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:Through scientific research addressing the effect of calcined deer antler slices on promoting the proliferation of bone marrow mesenchymal stem cells,it aims to provide empirical support for the integration and innovation of traditional Chinese medicine and modern regenerative medicine,and promote the widespread application of traditional Chinese medicine in the treatment of skeletal system diseases.OBJECTIVE:To investigate the effect of calcined deer antler slices on bone marrow mesenchymal stem cell proliferation.METHODS:Different calcination samples were prepared by wrapping deer antler slices with materials such as clay,yellow clay,and salted yellow clay,resulting in seven different samples(clay-cotton cloth,yellow clay-cotton cloth,salted yellow clay-cotton cloth,yellow clay-tin foil,salted yellow clay-tin foil,yellow clay-honey roasted,salted yellow clay-honey roasted antler slices).Water-soluble extract content in deer antler slices was determined before and after calcination.CCK-8 assay was used to evaluate the effects of different aqueous extracts of calcined antler slices on the proliferation activity of bone marrow mesenchymal stem cells.RESULTS AND CONCLUSION:(1)Calcination significantly increased the water-soluble extract content of deer antler slices,with the highest content observed in samples treated with yellow clay and honey.(2)Calcined deer antler slices significantly promoted bone marrow mesenchymal stem cell proliferation,among which the yellow clay-honey roasted deer antler slices have the most significant effect on promoting the proliferation of bone marrow mesenchymal stem cells.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

BACKGROUND:Steroid-induced osteonecrosis of the femoral head is closely related to ferroptosis in osteoblasts.Deer antler peptide can promote the survival and functional establishment of osteoclasts by inhibiting ferroptosis in osteoblasts,and has the potential to treat steroid-induced osteonecrosis of the femoral head,but its regulatory mechanism of ferroptosis in osteoblasts has not yet been clarified.OBJECTIVE:To investigate the mechanism by which deer antler peptide inhibits dexamethasone-induced ferroptosis in osteoblasts.METHODS:(1)Different concentration gradients of antler peptide and dexamethasone were used to intervene in MC3T3-E1 14 cells,and the cell activity was detected by cell counting kit-8 method to determine the effect concentration of antler peptide and dexamethasone.(2)MC3T3-E1 14 cells treated with dexamethasone(800 μmol/L)were intervened with different concentrations of gradient antler polypeptide,which were then divided into blank control group,dexamethasone group and dexamethasone+antler peptide group.Cell counting kit-8 method was used to calculate the effects of different concentrations of antler polypeptide on the proliferation of MC3T3-E1 14 cells.(3)Glutathione,superoxide dismutase,malondialdehyde,lipid peroxide,cellular iron,and reactive oxygen species levels in the blank control group,dexamethasone group and dexamethasone+antler peptide group were detected using kits.The protein expressions of glutathione peroxidase 4 and solute carrier family 7 member 11 were detected by western blot to verify the pathway by which antler polypeptide inhibits ferroptosis.RESULTS AND CONCIUSION:After cell activity was detected by cell counting kit-8 assay,antler peptide(10 mg/mL)and dexamethasone(800 μmol/L)were selected to treat MC3T3-E1 14 cells for 24 hours in subsequent experiments.After treatment with dexamethasone,malondialdehyde,lipid peroxide,cellular iron and reactive oxygen species levels were all increased(P<0.01),while glutathione content and superoxide dismutase activity were decreased and the protein expression of glutathione peroxidase 4 and solute carrier family 7 member 11 were also decreased(P<0.05-0.01).After antler peptide intervention,the changes in the above indexes were obviously reversed(P<0.05-0.01).To conclude,antler peptide may inhibit ferroptosis in osteoblasts by regulating the glutathione peroxidase 4/solute carrier family 7 member 11 axis,and thereby exert a therapeutic role in steroid-induced osteonecrosis of the femoral head.

