OBJECTIVES: This cross-sectional study aims to explore the association between oral health status and cognitive function in Chinese elderly individuals. METHODS: The survey participants were composed of elderly people aged≥60 who were admitted to West China Hospital of Stomatology, Sichuan University from August 2022 to March 2024. They were divided into a cognitive impairment (CI) group and a healthy control (HC) group according to the Montreal Cognitive Assessment (MoCA) score. General information and oral health indicators of all elderly people were collected. Independent sample t-test and chi-square test were used for inter-group comparison, and multiple linear regression model was applied for multivariate analysis of MoCA scores. RESULTS: A total of 402 elderly people were included in the study, and the number of remaining teeth in the CI group was significantly lower than that in the HC group. The decayed, missing, filled teeth index, debris index-simplified, gingival index, probing depth (PD), and clinical attachment loss in the CI group were all significantly higher than those in the HC group. There was no difference in denture wearing between the two groups. The results of multiple linear regression showed that there was a correlation between the number of remaining teeth and PD and MoCA scores after correcting for confounding factors. CONCLUSIONS Elderly individuals with CI have more prominent oral health issues compared to those with normal cognitive function. There may be a bidirectional relationship between the number of remaining teeth, PD, and cognitive function in elderly people.
Humans ; Oral Health ; Aged ; Cross-Sectional Studies ; Cognitive Dysfunction/epidemiology* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Linear Models ; Aged, 80 and over ; Periodontal Index ; Cognition

OBJECTIVES: This study aimed to investigate the perception of dental outpatient care quality from multiple perspectives of administrators, physicians, nurses, and patients and propose nursing care quality evaluation indices that are consistent with the clinical reality to provide reference for the construction of a scientific, systematic, and comprehensive dental outpatient care quality evaluation system. METHODS: A total of 39 interviewees, including 7 administrators, 11 doctors, 11 nurses, and 10 patients, were selected for semi-structured in-depth interviews in five regionally representative tertiary-level A stomatological specialty hospitals nationwide during January-April 2024 by using a multistage sampling method. Colaizzi 7-step analysis was used to analyze and summarize the interview data. Themes were extracted on the basis of the Structure-Process-Outcome (SPO) three-dimensional quality assessment model. RESULTS: Five main themes and 15 secondary themes were extracted from three quality dimensions: structure, process, and result. The related topics of structural quality were as follows: disinfection and isolation norms, equipment and consumable management, nursing manpower ratio and nurse education structure, and emergency capability. The related topics of process quality were as follows: pre-diagnosis risk assessment, patient triage and guidance, communication and attitude, health education, humanistic care, continuous care, specialty operation, and four-hand operation. The related topics of result quality were as follows: satisfaction, adverse event management and analysis, effective complaints and disputes. CONCLUSIONS Structure quality is the foundation, process quality is the core, and result quality is the key in the evaluation of the quality of oral outpatient care. The standardization of disinfection and isolation, equipment and consumable management, allocation of reasonable nursing manpower and post capacity, implementation of high-quality nursing services, and improvement of the quality and satisfaction of medical cooperation are necessary guarantees to ensure the quality of oral outpatient care.
Humans ; Quality of Health Care ; Ambulatory Care/standards* ; Dental Care/standards* ; Outpatients

