This article reviews the recent advancements in incision and flap design for periodontal regenerative surgery, with a particular focus on the application of minimally invasive surgical techniques and non-crestal approaches. When applied to periodontal regeneration, traditional flap designs, such as the modified Widman flap, present disadvantages including wound dehiscence and gingival recession, compromising regenerative outcomes. To address these issues, researchers have developed a series of novel techniques, including papilla preservation techniques, minimally invasive techniques, and single-flap techniques. However, these techniques usually involve horizontal or oblique incisions near the interdental papilla adjacent to the intrabony defect, which may still lead to wound dehiscence, limiting periodontal regeneration. Also they may cause gingival recession and reduction in papilla height, resulting in "black triangles". In recent years, a series of new techniques utilizing non-crestal approaches have emerged, altering incision placement to preserve the interdental papilla. Examples include the entire papilla preservation technique using a lateral incision approach, non-incised papilla surgical approaching by an apical incision, and apically incised coronally advanced surgical technique. By placing incisions away from the papilla, these methods achieve complete papilla preservation and provide greater space for regeneration, effectively promoting the regeneration of both intrabony and suprabony periodontal tissues. This article systematically analyzes the key surgical points, indications, and clinical efficacies of different incision designs in periodontal regenerative surgery. Detailed case presentations illustrate the step-by-step procedures of these techniques, demonstrating their favorable outcomes in treating intrabony defects. The aim is to encourage future clinical studies to validate the effectiveness and safety of these novel techniques.

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 and Aims:Surgical treatment is a cornerstone of breast cancer management;however,the physical trauma and psychological burden associated with surgery may adversely affect patients'quality of life(QoL).Based on data from a prospective cohort,this study was conducted to evaluate changes in postoperative QoL among breast cancer patients and to identify mediating factors influencing QoL,thereby providing evidence for perioperative rehabilitation strategies.Methods:Female breast cancer patients who underwent local surgical treatment at Suining Central Hospital between June 2024 and January 2025 were enrolled.The Constant-Murley Shoulder Score,EORTC QLQ-C30,and QLQ-BR23 questionnaires were used pre-and postoperatively to assess shoulder joint function,and QoL.Paired t-tests were used to analyze changes in scores before and after surgery.A mediation model was applied to explore the indirect pathways through which surgery impacts QoL.Additionally,subgroup analyses were conducted to compare QoL changes across different surgical modalities.Results:A total of 148 patients were included,with median age of 54(46-60)years old Postoperative psychological health significantly improved,while shoulder function and overall QoL scores markedly declined(all P<0.001).According to QLQ-C30,functional domains such as physical and role functioning worsened,while symptom burden increased.The QLQ-BR23 revealed significantly higher scores for breast and upper limb symptoms postoperatively(both P<0.001).Subgroup analyses showed that patients undergoing axillary lymph node dissection experienced greater declines in shoulder function and QoL compared to those receiving sentinel lymph node biopsy(both P<0.05).QoL deterioration was comparable between mastectomy and breast-conserving surgery,although the former was associated with more prominent pain and breast symptoms.Mediation analysis indicated that shoulder function,breast symptoms,and physical functioning served as mediators in the impact of surgery on QoL,while better psychological health exerted a protective effect.Conclusion:Surgical treatment significantly affects postoperative QoL in breast cancer patients,with local functional impairment and symptom exacerbation serving as key mediators.Different surgical approaches have varying impacts on QoL.Enhancing postoperative shoulder rehabilitation,symptom management,and psychological support may improve patients'QoL.

