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*

{L-End}Objective To analyze the correlation between occupational burnout and sleep quality among steelworkers. {L-End}Methods A total of 11 491 steelworkers from a large steel enterprise in Gansu Province were selected as the research subjects using convenient sampling method. The Burnout Questionnaire and the Pittsburgh Sleep Quality Index Scale were used to investigate their occupational burnout and sleep quality. Hierarchical regression analysis was used to analyze the effects of occupational burnout on the sleep quality. {L-End}Results The detection rate of occupational burnout and sleep disorder were 50.4% and 39.0%, respectively. There was a positive correlation between the level of occupational burnout and the total score of sleep quality (Spearman correlation coefficient=0.454, P<0.05). The results of hierarchical regression analysis, adjusting for confounding factors such as gender, age, marital status, education level, alcohol consumption, exercise, weekly working hours, seniority, work shift, noise exposure, dust exposure, and high-temperature work, showed that the score of occupational burnout was positively related to the score of sleep quality(P<0.01), explaining 16.0% of the variance in the score of sleep quality among these steelworkers. {L-End}Conclusion The detection rate of occupational burnout and sleep disorders are relatively high among the steelworkers in this enterprise. Higher levels of occupational burnout are associated with poorer sleep quality. Alleviating occupational burnout among steelworkers may contribute to improving their sleep quality.

Objective : This study aims to explore the general rules of profile⁃based forehead protrusion value and appearance in Anhui province, and the results will provide guidance for clinical orthodontic works on matching lateral forehead protrusion and the lower third of the face in the future. Methods : A total of 262 patients were included in this cross⁃sectional study. The materials for the study were the lateral cephalometric radiographs and standard 90⁃degree profile photographs taken from the subjects at the same time. The Frankfurt horizontal( FH) plane was used to calibrate the head position parallel to the ground. The samples were grouped according to genders, ages and dentoskeletal classifications. The measurement points of forehead protrusion in profile included hairline point and soft tissue nasion point. The point where the parallel line connecting two points was tangent to the forehead contour was defined as the most convex point. The value of forehead protrusion in profile was expressed by the distance between two parallel lines. The forehead morphology was studied by tracing the forehead on lateral photographs. P-values < 0. 05 were considered statistically significant. Results : The lateral forehead protrusion of female was larger than that of male, and the difference between male and female decreased gradually from children (P < 0. 001), adolescents (P < 0. 001) to adults. The shape of the forehead differed between the two sexes. Female forehead is round, protruding part in the middle, the overall appearance like an arc; Male forehead was more straight, the most convex point was generally located near the eyebrow arch. Conclusion Gender is an important factor influencing profile forehead protrusion and appearance. The difference between male and female forehead protrusion decreases with age. But the shape remains different.

OBJECTIVE：To comprehensi vely evaluate the application progress of network pharmacology methods in TCM compound prescription research ，and to provide reference for modernization of TCM compound prescription research. METHODS ： Taking“network pharmacology ”and“TCM compound prescription ”as keywords ，the literatures were retrieved from CNKI ， Wanfang database and VIP during May 2006 to May 2020. Screening literature ，the databases ，analysis platforms ，and software used of the literature were summarized ；on the basis of quantitative analysis ，the application of network pharmacology in the research of traditional Chinese medicine compound were summarized. RESULTS & CONCLUSIONS ：There were a total of 761 valid literatures ，among which the number of literatures that could be retrieved in 2019 reached 313. In the modernization research of TCM compound prescription ，network pharmacology methods were mainly usedmechanism ，material basis of pharmacodynamics ， compatibility law ，compound optimization ，and“effect-toxic”network. Commonly used databasesand platforms included traditional chinese medicine information database （TCMSP and TCMID ），therapeutic target database （TTD，OMIM），drug targets and target prediction platform （Drugbank，SwissTargetPrediction，TargetNet，PharmMapper），network pharmacology analysis and prediction software and platform （CytoScape），etc. Network pharmacology method was widely used in the field of TCM compound prescription research ，and provided new ideas and methods for the modernization of TCM compound prescription research. In the future，the related research can be combined with the pharmacokinetic parameters ，the efficacy of active compounds and related basic experiments ，use the weighted method to carry out network pharmacology analysis ，and integrate the information of multiple databases to improve the scientificity of research results.

