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*

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective:To explore the clinical distribution characteristics and changes of common inhalant allergens and food allergens in all outpatient and inpatient children visiting Shanghai Children′s Hospital from 2020 to 2024, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases in children.Methods:A retrospective cohort study was conducted to retrospectively enroll all outpatient and inpatient children who visited Shanghai Children′s Hospital and underwent serum allergen-specific IgE (sIgE) antibody testing from January 2020 to August 2024, and the characteristics and changing trends of allergens in the past 5 years were analyzed. A total of 127 310 tests were included. There were 76 776 male tests (60.31%) and 50 534 female tests (39.69%). There were 27 392 tests (21.52%) aged 0-3 years (infant group), 51 596 tests (40.53%) aged 4-6 years (preschool group), 44 574 tests (35.01%) aged 7-12 years (school-age group), and 3 748 tests (2.94%) aged 13-18 years (adolescent group). The χ2 test was used for statistical analysis. Results:The difference in total positivity rate between different years was statistically significant ( χ2=2 907.478, P<0.001). The positive rates of inhalant allergens such as house dust, Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cockroach, cat dander, mugwort, Humulus scandens, mold fungi mix, and food allergens such as beef and mutton increased significantly with age (The χ2 values were 649.496, 3 414.686, 303.247, 1 277.408, 40.477, 189.952, 600.737, 203.198, and 15.301, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, <0.001,<0.001,<0.001, and 0.002, respectively). The positive rates of inhalant allergen such as Ambrosia elatior (1.59%) and food allergens such as egg white (17.36%), milk (30.48%), shrimp (8.27%), crab (8.13%), codfish (2.61%), salmon (0.66%), mytilus edulis (2.89%), lobster/scallop (5.27%), cashew nuts (5.09%), peanuts (3.54%), and soybean (1.73%) were highest at the age of 0-3 years and decreased significantly with age (The χ2 values were 10.365, 2 407.443, 139.085, 872.548, 870.245, 106.823, 47.674, 47.244, 559.422, 369.800, 384.788, 153.660, respectively, and the P values were 0.016, 0.000,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001, respectively). Inhaled allergens mainly have a greater impact on children with respiratory-related diseases such as allergic rhinitis and asthma, while food allergens mainly have a greater impact on children with atopic dermatitis/eczema. The positive rate of sIgE of various allergens in the allergic rhinitis combined asthma group were higher than that of allergic rhinitis alone, and the sIgE positive rate of total allergens and inhaled allergens was significantly higher than that of allergic rhinitis alone ( χ2=20.851, 39.155, the P values were both<0.001). Among them, the sIgE positive rate of Ambrosia elatior and cashew nuts showed significant difference ( χ2=5.044, 8.420, P=0.025, 0.004); and the sIgE positive rate of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, grass pollens mix and mold fungi mix had extremely significant difference ( χ2=26.409, 25.990, 21.283, 16.411, the P values were all <0.001). The inhaled allergens and food allergens with the highest positive rates in the 5 years were Dermatophagoides pteronyssinus/ Dermatophagoides farinae (56.21%) and milk (47.47%), and as time went by, the positive rates gradually decreased. There is a moderate correlation between the three allergens of Ambrosia elatior, Amaranthus retroflexus, and tree pollens mix (0.55, 0.70, 0.63), and there is a moderate correlation between mango and tree pollens mix (0.50). Conclusion:Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, dog dander, egg white, and milk may be important allergens for children in Shanghai City from 2020 to 2024. The positive rates vary among different genders, age groups, and disease groups, but the positive rates of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, milk and cat dander allergens remain in the top three.