Background and Aims:Surgical treatment is a cornerstone of breast cancer management;however,the physical trauma and psychological burden associated with surgery may adversely affect patients'quality of life(QoL).Based on data from a prospective cohort,this study was conducted to evaluate changes in postoperative QoL among breast cancer patients and to identify mediating factors influencing QoL,thereby providing evidence for perioperative rehabilitation strategies.Methods:Female breast cancer patients who underwent local surgical treatment at Suining Central Hospital between June 2024 and January 2025 were enrolled.The Constant-Murley Shoulder Score,EORTC QLQ-C30,and QLQ-BR23 questionnaires were used pre-and postoperatively to assess shoulder joint function,and QoL.Paired t-tests were used to analyze changes in scores before and after surgery.A mediation model was applied to explore the indirect pathways through which surgery impacts QoL.Additionally,subgroup analyses were conducted to compare QoL changes across different surgical modalities.Results:A total of 148 patients were included,with median age of 54(46-60)years old Postoperative psychological health significantly improved,while shoulder function and overall QoL scores markedly declined(all P<0.001).According to QLQ-C30,functional domains such as physical and role functioning worsened,while symptom burden increased.The QLQ-BR23 revealed significantly higher scores for breast and upper limb symptoms postoperatively(both P<0.001).Subgroup analyses showed that patients undergoing axillary lymph node dissection experienced greater declines in shoulder function and QoL compared to those receiving sentinel lymph node biopsy(both P<0.05).QoL deterioration was comparable between mastectomy and breast-conserving surgery,although the former was associated with more prominent pain and breast symptoms.Mediation analysis indicated that shoulder function,breast symptoms,and physical functioning served as mediators in the impact of surgery on QoL,while better psychological health exerted a protective effect.Conclusion:Surgical treatment significantly affects postoperative QoL in breast cancer patients,with local functional impairment and symptom exacerbation serving as key mediators.Different surgical approaches have varying impacts on QoL.Enhancing postoperative shoulder rehabilitation,symptom management,and psychological support may improve patients'QoL.

This article reviews the recent advancements in incision and flap design for periodontal regenerative surgery, with a particular focus on the application of minimally invasive surgical techniques and non-crestal approaches. When applied to periodontal regeneration, traditional flap designs, such as the modified Widman flap, present disadvantages including wound dehiscence and gingival recession, compromising regenerative outcomes. To address these issues, researchers have developed a series of novel techniques, including papilla preservation techniques, minimally invasive techniques, and single-flap techniques. However, these techniques usually involve horizontal or oblique incisions near the interdental papilla adjacent to the intrabony defect, which may still lead to wound dehiscence, limiting periodontal regeneration. Also they may cause gingival recession and reduction in papilla height, resulting in "black triangles". In recent years, a series of new techniques utilizing non-crestal approaches have emerged, altering incision placement to preserve the interdental papilla. Examples include the entire papilla preservation technique using a lateral incision approach, non-incised papilla surgical approaching by an apical incision, and apically incised coronally advanced surgical technique. By placing incisions away from the papilla, these methods achieve complete papilla preservation and provide greater space for regeneration, effectively promoting the regeneration of both intrabony and suprabony periodontal tissues. This article systematically analyzes the key surgical points, indications, and clinical efficacies of different incision designs in periodontal regenerative surgery. Detailed case presentations illustrate the step-by-step procedures of these techniques, demonstrating their favorable outcomes in treating intrabony defects. The aim is to encourage future clinical studies to validate the effectiveness and safety of these novel techniques.

Objective To explore the correlation between the pulmonary artery diameter(PAD),PAD/aortic diameter(AOD),right ventricular diameter(RVD),RVD/left ventricular diameter(LVD)measured on pulmonary artery CT angiography(CTPA)cross-sectional images and the degree of embolism,cardiac biomarkers in patients with medium-to-high risk acute pulmonary embolism(APE).Methods The clinical data of 53 patients with medium-to-high risk APE,who received interventional treatment at the Putian Municipal First Hospital of China From January 2021 to December 2023,were retrospectively analyzed.The PAD,PAD/AOD,RVD,and RVD/LVD were measured on CTPA cross-sectional images.The correlations of the above indexes with CT embolism index(CTEI),N terminal pro B type natriuretic peptide(NT-proBNP),and cardiac troponin Ⅰ(cTnⅠ)were analyzed.Results A weak-moderate positive correlation existed between PAD,RVD,RVD/LVD and CTEI(r=0.506,r=0.310,r=0.452 respectively,P＜0.001,P=0.024,P=0.001 respectively),while no correlation existed between PAD/AOD and CTEI(r=0.247,P=0.075).Compared with the NT-proBNP negative group,in the NT-proBNP positive group the values of PAD,PAD/AOD and RVD/LVD were higher(all P＜0.05),and there was no statistically significant difference in RVD value between the two groups(P＞0.05).A weak-moderate positive correlation existed between NT-proBNP and PAD,PAD/AOD,RVD,RVD/LVD(r=0.454,r=0.326,r=0.302,r=0.405 respectively,P=0.001,P=0.017,P=0.028,P=0.003 respectively).There were no statistically significant differences in PAD,PAD/AOD,RVD and RVD/LVD values between the cTnⅠ negative group and the cTnI positive group(all P＞0.05).No correlation existed between cTnⅠ and PAD,PAD/AOD,RVD,RVD/LVD(r=0.188,r=0.042,r=-0.021,r=0.139 respectively,and P=0.195,P=0.772,P=0.884,P=0.342 respectively).Conclusion CTPA cross-sectional quantitative indicators are helpful in evaluating the embolism degree of APE and right heart function,but it cannot be used to assess myocardial injury.

