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 examine the relationship between self-management behaviors and time perspective among patients with comorbid diabetes, so as to provide the evidence for improving self-management behaviors among patients with comorbid diabetes. Methods: The patients with comorbid diabetes who were registered in the chronic disease health management system of Minhang District, Shanghai Municipality in 2021, followed up regularly, and lived in Meilong Town were recruited. Demographic information and family history of diabetes were collected through questionnaire surveys. Time perspective and self-management behaviors were assessed using the Zimbardo Time Perspective Inventory and Diabetes Self-Management Behavior Scale, respectively. The relationship between self-management behaviors and time perspective was analyzed using a multivariable ordinal logistic regression model. Results: A total of 907 patients with comorbid diabetes were enrolled, including 472 males (52.04%) and 435 females (47.96%). There were 652 cases aged 65 years and above, accounting for 71.89%. In terms of the types of time perspective, 280 patients were future-oriented (30.87%), 236 were balanced (26.02%), 162 were sensation-seeking (17.86%), 123 were fatalistic (13.56%), and 106 were negative (11.69%). In terms of the self-management behaviors, 46 patients were good (5.07%), 643 were moderate (70.89%), and 218 were poor (24.04%). Multivariable ordinal logistic regression analysis showed that after adjusting for age, gender, educational level, marital status, occupation status, monthly income, and family history of diabetes, the patients with comorbid diabetes who had a future-oriented time perspective had better self-management behaviors (OR=1.874, 95%CI: 1.204-2.915). Conclusion The self-management behaviors among patients with comorbid diabetes are moderate to poor, and patients with a future-oriented time perspective can better engage in self-management behaviors.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

OBJECTIVE To analyze the clinical characteristics and the correlation between laboratory indicators and prognosis of severe Mycoplasma pneumoniae pneumonia(SMPP)in children.METHODS A total of 85 children with SMPP admitted to Anhui Provincial Children's Hospital from Nov.2021 to May 2024 were selected as the study subjects.Based on clinical typing at admission,they were divided into a high-risk group(n=59)and a low-risk group(n=26).The clinical manifestations,laboratory indicators and outcomes at 28 days of treatment were compared between the two groups.RESULTS The duration of fever and cough before admission in the high-risk group was(7.17±1.09)days and(6.79±1.25)days,respectively,which was longer than that in the low-risk group(P＜0.05).There were no statistically significant differences in pulmonary auscultation(wheezing rales,moist rales)and extrapulmonary complications between the two groups.The levels of C-reactive protein(CRP),serum amyloid A(SAA),platelets(PLT),fibrinogen(FIB),D-dimer(DD)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the high-risk group were(11.62±1.45)mg/L,(226.88±36.83)mg/L,(3 18.57±39.82)×109/L,(4.28±0.74)g/L,(0.81±0.12)μg/ml and(2 295.48±413.75)pg/ml,respectively,all of which were higher than those in the low-risk group(P＜0.05).Within 28 days after treatment of children in both groups,one patient in the high-risk group died.CONCLUSIONS Compared with children with SMPP in the low-risk group,those in the high-risk group have a higher risk of prognostic mor-tality,suggesting a correlation between the children's blood CRP,SAA,PLT,FIB,DD and NT-proBNP levels and the prognosis of children with SMPP.

