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 explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective To explore the efficacy and mechanism of Haikun Shenxi capsules combined with sodium-glucose co-transporter 2 inhibitor(SGLT2i)in the treatment of end-stage renal disease(ESRD).Methods A prospective study was conducted,150 ESRD patients admitted to the department of nephrology of the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from January 2024 to March 2025 were selected as the research subjects.The patients were divided into a control group,a treatment group,and a combined group using a random number table method,with 50 cases in each group.The control group was given compound Salvia Miltiorrhiza injection,the treatment group was given Haikun Shenxi capsules,and the combined group was given Haikun Shenxi capsules combined with an SGLT2i(Canagliflozin).All three groups were treated continuously for 4 weeks.The differences in clinical efficacy,renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr),endogenous creatinine clearance rate(Ccr),24-hour urine protein],renal fibrosis indicators[serum fibronectin(FN),serum hyaluronic acid(HA),serum laminin(LN),plasma typeⅢprocollagen(PC-Ⅲ)],inflammatory factor indicators[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),vascular cell adhesion molecule-1(VCAM-1),monocyte chemoattractant protein-1(MCP-1)]before and after treatment,and adverse reactions were observed among the three groups.Results There were no statistically significant differences in renal function indicators,renal fibrosis indicators,and inflammatory factor indicators among the three groups before treatment;the total effective rate of treatment in the combined group was significantly higher than that in the control group and the treatment group[96.00%(48/50)vs.76.00%(38/50),84.00%(42/50),both P<0.05];after treatment,the levels of BUN,SCr,24-hour urine protein,HA,PC-Ⅲ,LN,hs-CRP,TNF-α,VCAM-1,and MCP-1 in the combined group were significantly lower than those in the control group and the treatment group[BUN(mmol/L):11.62±3.24 vs.18.56±4.37,15.34±4.24,SCr(μmol/L):152.38±20.61 vs.216.58±23.67,184.62±21.62,24-hour urine protein(mg):142.68±31.52 vs.246.29±46.34,195.64±34.28,HA(g/L):1.43±0.35 vs.2.61±0.32,2.16±0.34,PC-Ⅲ(μg/L):115.37±16.57 vs.135.81±18.65,127.64±17.48,LN(μg/L):125.67±24.19 vs.146.38±23.68,136.62±25.67,hs-CRP(mg/L):4.05±1.25 vs.5.16±1.42,4.62±1.38,TNF-α(ng/L):4.13±1.04 vs.5.06±1.18,4.62±1.08,VCAM-1(μg/L):0.81±0.23 vs.1.13±0.27,0.98±0.24,MCP-1(ng/L):72.19±10.62 vs.94.68±13.58,83.64±12.74,all P<0.05],the levels of Ccr and FN in the combined group were significantly higher than those in the control group and the treatment group[Ccr(mL/min):53.68±8.46 vs.34.34±6.27,41.68±7.25,FN(mg/L):154.69±21.67 vs.132.62±18.61,146.28±20.36,all P<0.05].There was no statistically significant difference in the incidence of adverse reactions among the three groups.Conclusion Haikun Shenxi capsules combined with SGLT2i have a more significant effect in the treatment of ESRD,which can improve renal function,delay renal fibrosis,reduce inflammatory response,and do not increase the incidence of adverse reactions.

Objective:To explore the potential categories of internal ability of elderly patients with ischemic stroke, identify the influencing factors and propose corresponding nursing interventions.Methods:This was a cross-sectional study. From January 2025 to May 2025, the elderly patients with ischemic stroke in Tianjin Huanhu Hospital were selected by convenient sampling method. The general information questionnaire, the Internal Capacity Assessment Scale for the Older People, the Health Literacy Scale for stroke patients and the Perceived Social Support Scale were used to investigate. To determine latent categories of patients' intrinsic capacity, potential profile analysis was employed. Subsequently, multivariable Logistic regression examined factors associated with these categories.Results:A total of 260 survey questionnaires were distributed, and 256 valid questionnaires were finally collected, with an effective response rate of 98.46% (256/260). Among of them, there were 166 males and 90 females, aged 68.00 (63.00, 74.00) years.The intrinsic ability of elderly patients with ischemic stroke could be divided into three potential categories: low sensation-low exercise group (27.0%, 69/256), relatively stable intrinsic ability group (37.5%, 96/256) and low cognition-low psychology group (35.5%, 91/256). Multivariable Logistic regression showed that advanced age (compared to the low sensation-low exercise group, OR=0.902; compared to the relatively stable intrinsic ability group, OR=0.813), smoking (compared to the low sensation-low exercise group, OR=0.459; compared to the relatively stable intrinsic ability group, OR=0.442), the lower the Barthel index (compared to the low sensation-low exercise group, ≤40 points with OR=0.157; 41-60 points with OR=0.285) were more likely to enter the low cognition-low psychology group (all P<0.05); other chronic disease types ≤1 (compared to the low cognition-low psychology group, OR=2.630), higher health literacy scores (compared to the low cognition-low psychology group, OR=1.033) were more likely to enter the relatively stable intrinsic ability group (both P<0.05); and stroke frequency was the first occurrence (compared to the low cognition-low psychology group, OR=2.725) was more likely to enter the low sensation-low exercise group ( P<0.05). Conclusions:In older adults with ischemic stroke, the characteristics of intrinsic ability are clearly categorized. To enhance patient outcomes, healthcare professionals are advised to tailor nursing interventions based on the unique features and specific influencing factors associated with each potential category.

