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 investigate the improvement effects and mechanism of matrine(Mat)on inflammation and pulmo-nary fibrosis in rats with chronic obstructive pulmonary disease(COPD)based on the transforming growth factor-β1(TGF-β1)/signal transduction protein Smad3 pathway.Methods:The COPD model rats were established by the method of smoking combined with lipo-polysaccharide(LPS).The rats were grouped into COPD group,Mat group(100 mg/kg)and Mat+TGF-β1 group(100 mg/kg Mat+1.25 μg/kg TGF-β1),in addition,with 15 rats in each group.Another 15 randomly selected rats were set as a control group before modeling.Lung function analyzer was applied to detect the lung function of rats;HE staining was applied to observe the pathological changes of lung tissue in rats;the contents of TNF-α,IL-1β,TGF-β1 in the supernatant of alveolar lavage fluid(BALF)were detect-ed by ELISA;TUNEL staining was applied to observe apoptosis in lung tissue;immunohistochemistry was applied to detect the expres-sions of caspase-3 and matrix metalloproteinase-9(MMP-9)proteins in lung tissue;Western blot was applied to detect the expression of TGF/Smad3 pathway related proteins.Results:Compared with the control group,there were obvious inflammatory cell infiltration and cell exfoliation in the lung tissue of COPD rats,FVC,FEV0.1/FVC,FEV0.3/FVC obviously decreased(P<0.05);the levels of TNF-α,IL-1β,TGF-β1,the number of apoptotic cells,the expressions of caspase-3,MMP-9,TGF-β1,p-Smad3,Fibronectin,Col-lagen Ⅰ and α-SMA obviously increased(P<0.05);compared with COPD group,the pathological damage of lung tissue in Mat group was obviously improved,while FVC,FEV0.1/FVC and FEV0.3/FVC obviously increased(P<0.05);the levels of TNF-α,IL-1β,TGF-β1,the number of apoptotic cells,the expressions of caspase-3,MMP-9,TGF-β1,p-Smad3,Fibronectin,Collagen Ⅰ and α-SMA obviously increased(P<0.05);compared with Mat group,Mat+TGF-β1 group obviously reversed the improvement effect of Mat on COPD rats.Conclusion:Mat can improve pulmonary inflammation and fibrosis in COPD rats,which may be related to inhibiting the activation of TGF-β1/Smad3 pathway.

Objective:To investigate the improvement effects and mechanism of matrine(Mat)on inflammation and pulmo-nary fibrosis in rats with chronic obstructive pulmonary disease(COPD)based on the transforming growth factor-β1(TGF-β1)/signal transduction protein Smad3 pathway.Methods:The COPD model rats were established by the method of smoking combined with lipo-polysaccharide(LPS).The rats were grouped into COPD group,Mat group(100 mg/kg)and Mat+TGF-β1 group(100 mg/kg Mat+1.25 μg/kg TGF-β1),in addition,with 15 rats in each group.Another 15 randomly selected rats were set as a control group before modeling.Lung function analyzer was applied to detect the lung function of rats;HE staining was applied to observe the pathological changes of lung tissue in rats;the contents of TNF-α,IL-1β,TGF-β1 in the supernatant of alveolar lavage fluid(BALF)were detect-ed by ELISA;TUNEL staining was applied to observe apoptosis in lung tissue;immunohistochemistry was applied to detect the expres-sions of caspase-3 and matrix metalloproteinase-9(MMP-9)proteins in lung tissue;Western blot was applied to detect the expression of TGF/Smad3 pathway related proteins.Results:Compared with the control group,there were obvious inflammatory cell infiltration and cell exfoliation in the lung tissue of COPD rats,FVC,FEV0.1/FVC,FEV0.3/FVC obviously decreased(P<0.05);the levels of TNF-α,IL-1β,TGF-β1,the number of apoptotic cells,the expressions of caspase-3,MMP-9,TGF-β1,p-Smad3,Fibronectin,Col-lagen Ⅰ and α-SMA obviously increased(P<0.05);compared with COPD group,the pathological damage of lung tissue in Mat group was obviously improved,while FVC,FEV0.1/FVC and FEV0.3/FVC obviously increased(P<0.05);the levels of TNF-α,IL-1β,TGF-β1,the number of apoptotic cells,the expressions of caspase-3,MMP-9,TGF-β1,p-Smad3,Fibronectin,Collagen Ⅰ and α-SMA obviously increased(P<0.05);compared with Mat group,Mat+TGF-β1 group obviously reversed the improvement effect of Mat on COPD rats.Conclusion:Mat can improve pulmonary inflammation and fibrosis in COPD rats,which may be related to inhibiting the activation of TGF-β1/Smad3 pathway.

