) and non-decitabine group(69 cases) were 9.1% and 29.6%, respectively, the difference was statistically significant(P =0.042). The 1-year cumulative incidence of acute graft-versus-host disease (aGVHD) in decitabine group and non-decitabine group was 62.2% and 70.5%, respectively, and the 1-year cumulative incidence of chronic inhibitor-versus-host disease (cGVHD) was 18.9% and 14.1%, respectively, there were no significant differences in the incidence of aGVHD and cGVHD between the two groups (P >0.05). Of the 115 patients, there were no significantly differences in the 1-year CIR(21.7% vs 28.8%, P =0.866), NRM(10.9% vs 3.9%, P =0.203), OS(75.2% vs 83.8%, P =0.131) and LFS(74.6% vs 69.1%, P =0.912) between the decitabine group(37 cases) and the non-decitabine group(78 cases). CONCLUSION Decitabine-based conditioning regimen could reduce the relapse rate of AML CR1 patients with good safety.
Humans ; Leukemia, Myeloid, Acute/therapy* ; Hematopoietic Stem Cell Transplantation/methods* ; Decitabine/therapeutic use* ; Transplantation Conditioning/methods* ; Retrospective Studies ; Graft vs Host Disease ; Transplantation, Homologous ; Male ; Female ; Adult ; Middle Aged ; Adolescent ; Young Adult

AIM:Flow cytometry was used to evaluate the effects of short-term storage conditions(fresh,frozen at-80℃for 7 d,and stored at 4℃for 7 d)on the median fluorescence intensity(MFI)of antibodies and the percentage of immune cell subsets in mouse peripheral blood mononuclear cells(PBMCs)and splenocytes.METHODS:The PBMC and splenocyte suspensions from six male Kunming mice were collected and analyzed under three different processing con-ditions to compare differences in the antibody MFI and percentages of monocyte subsets(Ly-6clow/Ly-6cmedium/Ly-6chigh),macrophages(M1/M2),and dendritic cells.RESULTS:Both tissue and antibody specificity were demonstrated by changes in the antibody MFI values.Following storage at-80℃,the MFIs of certain antibodies(such as CD45 and F4/80 in PBMCs,and CD115,Ly-6c,F4/80,CD80 and MHC-II in the spleen)were similar to those of the fresh groups,where-as after storage at 4℃,the MFIs of other antibodies(such as 7-AAD,CD115,Ly-6c and MHC-II in PBMCs,and CD11b,CD206 and CD11c in the spleen)were closer to those of the fresh groups.The MFI of most of the examined anti-bodies varied significantly following storage.Both storage conditions significantly reduced the viability of PBMCs and sple-nocytes.In PBMCs stored at 4℃,the percentages of total monocytes,Ly-6cmedium/Ly-6chigh monocytes,total macrophages,and dendritic cells were similar to those in the fresh group.Compared with the fresh group,both storage groups presented significantly lower percentages of M1 macrophages and dendritic cells(P<0.05).There were no statistically significant differences in the percentages of total monocytes,Ly-6cmedium monocytes,Ly-6chigh monocytes,total macrophages,M1 and M2 macrophages,or dendritic cells in the spleen among the three groups(P>0.05).The percentage of Ly-6clow monocytes did not differ substantially(P>0.05)between the fresh and-80℃frozen groups but was significantly lower in the 4℃storage group than in the fresh group(P<0.05).CONCLUSION:The storage conditions of the samples had a substantial effect on the flow cytometry results(antibody MFI and cell subset percentages)of the PBMCs and splenic cells,with tissue specificity.If the percentage of immune cell subgroups(particularly monocytes/macrophages/dendritic cells)in PBMCs is highly important,storage at 4℃for 7 d is preferable.If the MFI values of specific antibodies(such as CD45 and F4/80)are important,freezing at-80℃may be more appropriate.If the MFI values of most antibodies or the percentages of criti-cal subgroups(such as total monocytes/Ly-6chigh/total macrophages/dendritic cells)in splenic cells need to be close to those of fresh samples,4 ℃ storage for 7 d is more effective.Freezing at-80℃is preferable if the MFI values of particular anti-bodies(such as CD115 and Ly-6c)need to be determined.