OBJECTIVES: This study aimed to construct an evaluation index system for nursing quality management in outpatient dental clinics based on the structure-process-outcome model and provide an objective standard for the evaluation of nursing quality in outpatient dental clinics. METHODS: Through literature review, multi-subject interviews, and expert meetings, the first draft of the evaluation index for nursing quality management in outpatient dental clinics was formulated. The Delphi method was adopted to select and invite 15 experts in the fields of hospital infection management, nursing management, and specialized oral care from across the country to modify the first draft. RESULTS: The positive coefficients of the experts in the two rounds of consultation were 86.7% and 92.3%, respectively. The total authority coefficients of the experts were 0.791 and 0.717, respectively. The mean scores of the importance and feasibility of the third-level indices in the two rounds of consultation were all ≥4.333; the coefficients of variation were all ≤0.150; and the Kendall's coordination coefficients were 0.308 and 0.184 respectively, with P<0.05 for all. These results indicated that the experts were motivated to participate in this study. They recognized the importance and feasibility of the overall items in this index system, and their opinions were relatively consistent. Finally, an evaluation index system, which included 3 first-level indices, 7 second-level indices, 22 third-level indices, and 69 index connotations, for nursing quality management in outpatient dental clinics was determined. The weights of the three first-level indicators were all 0.333. Patient satisfaction (0.076, outcome dimension), hand hygiene (0.061, outcome dimension), chair care ratio (0.057, structural dimension), and turnover rate (0.057, structural dimension) were the top tertiary indicators in terms of portfolio weight. CONCLUSIONS The construction method of the evaluation index system for nursing quality management in outpatient dental clinics is scientific and reliable. It can provide a reference for the evaluation of the management level of nursing quality in outpatient dental clinics and promote the continuous improvement of nursing quality in outpatient dental clinics.
Humans ; Dental Clinics ; Delphi Technique

Objective:To delineate clinical characteristics of infantile myofibroma/myofibromatosis (IM) .Methods:A retrospective analysis was conducted on histologically confirmed IM cases from Beijing Children's Hospital, Henan Children's Hospital, and Maternity and Child Health Care of Guangxi Zhuang Autonomous Region between August 2014 and July 2021. The clinical, pathological, imaging features, and outcomes were analyzed and summarized.Results:A total of 44 IM patients were included, comprising 28 males (63.6%) and 16 females (36.4%). Their ages at onset ( M[ Q1, Q3]) were 14.8 (4.7, 42.4) months, and 26 patients (59.1%) developed IM before the age of 1 year. Seven patients (15.9%) were initially diagnosed with IM. Skin involvement occurred in 42 patients (95.5%), of whom 30 (71.4%) presented with a solitary lesion and 12 (28.6%) with multiple lesions. Skin lesions mainly manifested as painless, firm nodules or masses. The most commonly involved extracutaneous site was the skeletal system (21/44, 47.7%). Histopathological examination of all 44 IM cases revealed a biphasic architecture pattern, characterized by the coexistence of two distinct morphologies or cell types within the tumor tissues (including spindle cell areas composed of fascicularly and densely arranged myofibroblasts, and primitive mesenchymal cell areas composed of small, round undifferentiated cells. Immunohistochemical study was performed in 42 cases; 40 (95.2%) were positive for smooth muscle actin, and 20 (47.6%) were positive for CD34. Genetic testing was conducted in 3 cases, and NOTCH mutations were identified in 2. Among the 44 patients, 30 patients (68.2%) underwent surgical excision, 5 patients (11.4%) received intralesional injections of triamcinolone acetonide, 1 patient (2.3%) received chemotherapy for intestinal involvement, and 8 patients were managed expectantly. During the follow-up of 49 (36, 60) months, lesions completely resolved in 42 cases (95.5%), while 2 cases died of pulmonary infection following chemotherapy or postoperative airway compression. Conclusions:IM predominantly affected infants and young children, with the skin and skeletal system being the most commonly involved sites. Skin lesions often manifested as firm nodules or masses, and histopathological examination was crucial for definitive diagnoses. Most IM cases exhibited favorable outcomes.

