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: Recent studies have overturned the traditional concept of the lung as a "sterile organ" revealing that pulmonary microbiota dysbiosis and abnormal surfactant proteins (SPs) expression are involved in the progression of silicosis. This study aimed to investigate the relationship between abnormal SPs expression and dysbiosis of lung microbiota in silica-induced lung fibrosis, providing insights into mechanisms of silicosis. METHODS: Lung pathology, SPs expression, and microbiota composition were evaluated in silica-exposed mice. A mouse model of antibiotic-induced microbiota depletion was established, and alveolar structure and SPs expression were assessed. The roles of the lung microbiota and SPs in silicosis progression were further evaluated in mice with antibiotic-induced microbiota depletion, both with and without silica exposure. RESULTS: Silica exposure induced lung inflammation and fibrosis, along with increased expression of SP-A expression. Antibiotics (Abx)-induced microbiota depletion elevated SP-A and SP-D expression. Furthermore, silica exposure altered lung microbiota composition, enriching potentially pathogenic taxa. However, antibiotic-induced microbiota depletion prior to silica exposure reduced silica-mediated lung fibrosis and inflammation. CONCLUSION Lung microbiota is associated with silica-induced lung injury. Overproduction of SP-A and SP-D, induced by Abx-induced microbiota depletion, may enhance the resistance of mouse lung tissue to silica-induced injury.
Animals ; Silicosis/prevention & control* ; Lung/metabolism* ; Mice ; Anti-Bacterial Agents/pharmacology* ; Microbiota/drug effects* ; Silicon Dioxide/toxicity* ; Mice, Inbred C57BL ; Male ; Pulmonary Surfactant-Associated Proteins/genetics*

Under the influence of long-term space flights and the confined space environment,it is very easy to induce space depression syndrome,mainly manifested as decreased emotional stability,sleep disorders,mental fatigue,etc.,which seriously affect the living conditions and working abilities of astronauts.The current treatment methods mainly focus on psychological support and drug intervention.Acupuncture has a good effect in treating depression.Therefore,starting from the TCM pathogenesis and modern medical pathogenesis of aerospace depression syndrome,we conducted literature retrieval from databases such as the Chinese Medical Classic,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,and Web of science.For the included literature,we adopted the stratified evidence scoring method and combined the TCM mechanism and modern medical mechanism of the effect of acupuncture.A prescription for acupuncture points was constructed to provide a basis for selecting acupuncture points for the prevention of aerospace depression syndrome through acupuncture.

Objective To investigate whether transcutaneous electrical acupoint stimulation(TEAS)can improve the muscle strength,endurance and work efficiency of calf muscles in healthy young men,aiming to explore a new method for preventing and combating microgravity-induced muscle atrophy in space environments.Methods 40 healthy young men aged 18-35 years were randomly divided into a Control group(Pseudo Transcutaneous Electrical Acupoint Stimulation)and a Experimental group(Transcutaneous Electrical Acupoint Stimulation)in a 1∶1 ratio,with 20 participants in each group.In the Control group,the indicator light of the stimulator was covered,and the device was turned on,but the electrodes did not contact the skin,The device automatically turned offafter 3 seconds.In the Experimental group,the TEAS device was connected to the current and TEAS intervention was performed.The electrical stimulation waveform was a sperse-dense wave with a frequency of 4/20 Hz,and the intensity was determined by patient tolerance.The acupoints selected for electrical stimulation in both groups were bilateral Zusanli(ST36)、Liangqiu(ST34),Taixi(KI3),and Fuliu(KI7).Zusanli and Liangqiu were paired,and Taixi and Fuliu were paired.The intervention frequency was 30 min/time,1 time/day,6 days/week,for 2 weeks.The relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral calf muscles were measured using an isokinetic dynamometer at 0th,7th,and 14d day of the experiment.Results After 1 week of TEAS,compared with Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,compared with Control group,the relative peak torque at 60°/s and the relative peak torque at 180°/s of the bilateral posterior calf muscles in the Experimental group were significantly increased(all P<0.05).After 2 weeks TEAS;compared with the Control group,there were no significant changes in the relative peak torque at 60°/s,relative peak torque at 180°/s and average power at 180°/s of the bilateral anterior calf muscles in the Experimental group(all P>0.05);however,the relative peak torque at 60°/s,relative peak torque at 180°/s,and average power at 180°/s of the bilateral posterior calf muscles were significantly increased in the Experimental group(all P<0.05).Conclusion TEAS of Zusanli,Liangqiu,Fuliu and Taixi acupoints on the lower limbs for 2 weeks can effectively improve the maximum muscle strength,endurance and work efficiency of the posterior calf muscles in healthy young men.