Objective To explore the efficacy and mechanism of Haikun Shenxi capsules combined with sodium-glucose co-transporter 2 inhibitor(SGLT2i)in the treatment of end-stage renal disease(ESRD).Methods A prospective study was conducted,150 ESRD patients admitted to the department of nephrology of the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology from January 2024 to March 2025 were selected as the research subjects.The patients were divided into a control group,a treatment group,and a combined group using a random number table method,with 50 cases in each group.The control group was given compound Salvia Miltiorrhiza injection,the treatment group was given Haikun Shenxi capsules,and the combined group was given Haikun Shenxi capsules combined with an SGLT2i(Canagliflozin).All three groups were treated continuously for 4 weeks.The differences in clinical efficacy,renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr),endogenous creatinine clearance rate(Ccr),24-hour urine protein],renal fibrosis indicators[serum fibronectin(FN),serum hyaluronic acid(HA),serum laminin(LN),plasma typeⅢprocollagen(PC-Ⅲ)],inflammatory factor indicators[hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),vascular cell adhesion molecule-1(VCAM-1),monocyte chemoattractant protein-1(MCP-1)]before and after treatment,and adverse reactions were observed among the three groups.Results There were no statistically significant differences in renal function indicators,renal fibrosis indicators,and inflammatory factor indicators among the three groups before treatment;the total effective rate of treatment in the combined group was significantly higher than that in the control group and the treatment group[96.00%(48/50)vs.76.00%(38/50),84.00%(42/50),both P<0.05];after treatment,the levels of BUN,SCr,24-hour urine protein,HA,PC-Ⅲ,LN,hs-CRP,TNF-α,VCAM-1,and MCP-1 in the combined group were significantly lower than those in the control group and the treatment group[BUN(mmol/L):11.62±3.24 vs.18.56±4.37,15.34±4.24,SCr(μmol/L):152.38±20.61 vs.216.58±23.67,184.62±21.62,24-hour urine protein(mg):142.68±31.52 vs.246.29±46.34,195.64±34.28,HA(g/L):1.43±0.35 vs.2.61±0.32,2.16±0.34,PC-Ⅲ(μg/L):115.37±16.57 vs.135.81±18.65,127.64±17.48,LN(μg/L):125.67±24.19 vs.146.38±23.68,136.62±25.67,hs-CRP(mg/L):4.05±1.25 vs.5.16±1.42,4.62±1.38,TNF-α(ng/L):4.13±1.04 vs.5.06±1.18,4.62±1.08,VCAM-1(μg/L):0.81±0.23 vs.1.13±0.27,0.98±0.24,MCP-1(ng/L):72.19±10.62 vs.94.68±13.58,83.64±12.74,all P<0.05],the levels of Ccr and FN in the combined group were significantly higher than those in the control group and the treatment group[Ccr(mL/min):53.68±8.46 vs.34.34±6.27,41.68±7.25,FN(mg/L):154.69±21.67 vs.132.62±18.61,146.28±20.36,all P<0.05].There was no statistically significant difference in the incidence of adverse reactions among the three groups.Conclusion Haikun Shenxi capsules combined with SGLT2i have a more significant effect in the treatment of ESRD,which can improve renal function,delay renal fibrosis,reduce inflammatory response,and do not increase the incidence of adverse reactions.