BACKGROUND:Through scientific research addressing the effect of calcined deer antler slices on promoting the proliferation of bone marrow mesenchymal stem cells,it aims to provide empirical support for the integration and innovation of traditional Chinese medicine and modern regenerative medicine,and promote the widespread application of traditional Chinese medicine in the treatment of skeletal system diseases.OBJECTIVE:To investigate the effect of calcined deer antler slices on bone marrow mesenchymal stem cell proliferation.METHODS:Different calcination samples were prepared by wrapping deer antler slices with materials such as clay,yellow clay,and salted yellow clay,resulting in seven different samples(clay-cotton cloth,yellow clay-cotton cloth,salted yellow clay-cotton cloth,yellow clay-tin foil,salted yellow clay-tin foil,yellow clay-honey roasted,salted yellow clay-honey roasted antler slices).Water-soluble extract content in deer antler slices was determined before and after calcination.CCK-8 assay was used to evaluate the effects of different aqueous extracts of calcined antler slices on the proliferation activity of bone marrow mesenchymal stem cells.RESULTS AND CONCLUSION:(1)Calcination significantly increased the water-soluble extract content of deer antler slices,with the highest content observed in samples treated with yellow clay and honey.(2)Calcined deer antler slices significantly promoted bone marrow mesenchymal stem cell proliferation,among which the yellow clay-honey roasted deer antler slices have the most significant effect on promoting the proliferation of bone marrow mesenchymal stem cells.

BACKGROUND:Steroid-induced osteonecrosis of the femoral head is closely related to ferroptosis in osteoblasts.Deer antler peptide can promote the survival and functional establishment of osteoclasts by inhibiting ferroptosis in osteoblasts,and has the potential to treat steroid-induced osteonecrosis of the femoral head,but its regulatory mechanism of ferroptosis in osteoblasts has not yet been clarified.OBJECTIVE:To investigate the mechanism by which deer antler peptide inhibits dexamethasone-induced ferroptosis in osteoblasts.METHODS:(1)Different concentration gradients of antler peptide and dexamethasone were used to intervene in MC3T3-E1 14 cells,and the cell activity was detected by cell counting kit-8 method to determine the effect concentration of antler peptide and dexamethasone.(2)MC3T3-E1 14 cells treated with dexamethasone(800 μmol/L)were intervened with different concentrations of gradient antler polypeptide,which were then divided into blank control group,dexamethasone group and dexamethasone+antler peptide group.Cell counting kit-8 method was used to calculate the effects of different concentrations of antler polypeptide on the proliferation of MC3T3-E1 14 cells.(3)Glutathione,superoxide dismutase,malondialdehyde,lipid peroxide,cellular iron,and reactive oxygen species levels in the blank control group,dexamethasone group and dexamethasone+antler peptide group were detected using kits.The protein expressions of glutathione peroxidase 4 and solute carrier family 7 member 11 were detected by western blot to verify the pathway by which antler polypeptide inhibits ferroptosis.RESULTS AND CONCIUSION:After cell activity was detected by cell counting kit-8 assay,antler peptide(10 mg/mL)and dexamethasone(800 μmol/L)were selected to treat MC3T3-E1 14 cells for 24 hours in subsequent experiments.After treatment with dexamethasone,malondialdehyde,lipid peroxide,cellular iron and reactive oxygen species levels were all increased(P<0.01),while glutathione content and superoxide dismutase activity were decreased and the protein expression of glutathione peroxidase 4 and solute carrier family 7 member 11 were also decreased(P<0.05-0.01).After antler peptide intervention,the changes in the above indexes were obviously reversed(P<0.05-0.01).To conclude,antler peptide may inhibit ferroptosis in osteoblasts by regulating the glutathione peroxidase 4/solute carrier family 7 member 11 axis,and thereby exert a therapeutic role in steroid-induced osteonecrosis of the femoral head.