Aim To investigate the effect of alfentanil on myocardial ischemia-reperfusion injury(MIRI)in rats and its regulatory mechanism on the sphingosine kinase 1(SphK1)/sphingosine-1-phosphate(S1P)signaling pathway dur-ing this process.Methods SPF grade SD male rats were randomly divided into sham surgery group,model group,positive drug group(compound salvia miltiorrhiza group),low dose alfentanil group,high dose alfentanil group,and high alfentanil+SphK1 agonist group(alfentanil+PMA group),with 20 rats in each group.Except the sham operation group,the MIRI model was reproduced by ligating the left anterior descending coronary artery and reperfusion.The activities of serum lactate dehydrogenase(LDH),creatine kinase(CK)and aspartate aminotransferase(AST)were detected by auto-matic biochemical analyzer;TTC was applied to detect the size of myocardial infarction in rats;HE staining was applied to observe the morphological characteristics of rat myocardial tissue;TUNEL staining was applied to detect myocardial cell ap-optosis in rats;ELISA was applied to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),inter-leukin-1β(IL-1β),and S1P;kits were applied to detect content of malondialdehyde(MDA)and activity of superoxide dismutase(SOD)in myocardial tissue;Western blot was applied to detect the expression level of SphK1 protein in myocar-dial tissue.Results Compared with the sham surgery group,the pathological damage to the myocardial tissue of rats was severe in the model group,the activities of serum central muscle injury markers LDH,CK,and AST,myocardial in-farction area,myocardial cell apoptosis rate,the levels of TNF-α,IL-6,IL-1β,MDA,S1P and the expression of SphK1 protein all increased,the activity of SOD decreased(P＜0.05).Compared with the model group,the myocardial tissue damage of rats was reduced in the positive drug group and the low and high dose alfentanil groups,the activities of serum central muscle injury markers LDH,CK,and AST,myocardial infarction area,myocardial cell apoptosis rate,the levels of TNF-α,IL-6,IL-1β,MDA,S1P and the expression of SphK1 protein all decreased,the activity of SOD increased(P＜0.05).The SphK1 agonist was able to reverse the impact of high-dose alfentanil on the above indicators(P＜0.05).Conclusion Alfentanil has protective effect on MIRI rats,and its mechanism may be related to the inhibition of SphK1/S1P signaling pathway.

Objective To explore the effect of health education based on LEARNS model in patients with urinary incontinence after laparoscopic radical prostatectomy. Methods A total of 76 patients with urinary incontinence after laparoscopic radical prostatectomy admitted to Fujian Cancer Hospital from February 2022 to December 2023 were selected and divided into control group and observation group according to random number table method,with 38 cases in each group. Patients in control group received routine health education,while patients in observation group received health education based on LEARNS model. Both groups were intervened for one month. Urinary control ability,pelvic floor muscle training knowledge level,pelvic floor muscle training accuracy rate and quality of life of two groups were compared before and after intervention. Results After the intervention,International Consultation on Incontinence questionnaire-urinary incontinence short form (ICIQ-UI SF) scores of patients in both groups were significantly lower than before intervention,and scores of pelvic floor muscle training knowledge questionnaire and 36-item short form health survey (SF-36) were significantly higher than before intervention (P<0.05). The ICIQ-UI SF score of observation group was significantly lower than that of control group,and the scores of pelvic floor muscle training knowledge questionnaire and SF-36 were significantly higher than those of control group (P<0.05). The correct rate of pelvic floor muscle training in observation group was significantly higher than that in control group (92.11％ vs. 68.42％,x2=6.727,P=0.009). Conclusion Health education based on LEARNS model can effectively improve the knowledge level and correct rate of pelvic floor muscle training of urinary incontinence patients after radical prostatectomy,improve the urinary control ability and quality of life of patients.

