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*

The gradient field, one of the core magnetic fields in magnetic resonance imaging (MRI) systems, is generated by gradient coils and plays a critical role in spatial encoding and the generation of echo signals. The uniformity or linearity of the gradient field directly impacts the quality and distortion level of MRI images. However, traditional point measurement methods lack accuracy in assessing the linearity of gradient fields, making it difficult to provide effective parameters for image distortion correction. This paper introduced a spherical measurement-based method that involved measuring the magnetic field distribution on a sphere, followed by detailed magnetic field calculations and linearity analysis. This study, applied to assess the nonlinearity of asymmetric head gradient coils, demonstrated more comprehensive and precise results compared to point measurement methods. This advancement not only strengthens the scientific basis for the design of gradient coils but also provides more reliable parameters and methods for the accurate correction of MRI image distortions.
Magnetic Resonance Imaging/instrumentation* ; Humans ; Image Processing, Computer-Assisted/methods* ; Nonlinear Dynamics ; Magnetic Fields ; Algorithms ; Phantoms, Imaging

Objective Based on the radiomics features extracted from the unenhanced CT images of the lower abdomen, a variety of machine learning models were constructed to explore their application value in the assessment of split renal function. Methods A retrospective analysis was conducted on the unenhanced CT images from 240 single kidneys in patients with clinically suspected renal dysfunction. Based on the results of single-photon emission computed tomography renal dynamic imaging, the cases were classified into the normal glomerular filtration rate group (n=118) and the decreased glomerular filtration rate group (n=122). The region of interest was outlined on the unenhanced CT images and the radiomics features were extracted. The features were selected by correlation analysis and least absolute shrinkage and selection operator, and the machine learning models were constructed based on the algorithms of decision tree, support vector machine, random forest, logistic regression, and extreme gradient boosting. Area under the receiver operating characteristic curve, accuracy, sensitivity, and specificity were calculated to compare the performance of different models. Results Sixteen radiomics features were selected for constructing the machine learning models. The support vector machine model showed relatively high performance for the assessment of split renal function on the test set, with an area under the receiver operating characteristic curve value of 0.883 (95% confidence interval: 0.804-0.961), an accuracy of 0.778, a sensitivity of 0.811, and a specificity of 0.743. Conclusion The machine learning models constructed based on unenhanced CT radiomics can be used to preliminarily assess split renal function, which provides an innovative, convenient, and safe method for clinical diagnosis and has positive significance for treatment.

[Objective] To investigate and summarize the clinicopathological features, diagnosis, treatment and prognosis of adrenocortical carcinoma with rhabdoid features. [Methods] The clinical diagnosis and treatment of a case of adrenocortical carcinoma with rhabdoid features admitled to Department of Urology, Weifang People's Hospital were reported.The clinical manifestations, pathological features, diagnosis and prognosis of the disease were analyzed in combination with relevant literature. [Results] A 34-year-old male patient was admitted due to scrotal distension and pain that had persisted for 6 months.Imaging examination showed a huge soft tissue tumor in the left adrenal region of the retroperitoneum with compression displacement of the left kidney, leading to obstruction of venous return in the left spermatic vein, which in turn caused varicose veins.The levels of serum renin, angiotensin, aldosterone, cortisol, and catecholamine were within normal ranges.Surgical resection of the tumor was performed, and postoperative pathological examination revealed that the tumor tissue was predominantly composed of rhabdoid cells, exhibiting positive immunohistochemical staining for INI 1, Syn, Calretinin and Vimentin.Genetic testing did not identify any deletion of SMARCB1 and SMARCA4 mutations.Therefore, the diagnosis was adrenocortical carcinoma with rhabdoid features.At the current 20-month follow-up, no recurrence or metastasis was observed.A review of the literature found that only 7 cases of this disease had been reported. [Conclusion] Adrenocortical carcinoma with rhabdoid features is a rare disease, and a definitive diagnosis is dependent upon pathological examination.Surgical resection remains the primary treatment.Long-term follow-up is essential, and further research is needed to evaluate the impact of adjuvant therapy.