Background and Aims:Chronic skin ulcers are a significant disease affecting patients'daily lives and psychological well-being.Abnormalities in the cells and extracellular matrix within the tissue may disrupt the balance of the microenvironment,hindering the normal skin repair process and leading to delayed healing of the ulcer.There is currently a lack of research on the mechanisms underlying the development of chronic ulcers and their diagnostic biomarkers.Single-cell sequencing,a newly developed high-throughput sequencing method in recent years,uses gene sequencing at the single-cell resolution to precisely reveal disease mechanisms and has been applied in various diseases.This study used single-cell transcriptome sequencing(scRNA-Seq)to investigate the cellular heterogeneity in chronic skin ulcer tissue to elucidate the potential molecular mechanisms behind delayed healing and provide new insights for clinical treatment.Methods:The scRNA-Seq technology was used to compare the differences in cell subpopulations and gene expression between chronic ulcer tissue and normal skin tissue.Single cells were sorted using a microfluidic platform,and cDNA libraries were constructed for subsequent differential gene analysis and functional enrichment analysis.Results:scRNA-Seq analysis revealed significant immune-metabolic remodeling features in chronic ulcer tissue:the number of B cells,monocytes,and macrophages in ulcer tissue increased by 2.1 to 3.5 times compared to the normal tissue control.This was accompanied by widespread activation of collagen synthesis genes(COL1A1/COL3A1)and synergistic suppression of immune regulators(e.g.,granzyme family GZMA/GZMB/H).Cross-cell subpopulation functional network analysis showed that hypoxia response mediated by the HIF-1 signaling pathway and PI3K/Akt pathway abnormalities formed a positive feedback loop,exacerbating the imbalance in the secretion of inflammatory factors(CXCL3/8,TGFBI)and compensatory upregulation of mitochondrial oxidative phosphorylation.Conclusion:Chronic skin ulcers exhibit significant differences in cellular heterogeneity and gene expression,suggesting that chronic ulcers are not simply tissue defects but a complex pathological process dominated by chronic inflammation and immune dysregulation.The coordinated dysregulation of multiple cell subpopulations in the ulcer microenvironment,along with persistent inflammatory responses and metabolic abnormalities,is interconnected through the HIF-1/TNF/MAPK pathway network.Downregulation of granzyme gene family members and abnormal histone modifications may contribute to immune clearance defects,providing a theoretical basis for developing novel therapies targeting epigenetic regulation or mitochondrial function.

Objective To explore the optimization and effect analysis method of rational drug use pre-prescription review rule base for traditional Chinese medicine(TCM).Methods The rules for the modules including indications,dosage range,incompatibility,administration route and repeated drug use of TCM decoction pieces and Chinese patent medicine were set to improve pre-prescription review rule base.The prescription rationality rate and intervention effectiveness rate to evaluate effect by χ2 test before and after the system optimization.Results After the optimization of pre-prescription review rule base for TCM,the rate of prescription rationality of the hospital increased from approximately 78.19%to 94.50%,and the rate of intervention effectiveness increased from approximately 82.80%to 97.15%.There were statistically significant differences in prescription rationality and intervention effectiveness rate between pre-and post-optimization groups(P＜0.05).Conclusion According to the current pre-prescription status of the hospital,optimizing pre-prescription review rules of TCM can improve the applicability of the review system for TCM prescriptions,and enhance the pre-prescription accuracy and the level of rational medication.However,rules optimization on other modules still needs to be further improved.

Background and Aims:Chronic skin ulcers are a significant disease affecting patients'daily lives and psychological well-being.Abnormalities in the cells and extracellular matrix within the tissue may disrupt the balance of the microenvironment,hindering the normal skin repair process and leading to delayed healing of the ulcer.There is currently a lack of research on the mechanisms underlying the development of chronic ulcers and their diagnostic biomarkers.Single-cell sequencing,a newly developed high-throughput sequencing method in recent years,uses gene sequencing at the single-cell resolution to precisely reveal disease mechanisms and has been applied in various diseases.This study used single-cell transcriptome sequencing(scRNA-Seq)to investigate the cellular heterogeneity in chronic skin ulcer tissue to elucidate the potential molecular mechanisms behind delayed healing and provide new insights for clinical treatment.Methods:The scRNA-Seq technology was used to compare the differences in cell subpopulations and gene expression between chronic ulcer tissue and normal skin tissue.Single cells were sorted using a microfluidic platform,and cDNA libraries were constructed for subsequent differential gene analysis and functional enrichment analysis.Results:scRNA-Seq analysis revealed significant immune-metabolic remodeling features in chronic ulcer tissue:the number of B cells,monocytes,and macrophages in ulcer tissue increased by 2.1 to 3.5 times compared to the normal tissue control.This was accompanied by widespread activation of collagen synthesis genes(COL1A1/COL3A1)and synergistic suppression of immune regulators(e.g.,granzyme family GZMA/GZMB/H).Cross-cell subpopulation functional network analysis showed that hypoxia response mediated by the HIF-1 signaling pathway and PI3K/Akt pathway abnormalities formed a positive feedback loop,exacerbating the imbalance in the secretion of inflammatory factors(CXCL3/8,TGFBI)and compensatory upregulation of mitochondrial oxidative phosphorylation.Conclusion:Chronic skin ulcers exhibit significant differences in cellular heterogeneity and gene expression,suggesting that chronic ulcers are not simply tissue defects but a complex pathological process dominated by chronic inflammation and immune dysregulation.The coordinated dysregulation of multiple cell subpopulations in the ulcer microenvironment,along with persistent inflammatory responses and metabolic abnormalities,is interconnected through the HIF-1/TNF/MAPK pathway network.Downregulation of granzyme gene family members and abnormal histone modifications may contribute to immune clearance defects,providing a theoretical basis for developing novel therapies targeting epigenetic regulation or mitochondrial function.