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Objective:To explore the structural relationship between WMSDs in the upper limbs and various risk factors in the occupational population in China, based on a large sample epidemiological survey and structural equation analysis, and to establish a structural equation model, so as to lay a foundation for the prevention and control of such diseases.Methods:The Chinese version of the Musculoskeletal Disorders Electronic Questionnaire was used to conduct a nationwide survey on the prevalence of WMSDs in the upper extremity. Six factors related to WMSDs in the upper extremity were extracted by the classification standard of adverse ergonomic factors and their source and confirmatory factor analysis, including work organization, work type, upper extremity work posture, individual factors, upper extremity fatigue and upper extremity WMSDs. The structural equation analysis was carried out and the structural equation model was established.Results:The incidence of WMSDs and fatigue in the upper limbs was 24.44% and 43.76%, respectively. The adjusted structural equation model fitting indicators were generally up to the standard (GFI=1.000, AGFI=1.000, RMSEA=0.043, NFI=0.808, TLI=0.784) . The four exogenous latent variables of work organization, work type, upper limb work posture and individual factors were correlated. There was a strong positive correlation between job type and upper limb work posture ( r=0.865) , a moderate positive correlation between work organization and job type and upper limb work posture ( r=0.570, 0.490) , and a weak negative correlation between individual factors and the other three exogenous latent variables. Upper limb work posture and individual factors had direct effects on upper limb WMSDs, and the effect coefficients were 0.10 and 0.06, respectively. Upper limb fatigue played a mediating role between work organization, work type, upper limb work posture and upper limb WMSDs. The effect coefficient was 0.46, and the composition ratios of indirect effects were 100.0%, 100.0%, and 38.3%, respectively. The direct path effect of upper limb work posture, individual factors and upper limb WMSDs was weaker than the mediating path through upper limb fatigue. Conclusion:When carrying out the prevention and control of upper limbWMSDs, it is necessary to comprehensively consider the pathogenesis path of upper limb muscle fatigue and upper limb WMSDs caused by work organization, work type, and upper limb work posture, so as to provide theoretical reference for improving the prevention and control level of such diseases.

This study aims to investigate the effects of Bushen Huoxue Decoction regulating adipose-derived stem cells(ADSCs)-exosomes(Exos) on the apoptosis of intervertebral disc nucleus pulposus cells(NPCs) and extracellular signal-regulated kinase(ERK) signaling pathway. Tert-butyl hydrogen peroxide(TBHP)-induced NPCs were divided into control, model, drug-containing serum, blank Exos, normal serum Exos, and drug-containing serum Exos groups. Cell viability and proliferation were examined by the CCK-8 assay and EdU staining, respectively. The cell cycle and apoptosis were evaluated by flow cytometry. Enzyme-linked immunosorbent assay was employed to measure the levels of interleukin(IL)-1β, tumor necrosis factor(TNF)-α, and IL-6. The mRNA levels of aggrecan, collagen type Ⅱ alpha 1 chain(COL2A1), and ERK were determined by qRT-PCR, and the protein levels of aggrecan, COL2A1, and p-ERK were determined by Western blot. The results showed that compared with the model group, the treatments with drug-containing serum, blank Exos, and normal serum Exos enhanced the viability and proliferation of NPCs, decreased the proportion of cells in the G_0/G_1 phase, increased the proportion of cells in the S phase, reduced apoptosis, lowered the levels of IL-1β, TNF-α, and IL-6, up-regulated the mRNA and protein levels of aggrecan and COL2A1, and down-regulated the mRNA level of ERK and the protein level of p-ERK. Compared with the drug-containing serum, blank Exos, and normal serum Exos groups, the treatment with drug-containing serum Exos enhanced the viability and proliferation of NPCs, decreased the proportion of cells in the G_0/G_1 phase, increased the cells in the S phase, reduced apoptosis, lowered the levels of IL-1β, TNF-α, and IL-6, up-regulated the mRNA and protein levels of aggrecan and COL2A1, and down-regulated the mRNA level of ERK and the protein level of p-ERK. The results confirmed that the Exos secreted by ADSCs after treatment with Bushen Huoxue Decoction-containing serum promoted the proliferation of degenerated NPCs, inhibited apoptosis and the expression of inflammatory mediators, and promoted the production of proteoglycans and collagen, thus delaying the progression of intervertebral disc degeneration, the mechanism of which was related to the regulation of the ERK signaling pathway.
Intervertebral Disc Degeneration/drug therapy* ; Apoptosis/drug effects* ; Nucleus Pulposus/cytology* ; Drugs, Chinese Herbal/pharmacology* ; Animals ; Rats ; MAP Kinase Signaling System/drug effects* ; Rats, Sprague-Dawley ; Collagen Type II/metabolism* ; Humans ; Cell Proliferation/drug effects* ; Stem Cells/metabolism* ; Aggrecans/metabolism* ; Cell Survival/drug effects* ; Male ; Cells, Cultured ; Tumor Necrosis Factor-alpha/metabolism*