Purpose To explore the value of 18F-FDG PET/CT for assessing the therapeutic effect of RANKL monoclonal antibody for vertebral giant cell tumors.Materials and Methods PET/CT data of 11 patients with vertebral giant cell tumors treated with RANKL monoclonal antibody in Peking University Third Hospital from October 2020 to September 2021 were retrospectively collected.Imaging characteristics such as the number,location and type of bone destruction were analyzed,the maximum standardized uptake value(SUVmax)and the longest diameter of the lesions were measured.The objective tumor response was evaluated based on the modified European organization for research and treatment of cancer(EORTC)criteria,response evaluation criteria in solid tumors(RECIST)1.1 and inverse Choi density/size(ICDS)criteria.Results The skeletal lesions of 11 patients were all single,with lytic destruction and incomplete bone cortex,and marginal bone sclerosis was observed after treatment.The lesions had a baseline SUVmax of 12.12±3.64 and a post-treatment SUVmax of 4.39±2.10,with a%ΔSUVmax ranging from 31.81%to 80.52%.Based on the modified EORTC criteria,two cases had complete response and nine cases showed partial response.The median longest diameter was 46.21(33.84,85.93)mm at baseline and 42.25(32.44,79.29)mm after medication,with a decrease ranging from 0.71%to 22.90%.Based on the modified RECIST 1.1 criteria,11 cases showed stable disease.Based on ICDS criteria,two cases had partial response and nine cases had stable disease.Conclusion PET/CT can be used to assess the efficacy of RANKL monoclonal antibody therapy for vertebral giant cell tumors,with a high objective response based on the modified EORTC criteria.

Purpose To explore the value of 18F-FDG PET/CT for assessing the therapeutic effect of RANKL monoclonal antibody for vertebral giant cell tumors.Materials and Methods PET/CT data of 11 patients with vertebral giant cell tumors treated with RANKL monoclonal antibody in Peking University Third Hospital from October 2020 to September 2021 were retrospectively collected.Imaging characteristics such as the number,location and type of bone destruction were analyzed,the maximum standardized uptake value(SUVmax)and the longest diameter of the lesions were measured.The objective tumor response was evaluated based on the modified European organization for research and treatment of cancer(EORTC)criteria,response evaluation criteria in solid tumors(RECIST)1.1 and inverse Choi density/size(ICDS)criteria.Results The skeletal lesions of 11 patients were all single,with lytic destruction and incomplete bone cortex,and marginal bone sclerosis was observed after treatment.The lesions had a baseline SUVmax of 12.12±3.64 and a post-treatment SUVmax of 4.39±2.10,with a%ΔSUVmax ranging from 31.81%to 80.52%.Based on the modified EORTC criteria,two cases had complete response and nine cases showed partial response.The median longest diameter was 46.21(33.84,85.93)mm at baseline and 42.25(32.44,79.29)mm after medication,with a decrease ranging from 0.71%to 22.90%.Based on the modified RECIST 1.1 criteria,11 cases showed stable disease.Based on ICDS criteria,two cases had partial response and nine cases had stable disease.Conclusion PET/CT can be used to assess the efficacy of RANKL monoclonal antibody therapy for vertebral giant cell tumors,with a high objective response based on the modified EORTC criteria.

Diabetic peripheral neuropathy(DPN)is a common and devastating complication of diabetes,for which effective therapies are currently lacking.Disturbed energy status plays a crucial role in DPN pathogenesis.However,the integrated profile of energy metabolism,especially the central carbohy-drate metabolism,remains unclear in DPN.Here,we developed a metabolomics approach by targeting 56 metabolites using high-performance ion chromatography-tandem mass spectrometry(HPIC-MS/MS)to illustrate the integrative characteristics of central carbohydrate metabolism in patients with DPN and streptozotocin-induced DPN rats.Furthermore,JinMaiTong(JMT),a traditional Chinese medicine(TCM)formula,was found to be effective for DPN,improving the peripheral neurological function and alleviating the neuropathology of DPN rats even after demyelination and axonal degeneration.JMT ameliorated DPN by regulating the aberrant energy balance and mitochondrial functions,including excessive glycolysis restoration,tricarboxylic acid cycle improvement,and increased adenosine triphosphate(ATP)generation.Bioenergetic profile was aberrant in cultured rat Schwann cells under high-glucose conditions,which was remarkably corrected by JMT treatment.In-vivo and in-vitro studies revealed that these effects of JMT were mainly attributed to the activation of adenosine monophosphate(AMP)-activated protein kinase(AMPK)and downstream peroxisome proliferator-activated receptor gamma coactivator 1-alpha(PGC-1α).Our results expand the thera-peutic framework for DPN and suggest the integrative modulation of energy metabolism using TCMs,such as JMT,as an effective strategy for its treatment.

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.