Objective:To explore the clinical distribution characteristics and changes of common inhalant allergens and food allergens in all outpatient and inpatient children visiting Shanghai Children′s Hospital from 2020 to 2024, and to provide a basis for the diagnosis, treatment and prevention of allergic diseases in children.Methods:A retrospective cohort study was conducted to retrospectively enroll all outpatient and inpatient children who visited Shanghai Children′s Hospital and underwent serum allergen-specific IgE (sIgE) antibody testing from January 2020 to August 2024, and the characteristics and changing trends of allergens in the past 5 years were analyzed. A total of 127 310 tests were included. There were 76 776 male tests (60.31%) and 50 534 female tests (39.69%). There were 27 392 tests (21.52%) aged 0-3 years (infant group), 51 596 tests (40.53%) aged 4-6 years (preschool group), 44 574 tests (35.01%) aged 7-12 years (school-age group), and 3 748 tests (2.94%) aged 13-18 years (adolescent group). The χ2 test was used for statistical analysis. Results:The difference in total positivity rate between different years was statistically significant ( χ2=2 907.478, P<0.001). The positive rates of inhalant allergens such as house dust, Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cockroach, cat dander, mugwort, Humulus scandens, mold fungi mix, and food allergens such as beef and mutton increased significantly with age (The χ2 values were 649.496, 3 414.686, 303.247, 1 277.408, 40.477, 189.952, 600.737, 203.198, and 15.301, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, <0.001,<0.001,<0.001, and 0.002, respectively). The positive rates of inhalant allergen such as Ambrosia elatior (1.59%) and food allergens such as egg white (17.36%), milk (30.48%), shrimp (8.27%), crab (8.13%), codfish (2.61%), salmon (0.66%), mytilus edulis (2.89%), lobster/scallop (5.27%), cashew nuts (5.09%), peanuts (3.54%), and soybean (1.73%) were highest at the age of 0-3 years and decreased significantly with age (The χ2 values were 10.365, 2 407.443, 139.085, 872.548, 870.245, 106.823, 47.674, 47.244, 559.422, 369.800, 384.788, 153.660, respectively, and the P values were 0.016, 0.000,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001,<0.001, respectively). Inhaled allergens mainly have a greater impact on children with respiratory-related diseases such as allergic rhinitis and asthma, while food allergens mainly have a greater impact on children with atopic dermatitis/eczema. The positive rate of sIgE of various allergens in the allergic rhinitis combined asthma group were higher than that of allergic rhinitis alone, and the sIgE positive rate of total allergens and inhaled allergens was significantly higher than that of allergic rhinitis alone ( χ2=20.851, 39.155, the P values were both<0.001). Among them, the sIgE positive rate of Ambrosia elatior and cashew nuts showed significant difference ( χ2=5.044, 8.420, P=0.025, 0.004); and the sIgE positive rate of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, grass pollens mix and mold fungi mix had extremely significant difference ( χ2=26.409, 25.990, 21.283, 16.411, the P values were all <0.001). The inhaled allergens and food allergens with the highest positive rates in the 5 years were Dermatophagoides pteronyssinus/ Dermatophagoides farinae (56.21%) and milk (47.47%), and as time went by, the positive rates gradually decreased. There is a moderate correlation between the three allergens of Ambrosia elatior, Amaranthus retroflexus, and tree pollens mix (0.55, 0.70, 0.63), and there is a moderate correlation between mango and tree pollens mix (0.50). Conclusion:Dermatophagoides pteronyssinus/ Dermatophagoides farinae, cat dander, dog dander, egg white, and milk may be important allergens for children in Shanghai City from 2020 to 2024. The positive rates vary among different genders, age groups, and disease groups, but the positive rates of Dermatophagoides pteronyssinus/ Dermatophagoides farinae, milk and cat dander allergens remain in the top three.