The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.

A target screening methodology was developed for detection of 63 kinds of chemical hazards substances,including 17 kinds of flame retardants,14 kinds of perfluorinated compounds,15 kinds of phthalate esters,5 kinds of fluorescent whitening agents and 12 kinds of ultraviolet absorbers,in various types of face masks using ultra high performance liquid chromatography-quadrupole-orbitrap high-resolution mass spectrometry based on an in-house database and mass spectral library.And the quantification was achieved using the external standard method.The results showed that the linear correlation coefficient(r)of all compounds was greater than 0.99,the limits of detection(LODs)ranged from 3.3 to 26.7 μg/kg(S/N=3),the limits of quantification(LOQs)ranged from 10.0 to 80.0 μg/kg(S/N=10),the average recoveries(n=6)were 72.3%-102.6%,and the relative standard deviations(RSDs)were 0.8%-9.9%.The validation of the screening results from both the database and mass spectral library was conducted,and benzophenone and dibutyl phthalate were detected from three positive samples.The human health exposure assessment of the inhalation exposure doses based on the relevant exposure models showed that the contents of benzophenone and dibutyl phthalate were within the recommended reference doses.The method represented a valuable technical reference for ensuring the quality and safety of face mask products and protecting consumer health.

Objective:To explore the overall efficacy of pediatric liver transplantation (LT) and the risk factors affecting the long-term outcomes.Methods:From October 2006 to December 2022, clinical profiles, intraoperative findings, perioperative managements and long-term follow-ups were retrospectively reviewed for 3004 cases (including 40 cases of retransplantation) of children with end-stage liver disease undergoing LT. Overall patient and graft survival rates after transplantation were explored by Kaplan-Meier survival curve. The survival rates of recipients receiving living donor liver transplantation and deceased donor liver transplantation, recipients with body weight ≤5 kg and >5 kg at the time of transplantation, recipients with age ≤5 months and >5 months, graft recipient weight ratio (GRWR) ≤5% and >5 %, and recipients with compatible and incompatible blood types were compared, as well as the survival rates of recipients from 2006 to 2011, 2012 to 2017, and 2018 to 2022. The occurrence of complications was analyzed. Cox regression was used to analyze the risk factors of long-term mortality, and those with <0.05 were included in the LASSO regression model to identify the independent risk factors.Results:As of December 2022, overall survivals at 1/5/10-year were 95.1 %(2 819/2 964), 93.1 % (2 759/2 964) and 91.8% (2 721/2 964) and 1/5/10-year graft survival rate 94.5 % (2 839/3 004), 92.0 % (2 764/3 004) and 86.2 % (2 589/3 004 ). The 5-year survival rate improved : Five-year survival rate at pediatric LT centers were 71.6 % (63/88, from 2006 to 2011), 91.6 % (1 009/1 101 ,from 2012 to 2017) and 95.5 % (1 695/1 775, from 2018 to 2022 ). Survival rates were lower in recipients with body weight ≤5 kg [83.7 % (41 /49) vs 94.4 % (2 746/2 915), P=0.001) ] and GRWR >5 % [90.0 % (378/420) vs 94.6 % (2 046/2 544), P=0.007 ] compared to those >5 kg and ≤5 %. Difference in surgical age and blood type compatibility were not statistically ( P=0.26 and 0.4 ). Infection [35.3 % (70/198) ]and surgical complications [24.2 % (48/198) ]were the main causes of mortality after transplantation. While