Objective:Serum cytokines and chemokines in patients with fever with thrombocytopenia syndrome (SFTS) and the severity of the disease was studied.Methods:Serum of 47 SFTS patients from 2014 to 2017 in Jinan city was collected. Serum of 11 dead patients and 36 survivors were selected as the survival group and serum of 10 healthy people was selected as the control group. Luminex liquid phase chip was used to detect and analyze the expression levels of 40 cytokines and chemokines in peripheral blood.Results:The expression levels of 27 cytokines and chemokines in the death group were significantly higher than those in the control group ( P<0.05). The expression level of 33 cytokines and chemokines in the death group was significantly higher than that in the survival group ( P<0.05). The expression level of 12 cytokines and chemokines in the survival group was significantly higher than that in the control group ( P<0.05). The expression levels of 10 cytokines and chemokines in the patients were increased in different degrees during the recovery period compared with the acute period ( P<0.05). The expression levels of 5 cytokines and chemokines were lower in the recovery period than in the acute period ( P<0.05). Receiver operating characteristic curve (ROC curve) analysis showed that 22 factors were statistically significant and could be used as biomarkers to predict the severity of the disease. Conclusions:The expression levels of various cytokines and chemokines in serum of SFTS patients changed significantly during the development of the disease and the cytokine storm caused by SFTS may be the cause of death.

Objective To explore efficacy and safety of simulated artificial pancreas in modulating stress hyperglycemia in critically ill patients. Methods A prospective randomized controlled study was performed. Seventy-two critically ill patients with stress hyperglycemia, aged 18-85 years, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score over 15, two consecutive random blood glucose 11.1 mmol/L or higher, glycated hemoglobin (HbA1C) below 0.065, unable to eat food for 3 days after inclusion, or only accepting parenteral nutrition, admitted to intensive care unit (ICU) in Shanghai Punan Hospital of Pudong New District from January 1st, 2015 to June 30th, 2017 were enrolled. The patients were divided into three groups according to the random number table method, high-intensity group and low-intensity group were injected Novolin R (high-intensity group 2/3 dosage, low-intensity group 1/3 dosage) to modulate stress hyperglycemia by simulated artificial pancreas. Simulated artificial pancreas consisted of Guardian real time glucose monitoring system (GRT system), close-circle control algorithm and micro-pump;subcutaneous injection of Humulin 70/30 was applied to modulate stress hyperglycemia in humulin group. Real-time glucose levels of interstitial fluid in abdominal wall, equivalent to blood glucose levels, 10 minutes each time, were monitored by using of GRT system for all patients in three groups. Fasting serum levels of stress hormones including epinephrine and cortisol and insulin resistance index (IRI) were recorded within 24 hours after inclusion. Mean blood glucose, blood glucose variation coefficient, blood glucose target-reaching rate, blood glucose target-reaching time, hypoglycemia rate and 6-month mortality were measured. Twenty healthy adults from health administration department of the hospital were recruited as healthy control group. Results A total of 60 eligible critically ill patients were included in this study, each group with 20 patients. There was no significant difference in gender, age, APACHE Ⅱ scores among three groups. The levels of serum epinephrine, cortisol and IRI within 24 hours after inclusion in the three groups were significantly higher than those in healthy control group. The mean blood glucose levels of humulin group, low-intensity group, high-intensity group were decreased (mmol/L: 10.2±3.2, 8.4±2.6, 8.1±2.2), the blood glucose target-reaching rate were increased [40.2% (3 295/8 196), 71.1% (5 393/7 585), 80.4% (6 286/7 818)], the blood glucose target-reaching time were shortened (hours: 49.1±5.8, 24.6±4.6, 17.5±4.2), the hypoglycemia rates were increased respectively [1.3% (108/8 196), 2.8% (211/7 585), 4.0% (313/7 818)], with statistically significant differences (all 1 = 0.000). There was no significant difference in blood glucose variation coefficient and 6-month mortality among three groups [blood glucose variation coefficient: (29.4±3.7)%, (28.5±5.3)%, (26.1±4.6)%, 6-month mortality: 55.0%, 45.0%, 40.0%, all 1 > 0.05]. Conclusions Simulated artificial pancreas could effectively and safely modulate stress hyperglycemia in critically ill patients, high-intensity modulation could bring about better efficacy in the regulation of hyperglycemia. High-frequency blood glucose monitoring by using GRT system could promptly identify hypoglycemia and help it to be corrected.

