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*

Nuclear receptor corepressor (NCoR1) interacts with various nuclear receptors and regulates the anabolism and catabolism of lipids. An imbalance in lipid/energy homeostasis is also an important factor in obesity and metabolic syndrome development. In this study, we found that the deletion of NCoR1 in intestinal epithelial cells (IECs) mainly activated the nuclear receptor PPARα and attenuated metabolic syndrome by stimulating thermogenesis. The increase in brown adipose tissue thermogenesis was mediated by gut-derived tricarboxylic acid cycle intermediate succinate, whose production was significantly enhanced by PPARα activation in the fed state. Additionally, NCoR1 deletion derepressed intestinal LXR, increased cholesterol excretion, and impaired duodenal lipid absorption by decreasing bile acid hydrophobicity, thereby reversing the possible negative effects of intestinal PPARα activation. Therefore, the simultaneous regulatory effect of intestinal NCoR1 on both lipid intake and energy expenditure strongly suggests that it is a promising target for developing metabolic syndrome treatment.

The mechanisms underlying autophagic defects in nonalcoholic steatohepatitis (NASH) remain largely unknown. We aimed to elucidate the roles of hepatic cyclooxygenase 1 (COX1) in autophagy and the pathogenesis of diet-induced steatohepatitis in mice. Human nonalcoholic fatty liver disease (NAFLD) liver samples were used to examine the protein expression of COX1 and the level of autophagy. Cox1^Δhepa mice and their wildtype littermates were generated and fed with 3 different NASH models. We found that hepatic COX1 expression was increased in patients with NASH and diet-induced NASH mice models accompanied by impaired autophagy. COX1 was required for basal autophagy in hepatocytes and liver specific COX1 deletion exacerbated steatohepatitis by inhibiting autophagy. Mechanistically, COX1 directly interacted with WD repeat domain, phosphoinositide interacting 2 (WIPI2), which was crucial for autophagosome maturation. Adeno-associated virus (AAV)-mediated rescue of WIPI2 reversed the impaired autophagic flux and improved NASH phenotypes in Cox1^Δhepa mice, indicating that COX1 deletion-mediated steatohepatitis was partially dependent on WIPI2-mediated autophagy. In conclusion, we demonstrated a novel role of COX1 in hepatic autophagy that protected against NASH by interacting with WIPI2. Targeting the COX1-WIPI2 axis may be a novel therapeutic strategy for NASH.

Objective:To explore whether the duration of oral estrogen treatment before progesterone application affects neonatal outcome in single frozen-thawed embryo transfer (FET) with artificial cycles.Methods:It was a retrospective cohort study. Patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), receiving single frozen blastocyst transfer with artificial cycle and delivering a single live birth in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were included. All FET cycles were divided into four groups according to the estrogen treatment duration before progesterone application, ≤12 d ( n=306), 13-15 d ( n=620), 16-18 d ( n=471), and ≥19 d ( n=275). Primary outcome was the incidence of small for gestational age (SGA). Secondary outcomes were the incidence of preterm birth, low birth weight, macrosomia and large for gestational age (LGA). Results:A total of 1 672 single blastocyst transfer cycles were included. The incidence of SGA among the four groups was 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), respectively, with no statistically significant difference ( P=0.204). The results of multiple logistic regression analysis showed that the duration of estrogen used before progesterone application did not affect the incidence of SGA in singleton offspring (with ≤12 d as the reference, 13-15 d: a OR=1.37, 95% CI: 0.70-2.70, P=0.361; 16-18 d: a OR=0.74, 95% CI: 0.40-1.36, P=0.336; ≥19 d: a OR=0.81, 95% CI: 0.44-1.49, P=0.501). There were no significant differences in neonatal preterm birth rate ( P=0.204), low birth weight ( P=0.582), incidences of macrosomia ( P=0.201) and LGA infants ( P=0.335) among the four groups. Conclusion:In artificial FET cycle, the duration of oral estrogen treatment before progesterone application does not affect the outcome of singleton offspring after single blastocyst transfer.