infection [35.7% (25/70) ] ,portal vein complications [18.6%(13/70) ]and lung injury [15.7 % (11/70) ]were the main reasons of death within 1 month after transplantation. The incidence of postoperative infection and acute rejection decreased from 86.5 %(76/88) and 38.2% (34/88) in 2006-2011 to 75.5% (1 340/1 775) and 22.2% (394/1 775). Post-transplantation surgery-related complications included portal veinous complications (3.1 %, 92/3 004), hemorrhage (2.3 %, 68/3 004) ,hepatic arterial complications (1.7 %, 50/3 004) and hepatic venous complications (1.1 %, 33/3 004). Univariate analysis revealed that risk factors related to postoperative mortality included preoperative anemia ( P=0.012), high preoperative leucocyte count ( P=0.026), preoperative renal insufficiency ( P=0.008), hypoproteinemia ( P=0.001), coagulation dysfunction ( P= 0.005), low body weight ( P=0.007), GRWR>5% ( P=0.001), intraoperative volume of blood loss and transfusion ( P<0.001) ,postoperative intensive care unit (ICU) time ( P<0.001), hospital length post-LT ( P=0.045) ,postoperative lung infection ( P<0.001), abdominal infection ( P=0.029), postoperative hemorrhage ( P<0.001), intestinal perforation ( P<0.001), acute rejection ( P<0.001) Epstein-Barr virus (EBV) infection ( P<0.001) and post-transplant lymphoproliferative disorder (PTLD) ( P=0.018). Multivariable analysis revealed that preoperative creatinine ( HR=1.015, 95% CI: 1.002-1.028, P=0.024), GRWR ( HR=2.082, 95% CI: 0.473-9.157, P=0.031) ,pulmonary infection ( HR=4.389, 95% CI: 2.248-8.569, P<0.001) ,postoperative abdominal hemorrhage ( HR= 6.922, 95% CI:1.871-25.610, P=0.004), intestinal perforation ( HR=9.154, 95% CI: 2.307-36.323, P=0.002) and acute rejection ( HR=0.452, 95% CI: 0.210-0.971, P=0.042) were important influencing factors of long-term survival post-LT. Conclusions:LT is currently the most effective treatment for end-stage liver disease in children. Improving preoperative organ function, optimizing surgical techniques, minimizing intraoperative hemorrhage and preventing postoperative complications can effectively enhance the long-term outcomes of LT recipients.

Objective To investigate the risk factors for delayed union of extra-articular fractures of the middle and lower third of the tibia treated by locking plate.Methods Total of 135 patients of extra-articular fractures of the middle and lower third of the tibia from January 2013 to December 2018 were retrospectively analyzed,including 85 males and 50 females,ranged from 19 to 80 years old.All cases were treated with locking plates.The patients were divided into union group and delayed union group ac-cording to the condition of fracture union.The risk factors of delayed healing were determined by univariate analysis of 14 factors that might affect fracture healing first,then the factors with significance were analyzed by binary Logistic regression.Results There were 13 patients of delayed union,and the rate of delayed union was 9.63％.Univariate analysis showed that delayed union was associated with age,smoking,reduction method,anemia and time of preoperative preparation.Regression analysis showed thatage[OR=0.849,95％CI(0.755,0.954),P=0.006],smoking[OR=0.020,95％CI(0.002,0.193),P=0.001],reduction method[OR=23.924,95％CI(2.210,258.943),P=0.009],anemia[OR=0.016,95％CI(0.001,0.289),P=0.005]were the con-tributory factors for delayed union.Conclusion Young age,smoking,closed reduction and anemia are the risk factors for de-layed union of extra-articular fractures of the middle and lower third of the tibia treated by locking plate.