Objective:To analyze the carriage status, subtype distribution and flanking gene sequence characteristics of oxacillinases (OXA enzyme) in 241 clinical strains of Pseudomonas aeruginosa, and assess their roles in the drug resistance of Pseudomonas aeruginosa and ability to horizontally transfer across species. Methods:Clinical P. aeruginosa isolates were collected from four hospitals in Sanya, Tangshan, Zhangjiakou, and Beijing. The prevalence of oxacillinases and their flanking gene sequences was analyzed by whole-genome sequencing (NGS) and bioinformatic approaches. Results:A total of 241 isolates of P. aeruginosa were gathered, and 35 blaOXA subtypes were identified through screening of 252 blaOXA genes. These genes were classified into three subfamilies: blaOXA-50-like (241, 95.6%), blaOXA-1-like (9, 3.6%) and blaOXA-10-like (2, 0.8%). Among these, 11 subtypes (11, 31.4%) were novel blaOXA subtypes. Nine of these belonged to the blaOXA-50-like subfamily and were designated as blaOXA-1244, blaOXA-1245, blaOXA-1246, blaOXA-1250, blaOXA-1252, blaOXA-1253, blaOXA-1254, blaOXA-1255, and blaOXA-1256. The remaining two belonged to the blaOXA-10-like subfamily and were named blaOXA-1247 and blaOXA-1248. Compared to the amino acid sequence of OXA-10, the newly identified subtype OXA-1247 exhibited a mutation at position 117, where a valine was replaced by a leucine. This change was thought to improve the enzyme′s ability to hydrolyze carbapenems. In the analysis of the flanking sequences of the blaOXA genes, Class I integrons were identified in four bacterial strains. The variable regions of these integrons carried three distinct patterns of resistance gene cassettes: aac( 6′) -Ib-blaOXA-1247-ant( 3′′) -Ia, aac( 6′) -Ib-blaOXA-1248 and aac( 6′) -Ib- blaIMP-45-blaOXA-1-catB3. Among these, the strain BJ2326 carried a class I integron that was connected to the downstream IS CR1 element to form a composite class I integron structure, additionally carrying the resistance gene blaPER-1. Out of the 223 non-wild-type P. aeruginosa strains, 127 strains exhibited non-wild-type profiles to the four beta-lactam antibiotics MEM, CAZ, FEP, and TZP, with the combination of MEM+CAZ+FEP being the most prevalent, representing 57.0% of the total. Conclusions:The blaOXA genes in 241 clinical P. aeruginosa strains showed diversity. Some blaOXA genes had a co-transfer risk with the metallo-β-lactamase resistance gene blaIMP-45. Among the 11 newly discovered blaOXA subtypes, the new subtype OXA-1247 may have carbapenemase activity and potential for horizontal transfer.

Objective To explore the characteristics of acupoint selection and the law of acupoint compatibility in the treatment of Guillain-Barré syndrome(GBS)based on data mining.Methods Literature on acupuncture treatment of GBS was searched and screened from China National Knowledge Infrastructure,Wanfang Data Knowledge Service Platform,VIP,SioMed,PubMed,Embase,Web of Science,and Cochrane Library from the establishment of the database to December 1,2024 and to build database.The author information and acupuncture prescriptions were modified and imported according to the data entry requirements of the Traditional Chinese medicine inheritance computing platform V3.5,the relevant data were analyzed and integrated through the"Acupoint Analysis"module of the platform.Results A total of 140 related papers,145 valid prescriptions,involving 237 acupoints.The acupoints with higher frequency were Zusanli,Hegu,Quchi,Yanglingquan and etc.The analysis yielded 42 core acupoints,22 sets of strong association rules for core acupoints,and 5 new core acupuncture prescriptions.Conclusion Acupuncture treatment for GBS follows the principle of"treating impotence by taking Yangming alone",takes"benefiting Qi and draining heat,supporting the correctness and opening up the collaterals"as the main method,and attaches importance to"regulating the spirit and connecting the internal organs".