AIM:Flow cytometry was used to evaluate the effects of short-term storage conditions(fresh,frozen at-80℃for 7 d,and stored at 4℃for 7 d)on the median fluorescence intensity(MFI)of antibodies and the percentage of immune cell subsets in mouse peripheral blood mononuclear cells(PBMCs)and splenocytes.METHODS:The PBMC and splenocyte suspensions from six male Kunming mice were collected and analyzed under three different processing con-ditions to compare differences in the antibody MFI and percentages of monocyte subsets(Ly-6clow/Ly-6cmedium/Ly-6chigh),macrophages(M1/M2),and dendritic cells.RESULTS:Both tissue and antibody specificity were demonstrated by changes in the antibody MFI values.Following storage at-80℃,the MFIs of certain antibodies(such as CD45 and F4/80 in PBMCs,and CD115,Ly-6c,F4/80,CD80 and MHC-II in the spleen)were similar to those of the fresh groups,where-as after storage at 4℃,the MFIs of other antibodies(such as 7-AAD,CD115,Ly-6c and MHC-II in PBMCs,and CD11b,CD206 and CD11c in the spleen)were closer to those of the fresh groups.The MFI of most of the examined anti-bodies varied significantly following storage.Both storage conditions significantly reduced the viability of PBMCs and sple-nocytes.In PBMCs stored at 4℃,the percentages of total monocytes,Ly-6cmedium/Ly-6chigh monocytes,total macrophages,and dendritic cells were similar to those in the fresh group.Compared with the fresh group,both storage groups presented significantly lower percentages of M1 macrophages and dendritic cells(P<0.05).There were no statistically significant differences in the percentages of total monocytes,Ly-6cmedium monocytes,Ly-6chigh monocytes,total macrophages,M1 and M2 macrophages,or dendritic cells in the spleen among the three groups(P>0.05).The percentage of Ly-6clow monocytes did not differ substantially(P>0.05)between the fresh and-80℃frozen groups but was significantly lower in the 4℃storage group than in the fresh group(P<0.05).CONCLUSION:The storage conditions of the samples had a substantial effect on the flow cytometry results(antibody MFI and cell subset percentages)of the PBMCs and splenic cells,with tissue specificity.If the percentage of immune cell subgroups(particularly monocytes/macrophages/dendritic cells)in PBMCs is highly important,storage at 4℃for 7 d is preferable.If the MFI values of specific antibodies(such as CD45 and F4/80)are important,freezing at-80℃may be more appropriate.If the MFI values of most antibodies or the percentages of criti-cal subgroups(such as total monocytes/Ly-6chigh/total macrophages/dendritic cells)in splenic cells need to be close to those of fresh samples,4 ℃ storage for 7 d is more effective.Freezing at-80℃is preferable if the MFI values of particular anti-bodies(such as CD115 and Ly-6c)need to be determined.

Objective:The genotoxicity risk of graphene artificial nerve sheath conduit was systematically evaluated to provide scientific evidence for their clinical safety and to establish methodological references for the genotoxicity assessment of nanomaterial medical devices.Methods:The potential effects of graphene artificial nerve sheath conduit on genetic and chromosomal endpoints were analyzed by integrating bacterial reverse mutation assays,in vitro chromosome aberration assays,mouse lymphoma cell TK gene mutation tests,and mammalian erythrocyte Pig-a gene mutation assays.Results:In the bacterial reverse mutation assay,all plates showed good background growth.There was no significant difference in the average number of revertant colonies between the test group and the negative control group,with a ratio around 1.0.In the in vitro chromosome aberration assay,the chromosomal aberration rate in the test group was less than 5％,showing no significant increase compared to the negative control group.In the mouse lymphoma cell TK gene mutation assay,the mutation frequency in the test group was less than twice that of the negative control group,with no significant difference.In the mammalian erythrocyte Pig-a gene mutation assay,the mutation frequencies of erythrocytes and reticulocytes in the test group were both less than 3× 10-6,showing no significant difference compared to the negative control group.Conclusions:Graphene artificial nerve sheath conduit exhibited no detectable genotoxicity under the tested conditions,the research results can provide reference and guidance for the genotoxicity evaluation of nanomaterial medical devices.