Objective To compare the short- and long- term effects and safety of endoscopic balloon dilatation vs. placement of specially designed reclaimable self-expanding anti-reflux esophageal stents for achalasia. Methods A total of 129 patients with achalasia were divided into 2 groups to receive either endoscopic scopic balloon dilatation(,l=63)or endoscopic placement of specially designed reclaimable self-expandinganti-reflux esophageal stents (n = 66). The dysphagia symptom scores were recorded before and 1-month,6-month and 12-month after the procedure, respectively. The change in width of esophagus, procedure related complications, length and costs of hospitalization were also analyzed. Results Dysphagia symptom score was significantly decreased after the treatment in both groups (P < 0.05). The effective rates evaluated at 1-month, 6-month and 12-month after the procedure in balloon dilatation group were 100. 0% , 96. 7% and 91.5% , respectively, which in stenting group were 100.0% , 98. 0% and 97.1% , respectively. There was no significant difference in changes of symptom score at 1-month and 6-month after treatment between the 2 groups (P > 0.05) , while at 12-month after treatment, the decrease of symptom score in stenting group was significantly higher than that in balloon dilatation group (P<0. 05). After the treatment, the significant widening of the stricture and narrowing of the dilated esophagus were achieve in both groups (P < 0.05),while no significant difference between these 2 groups was observed in changes of width (P > 0. 05). Procedure related complications in balloon dilatation group included esophageal perforation (n =1) and upper gastrointestinal bleeding (n=4) , which was not occurred in stenting group, but complications included hyperplasia of granulation tissue (n = 1), stent dislocation (n =2) and defulvium (n = 1) was observed inthe latter group. The length of hospitalization was similar in 2 groups (P > 0. 05) , and the cost of hospitalization in stenting group was significantly higher than that of balloon dilatation group (P < 0. 05). Conclusion Compared with endoscopic balloon dilatation, the specially designed reclaimable self-expanding antireflux stents is a more ideal method for achalasia, with similar short-term effect, but better long-term effect and safety.

Objective:To evaluate the potential mutagenicity of Echinacea Herb P.E via salmonella typhimurium Ames test. Methods:To test the Echinacea Herb P.E diffusion through Ames test. In the plate incorporation test of Salmonella Typhimurium,the average number of spontaneous revertants of TA97,TA98,TAl00,and TA102 at four concentrations was calculated after incubation at 37 ℃ for 48 hours. Results:Whether added S 9 or not,the number of induced revertants when compared to that of spontaneous revertants did not increase statistically significant. The result of Ames test was negative. Conclusion:Echinacea Herb P.E will not cause the increase of the back mutation in murine typhoid salmonella which shows that Echinacea Herb P.E will not cause gene mutation.

OBJECTIVETo study the changes in activity of phosphatidylinositol 4 kinase (PI 4 kinase), phosphatidylinositol 4 phosphate 5 kinase (PIP 5 kinase) and protein kinase C (PKC) during myocardial ischemia and elucidate the relationship between phosphatidylinositol signal pathways and prolonged myocardial ischemia.

METHODSIn vivo an ischemic rat model was used. Activity of PI 4 kinase, PIP 5 kinase and PKC were measured at different times in postischemic heart cells using isotope analysis.

RESULTSThe activity of PI kinase, PIP kinase and PKC in the myocardium increased to peak at 1 hour postischemia, with activities 6.1, 3.0 and 4.0 fold over control levels, respectively. Their activities declined to normal levels with time.

CONCLUSIONThe phosphatidylinositol signal pathway is involved in prolonged myocardial ischemia, but its mechanism needs further study.

1-Phosphatidylinositol 4-Kinase ; metabolism ; Animals ; Male ; Myocardial Ischemia ; enzymology ; Phosphotransferases (Alcohol Group Acceptor) ; metabolism ; Protein Kinase C ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Signal Transduction

Objective:To clone human anti MMP 2 antibodies from semisynthetic phage antibody library.Methods:Panning of semisynthetic phage antibody library against recombinant human MMP 2 was conducted to select specific antibodies.The antigen binding characterastics were analyzed by ELISAs.Results:MMP 2 binding phage antibody clones were obtanied after four rounds of panning,but they all showed binding activity to unrelated ags tested.One clone,AD20,was chosen for further analysis by competitive ELISA.It was found that the binding of AD20 to MMP 2 could be inhibited only by free MMP 2 but not unrelated Ags,while the binding to other Ags could not be inhibited by Ags tested,including MMP 2.Neutralization test demonstrated that AD20 could neutralize the enzymatic activity of MMP 2.Conclusion:A neutralizing human antibody against MMP 2 was obtained from a semisynthetic phage antibody library,which shows bindings with unrelated Ags nonspecifically that may be caused by different binding modes,a phenomenon termed polyreactivity.