Objective:To investigate the association between exposed cardia glands and gastroesophageal reflux disease (GERD) and identify risk factors for exposed cardia glands.Methods:Patients who underwent gastroscopy at Chengde Central Hospital from December 2023 to March 2024 were prospectively enrolled. Patients with exposed cardia glands meeting inclusion criteria comprised the observation group, while controls had no exposed cardia glands but met identical criteria. Demographic, lifestyle, and endoscopic characteristics were compared between the two groups.Results:A total of 204 patients were included in the observation group, while 310 in the control group. Univariate analysis demonstrated statistically significant differences between the observation group and the control group in the following factors: body mass index, waist circumference, smoking, alcohol consumption, tea/coffee intake, spicy food preference, sleeping posture, use of calcium channel blockers, Helicobacter pylori infection, peptic ulcer disease, and GERD ( P<0.05). Binary logistic regression analysis identified the following independent risk factors for exposed cardia glands: waist circumference ( P=0.012, OR=1.070, 95% CI: 1.015-1.129), alcohol consumption ( P=0.003, OR=2.166, 95% CI: 1.293-3.631), spicy food preference ( P=0.048, OR=1.611, 95% CI: 1.004-2.582), right-side sleeping posture ( P<0.001, OR=3.219, 95% CI: 1.696-6.108), use of calcium channel blockers ( P<0.001, OR=3.871, 95% CI: 2.263-6.621), Helicobacter pylori infection ( P<0.001, OR=3.512, 95% CI: 1.953-6.317), and GERD ( P<0.001, OR=2.905, 95% CI: 1.829-4.613) .Conclusion:Exposed cardia glands demonstrates significant association with GERD. Key independent risk factors include waist circumference, alcohol consumption, spicy diet, right-side sleeping position, calcium channel blockers use, and Helicobacter pylori infection.

Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279 743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2 500 g),normal birth weight(2 500-3 999 g),and macrosomia(≥4 000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Objective:To delineate clinical characteristics of infantile myofibroma/myofibromatosis (IM) .Methods:A retrospective analysis was conducted on histologically confirmed IM cases from Beijing Children's Hospital, Henan Children's Hospital, and Maternity and Child Health Care of Guangxi Zhuang Autonomous Region between August 2014 and July 2021. The clinical, pathological, imaging features, and outcomes were analyzed and summarized.Results:A total of 44 IM patients were included, comprising 28 males (63.6%) and 16 females (36.4%). Their ages at onset ( M[ Q1, Q3]) were 14.8 (4.7, 42.4) months, and 26 patients (59.1%) developed IM before the age of 1 year. Seven patients (15.9%) were initially diagnosed with IM. Skin involvement occurred in 42 patients (95.5%), of whom 30 (71.4%) presented with a solitary lesion and 12 (28.6%) with multiple lesions. Skin lesions mainly manifested as painless, firm nodules or masses. The most commonly involved extracutaneous site was the skeletal system (21/44, 47.7%). Histopathological examination of all 44 IM cases revealed a biphasic architecture pattern, characterized by the coexistence of two distinct morphologies or cell types within the tumor tissues (including spindle cell areas composed of fascicularly and densely arranged myofibroblasts, and primitive mesenchymal cell areas composed of small, round undifferentiated cells. Immunohistochemical study was performed in 42 cases; 40 (95.2%) were positive for smooth muscle actin, and 20 (47.6%) were positive for CD34. Genetic testing was conducted in 3 cases, and NOTCH mutations were identified in 2. Among the 44 patients, 30 patients (68.2%) underwent surgical excision, 5 patients (11.4%) received intralesional injections of triamcinolone acetonide, 1 patient (2.3%) received chemotherapy for intestinal involvement, and 8 patients were managed expectantly. During the follow-up of 49 (36, 60) months, lesions completely resolved in 42 cases (95.5%), while 2 cases died of pulmonary infection following chemotherapy or postoperative airway compression. Conclusions:IM predominantly affected infants and young children, with the skin and skeletal system being the most commonly involved sites. Skin lesions often manifested as firm nodules or masses, and histopathological examination was crucial for definitive diagnoses. Most IM cases exhibited favorable outcomes.