Objective:The genotoxicity risk of graphene artificial nerve sheath conduit was systematically evaluated to provide scientific evidence for their clinical safety and to establish methodological references for the genotoxicity assessment of nanomaterial medical devices.Methods:The potential effects of graphene artificial nerve sheath conduit on genetic and chromosomal endpoints were analyzed by integrating bacterial reverse mutation assays,in vitro chromosome aberration assays,mouse lymphoma cell TK gene mutation tests,and mammalian erythrocyte Pig-a gene mutation assays.Results:In the bacterial reverse mutation assay,all plates showed good background growth.There was no significant difference in the average number of revertant colonies between the test group and the negative control group,with a ratio around 1.0.In the in vitro chromosome aberration assay,the chromosomal aberration rate in the test group was less than 5％,showing no significant increase compared to the negative control group.In the mouse lymphoma cell TK gene mutation assay,the mutation frequency in the test group was less than twice that of the negative control group,with no significant difference.In the mammalian erythrocyte Pig-a gene mutation assay,the mutation frequencies of erythrocytes and reticulocytes in the test group were both less than 3× 10-6,showing no significant difference compared to the negative control group.Conclusions:Graphene artificial nerve sheath conduit exhibited no detectable genotoxicity under the tested conditions,the research results can provide reference and guidance for the genotoxicity evaluation of nanomaterial medical devices.

Objective Establish the fingerprint of the group and optimize the extraction process of the Yunpi Huatan Tongqiao decoction.Methods The macroscopic characterization and similarity analysis of the extract fingerprint were carried out by applying the total statistical moment method.With baicalin,wogonin,rosmarinic acid,liquiritin,glycyrrhizic acid and paste yield as key quality attributes,and extraction time,water addition and extraction times as key process parameters,the optimal extraction process was selected by AHP-independent weight method,and the process was verified.Results Establishing a total statistical moment similarity evaluation method,and the average statistical moment similarity of the total amount of fingerprints of different extraction methods was 0.8807.The ANOVA results of the process evaluation model function are displayed that P<0.0001,R2=0.9904,indicating that the model was statistically significant.The best extraction process was determined as follows:adding 10-fold volume of water in the whole prescription,extracting for 1.5 h and extracting twice.Conclusion The total statistical moment analysis method that conforms to the fingerprint characteristics of the fingerprint of the extract was established,which was stable and reliable,which provided a reference basis for the quality control of the whole process of the subsequent process research.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD. Methods: A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD. Results: The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD. Conclusion There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.
Cross-Sectional Studies ; Diabetes Mellitus/epidemiology* ; Humans ; Hyperlipidemias/epidemiology* ; Hypertension/epidemiology* ; Macular Degeneration/etiology* ; Risk Factors

AIM: To study the distribution of CYP2C9∗3 and VKORC1-1639G>A gene polymorphism in Han population in Anhui province and their influence on the stable dose of warfarin. METHODS: The blood samples of 1 169 patients from 6 tertiary general hospitals in 5 areas of Anhui province from January 2020 to December 2021 were selected, the genotype of CYP2C9∗3 and VKORC1-1639G>A was detected by fluorescent staining in situ hybridization technique. RESULTS: The distribution of CYP2C9∗3 genotypes in 1 169 patients: the frequencies of AA, AC and CC genes were 90.16%, 9.24% and 0.60%, respectively; The distribution of VKORC1 genotype: the frequencies of AA, AG and GG genes were 84.26%, 14.71% and 1.03% respectively; There was no significant difference between the two genotypes in gender, age and regional distribution (P>0.05). The average daily warfarin dose of CYP2C9∗3 AA genotype in 755 patients with stable warfarin dose was (3.02±0.59) mg/d, which was significantly higher than patients with AC genotype and CC genotype; The average daily warfarin dose of patients with VKORC1-1639AA genotype was (2.72±0.40) mg/d, which was significantly lower than that of patients with AG genotype and GG genotype (P<0.05). And the difference was statistically significant (P<0.05); There are significant differences in gender, age and clinical diagnosis between patients with stable dose of warfarin and those without stable dose (P<0.05). CONCLUSION: CYP2C9 and VKORC1 genotypes are associated with the stable dose of warfarin. Clinical anticoagulation therapy guided by CYP2C9 and VKORC1 genotypes can provide guidance for individualized medication of warfarin.