Objective To investigate the effect of sufentanil(SUF)on interleukin-1β(IL-1β)-induced chondrocyte damage and its regulatory relationship on the Janus activated kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Methods Rat chondrocytes were randomly separated into control group(NC group),IL-1β group,SUF low concentration(SUF-L)+IL-1β group(SUF-L+IL-1β group),SUF high concentration(SUF-H)+IL-1β group(SUF-H+IL-1β group),and SUF-H+IL-1β+STAT3 activator Colivelin group(SUF-H+IL-1β+Colivelin group).CCK-8 method and clonal formation assay were applied to detect the proliferation of chondrocytes,while flow cytometry was used to detect the apoptosis;qRT-PCR method was applied to detect the relative mRNA expression levels of JAK2 and STAT3;Western blot was used to detect the expression level of JAK2/STAT3 signaling pathway related proteins;ELISA was applied to determine the expression levels of IFN-γ,IL-6 and IL-8 in cell culture media of each group.Results Compared with the NC group,the cell survival rate and the clones formation number of the IL-1β group decreased,while the apoptosis rate,relative expression levels of JAK2 and STAT3 mRNA,the values of p-JAK2/JAK2 and p-STAT3/STAT3,and the expression levels of IFN-γ,IL-6 and IL-8 in the cell culture medium all increased(P<0.05);compared with the IL-1β group,the changes in corresponding indicators of chondrocytes in the SUF-L+IL-1β group and SUF-H+IL-1β group were opposite to the above(P<0.05);Colivelin reversed the protective effects of high-dose SUF on IL-1β-induced chondrocyte damage(P<0.05).Conclusion SUF can protect chondrocytes from IL-1β-induced damage by down-regulating the JAK2/STAT3 signaling pathway.

Objective To investigate the role of miRNAs in maternal amniotic fluid exosomes in development of isolated ventriculomegaly(VM)in fetuses.Methods Amniotic fluid samples were collected from 9 cases of moderate isolated VM and 8 normal control cases to extract exosomal miRNA,and miRNA sequencing technique was used to identify differentially expressed miRNAs between the two groups.Three miRNAs with significant differential expression between the two groups,whose high expression was associated with VM,were selected for verification with RT-qPCR.Dual luciferase reporter assays were used to verify the regulatory effect of miR-122-5p on its predicted target genes AKT3 and CCDC88C.Gene ontology(GO)and KEGG pathway analyses were performed to explore the possible roles of the top 40 significant differential miRNAs in the pathophysiology of VM.Results We identified a total of 272 differentially expressed miRNAs in VM cases,including 43 up-regulated and 229 down-regulated miRNAs.The target genes of these differential miRNAs were associated with DNA and transcription factor binding,transmembrane transporter and nucleic acid binding transcription factor activity,and cell developmental process.These miRNAs were mostly enriched in the MAPK,cGMP-PKG and Wnt signaling pathways.Verification with RT-qPCR showed that miR-122-5p expression level was significantly lower in VM group than in the control group(P<0.05),which was consistent with miRNA sequencing results;let-7b-5p expression level was significantly lower in VM group,which was contrary to miRNA sequencing result.Dual luciferase reporter assays showed that miR-122-5p was not capable of regulating AKT3 or CCDC88C expressions.Conclusions The highly abundant differentially expressed miRNAs in maternal amniotic fluid exosomes play important roles in the occurrence of fetal VM possibly by regulating the MAPK,PI3K-Akt,Wnt and cGMP-PKG signaling pathways.