Objective:To explore whether the duration of oral estrogen treatment before progesterone application affects neonatal outcome in single frozen-thawed embryo transfer (FET) with artificial cycles.Methods:It was a retrospective cohort study. Patients who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), receiving single frozen blastocyst transfer with artificial cycle and delivering a single live birth in the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were included. All FET cycles were divided into four groups according to the estrogen treatment duration before progesterone application, ≤12 d ( n=306), 13-15 d ( n=620), 16-18 d ( n=471), and ≥19 d ( n=275). Primary outcome was the incidence of small for gestational age (SGA). Secondary outcomes were the incidence of preterm birth, low birth weight, macrosomia and large for gestational age (LGA). Results:A total of 1 672 single blastocyst transfer cycles were included. The incidence of SGA among the four groups was 7.8% (24/306), 4.8% (30/620), 5.7% (27/471), and 7.6% (21/275), respectively, with no statistically significant difference ( P=0.204). The results of multiple logistic regression analysis showed that the duration of estrogen used before progesterone application did not affect the incidence of SGA in singleton offspring (with ≤12 d as the reference, 13-15 d: a OR=1.37, 95% CI: 0.70-2.70, P=0.361; 16-18 d: a OR=0.74, 95% CI: 0.40-1.36, P=0.336; ≥19 d: a OR=0.81, 95% CI: 0.44-1.49, P=0.501). There were no significant differences in neonatal preterm birth rate ( P=0.204), low birth weight ( P=0.582), incidences of macrosomia ( P=0.201) and LGA infants ( P=0.335) among the four groups. Conclusion:In artificial FET cycle, the duration of oral estrogen treatment before progesterone application does not affect the outcome of singleton offspring after single blastocyst transfer.

Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

Objective:To investigate whether there are differences in clinical pregnancy and perinatal outcomes among different protocols for artificial insemination by donor (AID) in female patients aged ≤35 years.Methods:This retrospective cohort study analyzed clinical data of patients who underwent AID at the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from January 1, 2016 to January 31, 2021. Based on ovulation induction therapy, patients were divided into 4 groups: natural cycle (NC) group, letrozole (LE)/clomiphene (CC) group, gonadotropin (Gn) group and LE/CC combined with Gn (LE/CC+Gn) group. The clinical outcomes, incidence of complications, and offspring health were compared among these groups, and logistic regression analysis was employed to investigate the effects of different protocols on the clinical and perinatal outcomes of AID cycles.Results:In NC group, LE/CC group, Gn group and LE/CC+Gn group, the cycle cancellation rate [0.5% (11/2 147), 1.1% (12/1 045), 1.6% (9/549), 3.2% (9/315), P<0.001], the clinical pregnancy rate [31.5% (673/2 136), 35.8% (370/1 033), 42.8% (231/540), 38.2% (117/306), P<0.001], the multiple pregnancy rate [0.7% (5/673), 3.2% (12/370), 3.5% (8/231), 6.8% (8/117), P<0.001], the abortion rate [12.8% (86/673), 9.2% (34/370), 5.2% (12/231), 8.5% (10/117), P=0.008] and the live birth rate [27.2% (581/2 136), 31.4% (324/1 033), 40.0% (216/540), 34.3% (105/306), P<0.001] were statistically significant, while the differences among the four groups in the ectopic pregnancy rate, the preterm birth rate, and the overdue birth rate were not statistically significant (all P>0.05). After adjusting for confounding factors, the differences were not statistically significant in all indicators compared with the NC group (all P>0.05), except for the miscarriage rate in the LE/CC+Gn group, which was significantly higher than that in the NC group (a OR=2.141, 95% CI: 1.12-4.09; P=0.021). For patients who have been using the same treatment protocol, the cumulative pregnancy rate and the cumulative live birth rate in the NC group and the LE/CC group increased with the increase of assisted reproductive cycles, and the difference was statistically significant (all P<0.001). Regardless of whether confounding factors were adjusted, there were no statistically significant differences in neonatal mortality rate, low birth weight rate, normal birth weight rate, macrosomia rate, and male-to-female ratio among the groups (all P>0.05). Conclusion:In AID cycles with female patients aged ≤35 years, stimulated cycles had similar pregnancy outcomes to natural cycles and did not increase the risk of adverse neonatal outcomes or multiple pregnancies. Choosing the LE/CC stimulation protocol can improve the cumulative pregnancy rate of patients with abnormal ovarian follicle development or ovulation function.