21 hydroxylase deficiency (21-OHD), the most common form of congenital adrenal hyperplasia, is caused by defects in CYP21A2 gene, which encodes the cytochrome P450 oxidase (P450C21) involved in glucocorticoid and mineralocorticoid synthesis. The diagnosis of 21-OHD is based on the comprehensive evaluation of clinical manifestation, biochemical alteration and molecular genetics results. Due to the complex structure of CYP21A2, special techniques are required to perform delicate analysis to avoid the interference of its pseudogene. Recently, the state-of-the-art diagnostic methods were applied to the clinic gradually, including the steroid hormone profiling and third generation sequencing. To standardize the laboratory diagnosis of 21-OHD, this consensus was drafted on the basis of the extensive knowledge, the updated progress and the published consensuses and guidelines worldwide by expert discussion organized by Rare Diseases Group of Pediatric Branch of Chinese Medical Association, Medical Genetics Branch of Chinese Medical Doctor Association, Birth Defect Prevention and Molecular Genetics Branch of China Maternal and Child Health Association. and Molecular Diagnosis Branch of Shanghai Medical Association.
Child ; Humans ; Adrenal Hyperplasia, Congenital/genetics* ; Steroid 21-Hydroxylase/genetics* ; Consensus ; China ; Clinical Laboratory Techniques ; Mutation

Objective To provide valid data and useful genetic counseling in the clinical application of non‐invasive prenatal test (NIPT) ,fetal chromosomal disorder were screened by massive parallel sequencing and made a follow‐up study .Methods Preg‐nant women with Down screening in high‐risk were screened by NIPT ;NIPT verified high‐risk individuals were suggested for kary‐otyping ;and we follow up on whoever showed low risk by NIPT before and after their deliveries .Results (1)Totally 1 676 cases of pregnant women were tested by NIPT ,25 cases prompted to be abnormal ,with an abnormal rate of 1 .49% ,karyotype analysis re‐sults in 12 cases of abnormalit ,the accuracies of NIPT for T21 ,T18 ,XO ,XXY ,and XYY were 99 .93% ,100 .00% ,99 .66% , 100 .00% ,100 .00% respectively ;the accuracy of NIPT for women with advanced paternal age and twins were both 100 .00% ;kary‐otyping positive individuals underwent abortion ,which gives a prenatal intervention rate of 100 .00% .(2)Out of 1 651 cases of NIPT low risk testers ,1 468 cases were successfully followed up ,with a 88 .91% success rate .We found chromosome abnormality with one case of inversion of chromosome 9 (maternal) .(3)Ultrasound‐detection possessed 98 .17% accuracy and 7 .69% in detec‐tion rate;in high‐risk pregnant woman ,Down screening had an accuracy of 0 .88% and false positive rate of 99 .12% ;98 .71%women were avoided prenatal diagnosis via NIPT .Conclusion Compare to ultrasound and maternal plasma screening ,NIPT is a far more accurate prenatal screening approach .To build effective follow‐up and service systems of NIPT is necessary to reduce birth de‐fects in medical institutions .