Objective:To explore whether thiotert treatment can inhibit proliferation and induce apoptosis in myelodysplastic syndromes(MDS)cells.Methods:CCK-8 assay was used for determining the cytotoxicity of thiotert to MDS cell line SKM-1 and the reversal effect of GSH,NAC,and Z-VAD-FMK on thiotert-induced inhibition of cell viability.EdU assay was deployed to detect the cell proliferation ability.Intracellular reactive oxygen species(ROS)was measured by flow cytometry after DCFH-DA staining.The expression of DNA damage-and apoptosis-related proteins was detected by Western blot.Results:Thiotert treatment significantly suppressed the cell viability and proliferation ability in SKM-1 cells.A large amount of ROS generation and markedly elevated C-PARP,C-Caspase 3,and γ-H2AX were observed after thiotert administration,while BCL-2 was significantly decreased.In addition,GSH,NAC,and Z-VAD-FMK were able to mitigate the cytotoxicity of thiotert on SKM-1 cells.Conclusion:Thiotert can promote MDS cell apoptosis by mediating ROS production and pro-apoptotic proteins expression.

Objective:To investigate the correlation between plasma total α-synuclein (α-syn), phosphorylated α-synuclein (p-α-syn), neurofilament light chain(NfL) and subtypes of Parkinson disease(PD).Methods:A total of 62 PD patients admitted to the Department of Neurology, the Affiliated Huai 'an No. 1 People 's Hospital of Nanjing Medical University from September 2021 to January 2023 were selected and scored on the Hoehn-Yahr stage(H-Y), unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ), levodopa equivalent daily dosage(LEDD), mini-mental state examination(MMSE), Parkinson disease quality of life questionnaire(PDQ-39) and activities of daily living(ADL). During the same period, 25 healthy individuals matched in age and sex were enrolled as the control group (HC). Clinical characteristics and blood samples were collected. The plasma levels of α-syn, p-α-syn and NfL were detected by enzyme-linked immunosorbent assay(ELISA). PD patients were divided into tremor dominant type (TD, n=27) and akinetic-rigid dominant type (AR, n=35) based on UPDRS-Ⅲ scores. Multifactorial Logistic regression analysis was performed by SPSS 25.0 software to determine the influencing factors of subtypes of Parkinson disease. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point of plasma NfL between the AR type and the TD type. Results:Plasma α-syn, p-α-syn, NfL levels in the PD group were significantly higher than those of the HC group ( Z=-2.537, -6.580, -7.101, all P<0.05). There were statistically significant differences between the AR type and the TD type in disease duration, H-Y stage, UPDRS-Ⅲ scores, LEDD and MMSE scores ( Z=-2.503, -3.021, -2.025, -2.086, -2.409, all P<0.05). While no significant difference was found in plasma α-syn and p-α-syn levels between the AR type and TD type ( Z=-0.341, -0.085, both P>0.05), the plasma NfL levels were notably higher in the AR type(92.79(16.84, 117.53) pg/mL) compared to the TD type (12.10(6.99, 100.17) pg/mL)( Z=-2.236, P<0.05). Plasma NfL levels were correlated with rigidity scores ( r=0.438, P<0.001), UPDRS-Ⅲ scores ( r=0.337, P<0.05) and motor subtypes ( r=0.286, P<0.05) in PD patients. Multivariate Logistic regression analysis showed that NfL was risk factor for AR( B=0.002, OR=1.002, 95% CI=1.001-1.003, P=0.017). The ROC curve analysis indicated that plasma NfL levels could predict different subtypes of PD with an AUC=0.667, optimal cutoff =26.527. Conclusion:There is a correlation between elevated plasma NfL levels and the occurrence of AR type of PD, suggesting that nerve injury is probably involved in the occurrence and progression of various motor subtypes of PD.