Objective:To evaluate the epidemiological protective effect of a booster dose of acellular DTP vaccine (DTaP) against pertussis in 6-year-old children.Methods:A retrospective cohort study was conducted to compare the incidence of pertussis in 6-year-old children who received DTaP versus DT vaccine boosters in 2023 over a two-year period from May 2023 to May 2025. The protective effect of the fifth dose of DTaP against pertussis in 6-year-old children was evaluated.Results:A total of 960 participants were enrolled in this study, including 480 children in the experimental group who received the fifth dose of DTaP vaccine and 480 children in the control group who received the DT vaccine booster. Baseline characteristics were balanced between the two groups. There were six confirmed cases of pertussis in the experimental group, with a reported incidence rate of 1.25%. In the control group, 14 pertussis cases were reported, with a reported incidence rate of 2.92%. The protective effectiveness(VE) of the DTaP vaccine against pertussis was 57.14% (95% CI:-10.59%-83.39%). For 6-year-old children who completed the booster immunization, the incidence data of pertussis were collected from the 14 th day after vaccination (i.e., the study day 0). Based on the annual cumulative incidence rate, the VE of DTaP against pertussis at 6, 12, 18, and 24 months after vaccination was 100%, 63.80% (95% CI:-14.49%-88.55%), 64.59% (95% CI: 1.17%-87.31%), and 57.60% (95% CI:-10.80%-83.78%), respectively. In the DTaP group, the annual cumulative incidence rate of 12 to 24 months did not show a significant upward or downward trend ( Z=-0.995, P=0.320). Conclusion:Boosting 6-year-old children with the DTaP vaccine provides measurable protection against pertussis. The protective efficacy is significant in the early stage (0 to 6 months) after vaccination, and it still remains effective at 12 to 24 months.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To explore the current status of orthopedic nurses' health science popularization information generation capacity and training needs in Beijing.Methods:This study was a cross-sectional survey. Convenience sampling was used to select 818 orthopedic nurses from 54 hospitals (48 Class Ⅲ hospitals and 6 ClassⅡ hospitals) in Beijing in April 2024 for the study. General Information Questionnaire, Self-assessment Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity, and Training Needs Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity were used to survey the study participants. Multiple linear regression was used to analyze the factors influencing orthopedic nurses' health science popularization information generation capacity. A total of 818 questionnaires were distributed and 781 valid questionnaires were recovered, with a valid recovery rate of 95.48% (781/818) .Results:The 781 orthopedic nurses had a total score of [49.00 (42.00, 57.00) ] on the Self-assessment Scale for Orthopedic Nurses' Health Science Popularization Information Generation Capacity. Multiple linear regression analysis showed that years of working experience, health status, intention to participate in health science popularization, stage of health science popularization behavior, and frequency of participation in health science popularization training were the factors influencing orthopedic nurses' health science popularization information generation capacity ( P<0.05), which explained 17.30% of the total variation. Beijing orthopedic nurses had training needs in five areas of assessing audience needs, assessing message risk, revising and improving messages, generating messages, and pretesting messages. Conclusions:The Beijing orthopedic nurses' health science popularization information generation capacity is at a medium and high level, but there is still much room for improvement. It is recommended to pay attention to the physical and mental health of orthopedic nurses, improve the work commitment, and build a long-term incentive mechanism to stimulate the enthusiasm of orthopedic nurses in health science popularization. Medical institutions or specialty societies should actively formulate training programs, build training platforms, and gradually perfect the orthopedic nurses' health science popularization training system in order to comprehensively enhance the health science popularization information generation capacity and help China's great health.

Objective:To explore the facilitators and barriers to the implementation of the Radiation Protection Standards for Medical Staff Engaged in Interventional Procedures, and to provide a basis for formulating effective implementation strategies. Methods:Using purposive sampling, semi-structured interviews were conducted with 12 medical staff members engaged in interventional procedures at Guizhou Provincial People's Hospital from January to March 2024. The interview guide was developed based on the consolidated framework for implementation research (CFIR). Interview data were analyzed using Colaizzi's seven-step method.Results:A total of 12 medical staff members were interviewed. Based on the CFIR framework, 19 facilitators and barriers were identified: three under the domain of intervention characteristics, ten under individual characteristics, five under inner setting, and one under outer setting.Conclusions:Numerous determinants affect the implementation of the Radiation Protection Standards for Medical Staff Engaged in Interventional Procedures. Special attention should be given to the domain of individual characteristics. Facilitating factors should be reinforced, while barriers should be dynamically analyzed and addressed through targeted implementation strategies to promote comprehensive and efficient implementation of the Radiation Protection Standards for Medical Staff Engaged in Interventional Procedures.

Thyrotoxic periodic paralysis(TPP) is a rare but potentially life-threatening complication of thyrotoxicosis. TPP secondary to thyrotoxicosis factitia(TF) is exceptionally uncommon. Here, we report the case of a 31-year-old female who developed TF and subsequent TPP after taking laxatives containing unknown ingredients. The patient presented with acute onset of quadriplegia. Laboratory investigations revealed severe hypokalemia(serum potassium 1.47mmol/L), thyrotoxicosis[thyroid stimulating hormone(TSH)<0.005 mIU/L, free thyroxine(FT 4) 30.84 pmol/L, free triiodothyronine(FT 3) 7.71 pmol/L], and a decreased thyroglobulin level(3.08 ng/mL). The patient′s symptoms resolved rapidly following potassium supplementation, and thyroid function gradually normalized after discontinuation of the suspected medication. This case highlights the importance of considering TF in the differential diagnosis of TPP, particularly in patients with a history of unknown medication use. It also underscores the diagnostic value of thyroglobulin measurement in identifying TF and outlines clinical strategies for the management of TF-induced TPP.