Objective To explore the optimization and effect analysis method of rational drug use pre-prescription review rule base for traditional Chinese medicine(TCM).Methods The rules for the modules including indications,dosage range,incompatibility,administration route and repeated drug use of TCM decoction pieces and Chinese patent medicine were set to improve pre-prescription review rule base.The prescription rationality rate and intervention effectiveness rate to evaluate effect by χ2 test before and after the system optimization.Results After the optimization of pre-prescription review rule base for TCM,the rate of prescription rationality of the hospital increased from approximately 78.19%to 94.50%,and the rate of intervention effectiveness increased from approximately 82.80%to 97.15%.There were statistically significant differences in prescription rationality and intervention effectiveness rate between pre-and post-optimization groups(P＜0.05).Conclusion According to the current pre-prescription status of the hospital,optimizing pre-prescription review rules of TCM can improve the applicability of the review system for TCM prescriptions,and enhance the pre-prescription accuracy and the level of rational medication.However,rules optimization on other modules still needs to be further improved.

Objective:To establish and validate a fluorescence PCR with internal positive control for rapid Mycoplasma detection. Methods:A fluorescence PCR with internal positive control for Mycoplasma detection was developed and verified for its specificity, limit of detection, and robustness. A sample of fever with thrombocytopenia syndrome (SFTSV) virus strains was tested with this method, and the result was compared with those of culture method and indicator cell culture method. Results:The established fluorescence PCR had good specificity and could amplify 11 kinds of plasmids containing Mycoplasma 16S rRNA gene with high efficiency. There was no cross reaction with the genomic DNAs of Clostridium sporogenes, Clostridium acetobutylicum, Lactobacillus acidophilus, Streptococcus pneumoniae, Bacillus subtilis, Staphylococcus aureus, Salmonella enteritidis, Escherichia coli, Pseudomonas aeruginosa, Aspergillus niger, Candida albicans, Vero cells, RD cells, and SF9 cells. The amplification efficiency of the internal positive control was basically consistent with that of the target gene of Mycoplasma, suggesting that the internal positive control could be used to detect the presence of PCR inhibitors. The sensitivity of the established method was high, and the detection limit was 10 colony-forming unit (CFU)/ml for Mycoplasma fermentans, 5 CFU/ml for Mycoplasma arginine, 5 CFU/ml for Mycoplasma gallisepticum, 5 CFU/ml for Mycoplasma hyorhinis, 5 CFU/ml for Acholeplasma laidlawii, 5 CFU/ml for Mycoplasma orale, 5 CFU/ml for Mycoplasma pneumoniae, 5 CFU/ml for Mycoplasma synoviae, and 1 CFU/ml for Spiroplasma citri by 7500 Fast real-time PCR system. At the detection limit of each species, there was no significant difference in the positive detection rate using different thermal cycler types. The established fluorescence PCR, culture method, and indicator cell culture were performed to detect Mycoplasma in the sample of SFTSV virus strains, and the results all showed Mycoplasma contamination. Conclusions:The established fluorescence PCR has high specificity, sensitivity, and robustness, and can be used as an alternative method for rapid detection of Mycoplasma.

Tardive dyskinesia (TD) is a medication-induced hyperkinetic movement disorder, generally manifested as involuntary spasms or choreiform movements of the tongue, lower face and jaw, and limbs (lasting at least several weeks). It occurs after using neuroleptic medication for at least several months, causing irreversible injuries to the nerve system and significantly impacting patients′ daily function. This review summarizes recent research progress regarding TD risk factors, possible pathogenesis, clinical characteristics, assessment and identification, and treatment and management approaches. The goal is to raise awareness of TD to archive early prevention and identification, standardize treatment, and improve patients′ prognosis and quality of life.