BACKGROUND: Immune-related adverse events (irAEs) are commonly occurred in patients treated with immune checkpoint inhibitors. However, evidence of irAEs derived from the Chinese population is relatively lacking. The aim of this study was to investigate the incidence and outcomes of irAEs in Chinese patients with lung cancer after receiving immune checkpoint inhibitors (ICIs). METHODS: Clinical and follow-up data from lung cancer patients who received at least one time of ICIs from January 2018 to September 2021 at Huadong Hospital, Fudan University were included. Statistical descriptions and Kaplan-Meier method were used to analyze the overall incidence of irAEs, as well as the incidence and outcomes of each type of irAEs. RESULTS: 135 patients were included in the study. 106 patients (78.5%) presented at least one type of irAEs, and the median time to first irAEs onset was 28 d. Most irAEs occurred at early time after treatment, and most irAEs were mild-moderate and reversible. 57 patients (42.2%) died at the study cutoff. The mortality rate of severe irAEs was 12.6% (n=17), and among them 7 patients (41.2%) died of pneumonitis. The median progression-free survival (PFS) and overall survival (OS) time of the total population was 505 d (95%CI: 352-658) and 625 d (95%CI: 491-759), respectively. Patients who presented any irAEs achieved a longer PFS than those who did not (median PFS: 533 d vs 179 d, P=0.037, HR=0.57), while patients who presented skin toxicities achieved a longer OS than patients who did not (median OS: 797 d vs 469 d, P=0.006, HR=0.70). CONCLUSIONS In real-world settings, irAEs in lung cancer patients were commonly observed, with pneumonitis as the most common fatal irAEs. In addition, patients who presented any irAEs may tend to achieve a longer PFS.
Humans ; Lung Neoplasms ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Immune Checkpoint Inhibitors/therapeutic use* ; Incidence ; Antineoplastic Agents, Immunological/therapeutic use* ; Drug-Related Side Effects and Adverse Reactions/drug therapy* ; Retrospective Studies

Transcranial direct current stimulation (tDCS) is a well-tolerated, safe and noninvasive physical brain stimulation method, which has been widely used in the treatment of some common mental disorders and neurological diseases and has achieved certain clinical effects. It is necessary to develop expert consensus on clinical treatment to improve the use norms in related fields. According to the clinical research published before August 2021 and the method of evidence-based medicine, we published an expert consensus on tDCS in the treatment of depressive disorders, schizophrenia, substance use-related disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anxiety disorders, post-traumatic stress disorder, sleep disorders, pain, Parkinson′s disease, stroke, and epilepsy. The consensus also introduced the safety and efficacy of the clinical use of tDCS, and standardized the treatment process and operation technology, aiming to provide guidance for the clinical application of tDCS and promote the standardized development of this treatment technology in the future.

Transcranial direct current stimulation (tDCS) is a well-tolerated, safe and noninvasive physical brain stimulation method, which has been widely used in the treatment of some common mental disorders and neurological diseases and has achieved certain clinical effects. It is necessary to develop expert consensus on clinical treatment to improve the use norms in related fields. According to the clinical research published before August 2021 and the method of evidence-based medicine, we published an expert consensus on tDCS in the treatment of depressive disorders, schizophrenia, substance use-related disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, anxiety disorders, post-traumatic stress disorder, sleep disorders, pain, Parkinson′s disease, stroke, and epilepsy. The consensus also introduced the safety and efficacy of the clinical use of tDCS, and standardized the treatment process and operation technology, aiming to provide guidance for the clinical application of tDCS and promote the standardized development of this treatment technology in the future.