Objective To evaluate the role of treadmill exercise‐stress echocardiography in the assessment of left ventricular ( LV ) function in patients with slow coronary flow ( SCF ) ,and discuss the possible mechanism of SCF . Methods Forty‐six patients with diagnosis of SCF were enrolled as SCF group . Forty age and sex matched adults were included as control group . All subjects had underwent clinical evaluation and exercise stress echocardiography . LV diastolic and systolic functions were assessed by conventional echocardiography , tissue Doppler imaging and two‐dimensional speckle tracking echocardiography at rest and during exercise . Results ①LV function in patients with SCF at rest :LV peak systolic longitudinal strain ( LS) was lower in patients with SCF than that in controls ( P ＜0 .05) . T here was no difference of LV ejection fraction ( LVEF) between the two group( P＞0 .05) . Early diastolic mitral annulus velocity ( M itral e′) and the ratio between the early mitral inflow velocity and Mitral e′( M itral E/e′) were significantly decreased in SCF group( all P＜0 .01 ) . ②LV function during exercise :LVEF ,LS and M itral e′were significant increased in two groups ( all P ＜0 .05 ) than those at rest ,but there was no significant difference of LVEF ,LS ,M itral e′ and M itral E/e′ between the two groups ( all P ＞ 0 .05 ) . Compared with control group ,ΔLS and ΔM itral e′were significantly higher in SCF group ( all P＜0 .05 ) . Conclusions LV systolic and diastolic function in patients with SCF are impaired at rest . LV systolic and diastolic function recover in patients with SCF during exercise .

OBJECTIVE ToobservetheprotectiveeffectandmechanismofCompoundGinkgo biloba(CGB)againstalcohol-inducedliverinjury.METHODS MiceweregivenCGB0.125,0.25and 0.75 g·kg -1 ,Ginkgo biloba extract (GBE)0.1 25 g·kg -1 and bifendate(Bif)0.1 5 g·kg -1 for 8 weeks, respectively.At the end of 4th week the mice were given wine by gavage (56% V/V,0.01 L·kg -1 ), and (56% V/V,0.016 L·kg -1 )at the end of the 8th week.The serum was obtained to measure alanine transaminase (GPT),aspartate aminotransaminase (GOT),mitochondrial aspartate aminotransferase (mGOT)and tumor necrosis factor-α(TNF-α).Liver histopathology was revealed by HE staining.The protein expression of cytochrome P450 (CYP)2E1 ,NF-E2-related factor 2 (Nrf2)and TNF-αin the liverwasanalyzedbyWesternblotting.RESULTS Comparedwithnormalcontrolgroup,theactivitiesof GOT and mGOT were increased in model group (P<0.01 ).Compared with model group,CGB 0.25 and 0.75 g·kg -1 groups and Bif 0.1 5 g·kg -1 group significantly decreased the activity of GOT and mGOT in serum (P<0.05,P<0.01 ),while there was no significant difference between these groups in serum GPT activity (P>0.05).Fatty degeneration and neutrophil infiltration were significantly ameliora-ted in CGB 0.25 and 0.75 g·kg -1 groups.Preliminary mechanism research showed CGB not only increased the protein expression of Nrf2 with a positive dose-effect relationship (r=0.942,P<0.01 ), but reduced the protein expression of hepatic CYP2 E1 and the level of TNF-αin hepatic tissue with a negative dose-effect relationship (r=-0.987,P<0.05;r=-0.940,P<0.05).In addition.The level ofTNF-αwasalsosignificantlydecreasedintheserum(P<0.05,P<0.01).CONCLUSION CGB may protect the liver fro m acute alcoholic injury and the mechanis m may be that it increases the protein expression of Nrf2,restrains the protein expression of hepatic CYP2E1 and TNF-αand reduces the TNF-αlevel in the serum.

The paper is to report the development of an optic-fiber sensing technology method to analyze metronidazole tablets rapidly. In this fiber-optic sensing system, the light from source delivering to probe can be dipped into simple-handling sample solution, absorbed by the solution and reflected to the fiber-optic and detected in the detection system at last. Then the drug content can be shown in the screen from the ultraviolet absorption spectra and the consistency between that obtained by this method and that in China Pharmacopoeia can be compared. With regard to data processing, a new method is explored to identify the authenticity of drugs using the similarity between the sample map and the standard pattern by full ultraviolet spectrum. The results indicate that ultraviolet spectra of tablets can be obtained from this technology and the determination results showed no significant difference as compared with the method in China Pharmacopoeia (P > 0.05), and the similarity can be a parameter to identify the authenticity of drugs.