Objective:To investigate the value of combined detection of biomarkers in early diagnosis and prognosis of patients with septic myocardial injury.Methods:The clinical data of 103 patients with sepsis admitted to the intensive care unit (ICU) of the First Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology from October 2018 to January 2021 were enrolled. According to the cardiac troponin I (cTnI) at admission of ICU, they were divided into septic myocardial injury group (cTnI ≥ 0.15 μg/L) and non-septic myocardial injury group (cTnI < 0.15 μg/L). The serum levels of heart-type fatty acid-binding protein (H-FABP), procalcitonin (PCT), C-reactive protein (CRP), MB isoenzyme of creatine kinase (CK-MB), cTnI and N-terminal pro-brain natriuretic peptide (NT-proBNP) within 6 hours after ICU admission and the worst value of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score within 24 hours after ICU admission in 103 patients was recorded as well as the 28-day prognosis of patient with septic myocardial injury. Spearman correlation analysis was used to analyze the correlation of each index; receiver operating characteristic curve (ROC curve) was drawn, and the area under ROC curve (AUC) was calculated to analyze the early diagnosis and prognostic value of each index and APACHEⅡ score alone or combined detection in patients with septic myocardial injury.Results:① Among 103 patients with sepsis, 58 patients were complicated with myocardial injury and 45 patients were not complicated with myocardial injury. The serum levels of PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in patients with septic myocardial injury were significantly higher than those in patients without septic myocardial injury [PCT (μg/L): 3.46±1.35 vs. 1.89±0.43, CRP (mg/L): 81.1±26.8 vs. 65.3±19.1, NT-proBNP (U/L): 8 261.4±2 346.9 vs. 6 120.2±1 809.6, CK-MB (U/L): 15.89±6.25 vs. 12.14±4.24, cTnI (μg/L): 1.50 (0.91, 2.21) vs. 0.18 (0.16, 0.19), H-FABP (μg/L): 26.45±8.24 vs. 12.82±5.73, APACHEⅡ score: 24.0 (18.0, 29.0) vs. 16.0 (14.0, 18.0), all P < 0.01]. Spearman correlation analysis showed that PCT, CRP and APACHEⅡ scores were positively correlated with NT-proBNP, CK-MB, cTnI and H-FABP. ROC curve analysis showed that H-FABP in the diagnosis of septic myocardial injury (AUC = 0.916) was superior to NT-proBNP (AUC = 0.756) and CK-MB (AUC = 0.675); the AUC of NT-proBNP and CK-MB combined with H-FABP was 0.921, the sensitivity was 82.1%, and the specificity was 88.2%.② Twenty-three patients survived in 28 days, and 35 died. The levels of serum PCT, CRP, NT-proBNP, CK-MB, cTnI, H-FABP and APACHEⅡ score in death group were significantly higher than those in survival group [PCT (μg/L): 3.86±1.27 vs. 2.84±1.24, CRP (mg/L): 92.3 (65.0, 101.7) vs. 74.3 (65.7, 79.8), NT-proBNP (ng/L): 9 106.4±2 013.9 vs. 6 975.5±2 266.7, CK-MB (U/L): 17.90±6.49 vs. 12.82±4.46, cTnI (μg/L): 2.11±0.86 vs. 1.12±0.44, H-FABP (μg/L): 30.08±7.90 vs. 20.93±5.14, APACHEⅡ score: 25.0 (20.0, 30.0) vs. 19.0 (17.0, 24.0), all P < 0.01]. ROC curve analysis showed that H-FABP in evaluating 28-day death of patients with septic myocardial injury (AUC = 0.839) was superior to PCT (AUC = 0.707), CRP (AUC = 0.716), NT-proBNP (AUC = 0.761), CK-MB (AUC = 0.733), cTnI (AUC = 0.824) and APACHEⅡ score (AUC = 0.724); the AUC of NT-proBNP and cTnI combined with H-FABP was 0.888, the sensitivity was 91.4%, and the specificity was 82.6%. Conclusions:H-FABP plays an important role in the early diagnosis and prognosis of septic myocardial injury. Early combined detection of NT-proBNP, CK-MB and H-FABP can significantly improve the diagnostic ability of septic myocardial injury, and NT-proBNP and cTnI combined with H-FABP can significantly improve the ability to predict the adverse prognosis of sepsis myocardial injury.

Objective:To study the survival outcomes in patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) treated with sorafenib combined with transcatheter arterial chemoembolization (TACE) versus sorafenib alone.Methods:The data of 92 patients with BCLC stage C HCC at Tianjin Medical University Cancer Institute& Hospital from January 2008 to December 2015 were retrospectively studied. There were 82 males and 10 females. The average age was 56.3 years. Classified according to whether there were vascular invasion and/or distant metastasis, patients were divided into the vascular invasion group ( n=24), the metastasis group ( n=48), and the vascular invasion combined with metastasis group ( n=20). All patients were treated with sorafenib, but some patients received combined treatment with TACE. The survival data of these patients on follow-up was collected. The Kaplan-Meier method was used for survival analysis, and the survival rates were compared by the log-rank test. Univariate and multivariate Cox analyses were used to determine the prognostic factors of patients’ survival. Results:There were no significant differences in the baseline clinical data among the three groups (all P>0.05). Multivariate Cox regression analysis showed that pre-treatment alpha fetal protein >20 μg/L ( HR=1.90, 95% CI: 1.13-3.12), alkaline phosphatase >125 U/L ( HR=1.60, 95% CI: 1.03-2.49) and sorafenib alone ( HR=2.11, 95% CI: 1.23-3.54) were independent risk factors of survival for these patients. There were no significant differences in the cumulative survival rates among the three groups ( P>0.05). In the vascular invasion group, the cumulative survival rates of patients treated with combined sorafenib and TACE ( n=4) were significantly higher than those treated with sorafenib alone ( n=20) ( P<0.05). Conclusion:Compared with sorafenib alone, sorafenib combined with TACE resulted in better prognosis for patients with BCLC stage C HCC. Subgroup analysis showed that patients with vascular invasion had significantly better survival treated with combined sorafenib and TACE than sorafenib alone.